title: Effects of Transdermal Testosterone Gel or an Aromatase Inhibitor on Prostate Volume in Older Men.
abstract: T replacement is being increasingly offered to older men with age-related low T; hence, monitoring prostate health is important during T therapy. Data suggest that estrogens have an independent effect on the prostate and some effects of T on the prostate might be mediated via its aromatization to estradiol. Although some studies have assessed the effects of T replacement on prostate volume, the differential effects of T and estradiol have not been delineated.
  
  
  
  The objective of the study was to investigate the relative effects of T and estradiol on prostate volume in older men with low T.
  
  
  
  Thirty-one men, 65 years old or older with total T less than 350 ng/dL (measured by mass spectrometry) participated in the study.
  
  
  
  The intervention included randomization to 5 g transdermal T gel (TT), 1 mg oral aromatase inhibitor (AI), or placebo daily for 12 months.
  
  
  
  The primary outcome was prostate volume measured by transrectal ultrasound at baseline and 12 months. Secondary outcomes included prostate-specific antigen levels and lower urinary tract symptoms score.
  
  
  
  Serum T levels increased in both intervention groups; estradiol levels increased in the TT group, whereas it decreased in the AI group. At 12 months, prostate volume significantly increased (4.5 ± 1.76 cc, P < .05) only in the TT group. Increase in prostate-specific antigen levels were seen in both intervention groups at 6 months (P < .01 and P < .001). The lower urinary tract symptoms score increased only in the TT group (P < .05).
  
  
  
  The tropic effects of T on the prostate are mediated via its aromatization to estradiol. Administration of AI for 12 months to older men was not detrimental to the prostate.
authors.affiliation: Laboratory of Clinical Investigation (J.P.D., D.M., J.M.E.) and Translational Gerontology Branch (M.S., L.F., C.W.C.), National Institute on Aging, and Imaging Section (M.G.), Medstar Harbor Hospital, Baltimore, Maryland 21225; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Jenny Pena
authors.initials: JP
authors.lastname: Dias
authors.affiliation: Laboratory of Clinical Investigation (J.P.D., D.M., J.M.E.) and Translational Gerontology Branch (M.S., L.F., C.W.C.), National Institute on Aging, and Imaging Section (M.G.), Medstar Harbor Hospital, Baltimore, Maryland 21225; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Denise
authors.initials: D
authors.lastname: Melvin
authors.affiliation: Laboratory of Clinical Investigation (J.P.D., D.M., J.M.E.) and Translational Gerontology Branch (M.S., L.F., C.W.C.), National Institute on Aging, and Imaging Section (M.G.), Medstar Harbor Hospital, Baltimore, Maryland 21225; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Michelle
authors.initials: M
authors.lastname: Shardell
authors.affiliation: Laboratory of Clinical Investigation (J.P.D., D.M., J.M.E.) and Translational Gerontology Branch (M.S., L.F., C.W.C.), National Institute on Aging, and Imaging Section (M.G.), Medstar Harbor Hospital, Baltimore, Maryland 21225; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.affiliation: Laboratory of Clinical Investigation (J.P.D., D.M., J.M.E.) and Translational Gerontology Branch (M.S., L.F., C.W.C.), National Institute on Aging, and Imaging Section (M.G.), Medstar Harbor Hospital, Baltimore, Maryland 21225; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Chee W
authors.initials: CW
authors.lastname: Chia
authors.affiliation: Laboratory of Clinical Investigation (J.P.D., D.M., J.M.E.) and Translational Gerontology Branch (M.S., L.F., C.W.C.), National Institute on Aging, and Imaging Section (M.G.), Medstar Harbor Hospital, Baltimore, Maryland 21225; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Gharib
authors.affiliation: Laboratory of Clinical Investigation (J.P.D., D.M., J.M.E.) and Translational Gerontology Branch (M.S., L.F., C.W.C.), National Institute on Aging, and Imaging Section (M.G.), Medstar Harbor Hospital, Baltimore, Maryland 21225; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Josephine M
authors.initials: JM
authors.lastname: Egan
authors.affiliation: Laboratory of Clinical Investigation (J.P.D., D.M., J.M.E.) and Translational Gerontology Branch (M.S., L.F., C.W.C.), National Institute on Aging, and Imaging Section (M.G.), Medstar Harbor Hospital, Baltimore, Maryland 21225; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Shehzad
authors.initials: S
authors.lastname: Basaria
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D000077384:Anastrozole; D047072:Aromatase Inhibitors / Q000494:pharmacology*; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D009570:Nitriles / Q000494:pharmacology*; D009929:Organ Size / Q000187:drug effects; D011467:Prostate / Q000000981:diagnostic imaging / Q000187:drug effects*; D013739:Testosterone / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome; D014230:Triazoles / Q000494:pharmacology*; D014463:Ultrasonography
chemical_list: D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077384:Anastrozole; D013739:Testosterone