An investigation of the relationship between sex-steroid levels and urological symptoms: results from the Boston Area Community Health survey.
OBJECTIVE
To investigate whether circulating levels of sex hormones are associated with urological symptoms, using data from the Boston Area Community Health (BACH) Survey.


METHODS
BACH used a multistage stratified-cluster approach to randomly sample 5506 adults aged 30-79 years in Boston, MA, USA. Anthropometric measures, lifestyle and psychosocial factors, comorbidities and urological symptoms were obtained using a questionnaire administered by an interviewer. Serum testosterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulphate (DHEAS), dihydrotestosterone (DHT) and oestradiol (E2) levels were measured, and bioavailable testosterone (BT) was calculated in 1899 men (538 Black, 651 Hispanic and 710 White). Regression analysis was used to investigate the relationships between androgen levels and American Urological Association symptom index (AUA-SI), lower urinary tract symptoms (LUTS) (> or = 8 on the AUA-SI), urinary incontinence (UI), dribble and hesitancy.


RESULTS
Of all subjects, 19% reported LUTS, 6% UI, 9% dribble and 4% hesitancy. Testosterone, BT and DHEAS levels were inversely related to the AUA-SI (P = 0.009, <0.001 and <0.001, respectively); SHBG values and the AUA-SI were positively correlated (P < 0.001). Adjusting for age, BT and DHEAS levels had negative relationships with the AUA-SI; BT and DHEAS levels were negatively related to LUTS and SHBG was positively related to LUTS (both P < 0.001); after age adjustment, only LUTS and DHEAS remained related, and only the relationship between dribble and E2 remained significant; no hormone levels were related to hesitancy.


CONCLUSIONS
Circulating levels of sex hormones are generally not significant predictors of urological symptoms in men after adjusting for age. The pathophysiology of LUTS is complex and probably includes factors other than circulating sex steroid levels.
Litman
Heather J
HJ
New England Research Institutes, Watertown, MA 02472, USA. hlitman@neriscience.com
Bhasin
Shalender
S
O'Leary
Michael P
MP
Link
Carol L
CL
McKinlay
John B
JB
D000328:Adult; D000368:Aged; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D013196:Dihydrotestosterone / Q000097:blood*; D004958:Estradiol / Q000097:blood*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D053448:Prostatism / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000097:blood* / Q000209:etiology / Q000503:physiopathology
D012738:Sex Hormone-Binding Globulin; D013196:Dihydrotestosterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate