Testosterone and prostate health are related through the action and intended nature of testosterone in the male body. Testosterone is the major hormone in the body responsible for sexual development, including reproductive development. In men, testosterone is largely produced by the testes; in women it is produced in significantly smaller amounts by the ovaries and adrenal glands. Men typically have a greater overall muscle mass than women, due to the fact that the male body produces up to 80% more testosterone than a woman's body (Folland & William, 2007). It would make sense to predict that testosterone's effects, both good and bad, would be greater in the male body than the female body, in relation to their intended effects in the male body. This article addresses testosterone and prostate health.
The relationship between testosterone and prostate health relates to factors of growth and sexual reproductive development. Testosterone is a 'grow' hormone; this hormone makes specific things in the body grow bigger. It is also involved in secondary systems, such as hair growth (pubertal), and voice change (in pubertal teens). Testosterone is very crucial also for normal development of the reproductive tract of men, and to a lesser extent, women.
Testosterone helps the testes develop, and controls how testosterone producing factors in the testes also develop. The job of the testicles are to provide a manufacturing facility for the millions of sperm a man will produce over his lifetime, and keep them at a temperature that is necessary for sperm survival. Sperm are ejaculated at the moment of orgasm. But, it is not all just sperm that is being launched out of the testicles and penis. Approximately 20% to 30% of ejaculate is composed of an alkaline fluid, whitish in appearance, which is manufactured and secreted by the prostate gland. Testosterone and prostate health are related through the fact that the prostate is a part of the male reproductive system. Let's take a look at the function and role of the prostate.
The word prostate literally means 'guardian' in its Greek origins; in male physiology, the prostate is located at the base of the bladder, through which the urethra passes en route to the penis. The seminal vesicle receives the spermatozoa from the testicles, and pumps them along with seminal fluid into the prostate. The following diagram shows the location and size of the prostate, and its relative position to the other elements of the male reproductive system:
Source: (Rush Medical Center, 2011)
Testosterone and prostate health, unlike testosterone and other issues, are causally linked. Without testosterone, the prostate will not develop. The prostate in healthy males adds prostatic fluid to the sperm and other fluids. The prostate is a muscular organ, and the combined contraction of the anal sphincter, the prostate, and penile muscles results in the ejaculation of the sperm and fluids through the urethra and out of the urethral opening of the penis.
The actual 'job' of the prostate is one related to a very Darwinian explanation of life: reproductive of the fittest. In this sense, the prostate produces prostatic fluid, which is alkaline and composed mostly of sugar. The nature of the prostatic fluid is to give the sperm a greater longevity period outside the male body, and greater chance of survival in the vaginal tract of a woman. The vaginal secretions are acidic, which would kill sperm (Moalem & Reidenberg, 2009). One might wonder why evolution would design an acidic environment in women that was unfriendly to sperm, the reality is that vaginal secretions are meant to ward off other bacteria (Moalem & Reidenberg, 2009); human design gave the human male an advantage through prostatic fluid
Therefore, the role of prostatic fluid is to provide a medium for sperm to get through the vaginal tract, into the uterus, and into the Fallopian tubes. Without prostatic fluid, sperm life is greatly decreased and hence reproduction is compromised. The relationship between testosterone and prostate health is such that without testosterone, the prostate may be undeveloped, underdeveloped, or functions of the prostate may be compromised or totally dysfunctional (Baum & Crespi, 2007).
Yes, it happens; we hear about it in the medical news often about the incidence of prostate cancer. Prostate cancer is the leading cause of cancer in men. The Centers for Disease Control stated that in 2007, a total of 223,307 men were diagnosed with prostate cancer; of those in the year 2007, over 29,000 men died from the cancer (CDC.gov, 2011). Testosterone and prostate health, and prostate cancer, are linked due to the nature of testosterone to act as a growth promoter. Imbalances in testosterone and other hormones can cause the prostate to increase in size, and can cause cellular level changes as well that may be precursors to prostate cancer (CDC.gov, 2011).
As a man ages, the size of the prostate tends to increase. This is called Benign Prostatic Hyperplasia; enlarged prostates can be due to testosterone imbalance or a bacterial infection (Prostatitis Treatment, 2011). This can narrow the flow of urine, and can be implicated in decreased ejaculate as well. The following illustration shows a normal prostate, and an enlarged prostate; an enlarged prostate can indicate a problem in the making and should be checked by a medical professional:
Source: (Prostatitis Treatment, 2011).
Testosterone and prostate health means keeping up with your doctor visits, getting regular prostate exams, and discussing any potential testosterone-related issues with the doctor that may be of concern.
Testosterone is critical in the development and function of the male reproductive system. Testosterone, simply put, makes things grow and makes things work. When something goes awry with the testosterone regulation pathway, other effects such as compromised prostate health can result. As a man ages, the endocrine system tends to function less efficiently. This too may be evolutionary, as an aging male body may not produce the most health sperm; hence it may be a male menopause type of mechanism. What the man experiences and what doctors see are clinically low levels of testosterone; testosterone and prostate health function in a delicate homeostasis. When that homeostasis is upset for any reason, including reasons relating to aging, the body responds in over-compensatory ways (Bain, 2010).
Testosterone and prostate health are one area in which an imbalance in androgens (where testosterone is the main androgen in males) can mean big changes and even life-altering changes for the individual. Normally, testosterone is converted to dihyrdrotestosterone (DHT), which is an androgen. This conversion is on the order of 5% of the total testosterone being converted to the more potent form of the androgen. Dihydrotestosterone has is the main androgen involved in the development of external male genitalia, and is also the main androgen in the prostate (as well as hair follicles). DHT is responsible for male pattern baldness. DHT is also responsible in the relationship of testosterone and prostate health; DHT enlarges the prostate.
What happens is this: low circulating levels of testosterone cause an increase in the conversion of testosterone to DHT; more DHT causes an increase in the size of the prostate. It is not well understood why low testosterone levels mean more of it is converted to DHT, though an over-compensatory mechanism of the body may be generally held to be the cause, in an attempt to achieve homeostasis once again (Bain, 2010). Testosterone and prostate health are directly linked through the production of DHT, and the overproduction of DHT. Underproduction of DHT does not necessarily mean low levels of testosterone are present.
As far as prostate cancer goes and the causal relationship with Testosterone. Nobody can so for sure yes or no. But many men who are diagnosed with prostate cancer and finish cancer therapy go on TRT without any reoccurrence. Actually there is a less than 1% prostate cancer rate of all the men in the past 17 years who have undergone TRT. This is a staggering number when you look at the number of men in the US that have an incidence of prostate cancer is 1 in 7. It should be also noted that studies have show prostate cancer manifested in most men just as there hormone levels decline and it is now common belief that one of the causes of all cancer thought by many physicians and practitioners is the imbalance of hormones.
Testosterone and prostate health should be thought of as existing in a causal relationship; testosterone is directly responsible for the development of the prostate, and at least 5% of testosterone is converted to DHT, a powerful sex hormone, which regulates the prostate's functions. Low levels of testosterone can cause in increase in the production of DHT, which leads to an increase in the size of the prostate (Baum & Crespi, 2007). Hyperplasia of cells in the prostate (overgrowth of cells) can be a precursor for cancer, and any enlarged prostate should be carefully monitored and treated (Prostatitis Treatment, 2011).
If you are experiencing difficulty urinating or ejaculating, or you are a male age 40 and over, it is a good idea to have a prostate exam and PSA test. If you are experiencing issues you think may be related to testosterone and prostate health, be sure to bring it up with your health professional. Testosterone replacement therapy may be indicated if cancer is not present, though other factors of your health will need to be examined for a full treatment plan to be effective.