Benign prostatic hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) is the most common cause of prostatic enlargement which results from proliferation of stromal and glandular elements. It is a common condition as men get older and can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder There is a very important role of androgen-dependent proliferation of glands and stroma
Clinical benign prostatic hyperplasia (BPH) is one of the most common diseases in ageing men and the most common cause of lower urinary tract symptoms (LUTS). The prevalence of BPH increases after the age of 40 years, with a prevalence of 8% till 60% at age 90 years..
The pathophysiology of BPH/BPE is still incompletely understood. The dominant role of the androgen system and the androgen receptor is well defined. Androgen receptors are expressed in BPH tissue in which they are activated by the potent androgen dihydrotestosterone. Synthesis of dihydrotestosterone is under control of the 5a-reductase enzyme. More recently, the impact of prostatic inflammation and metabolic parameters particularly for the development of BPE and LUTS has increasingly been recognized. (Gerontology 2019;65:458–464 https://doi.org/10.1159/000496289).
Dihydrotestosterone accumulation within the gland serves as the hormonal mediator for the hyperplasia. The accumulation probably occurs in part because of decreased catabolism of the molecule and in part because of enhanced intracellular binding of the molecule. The process is accelerated by estrogen, which enhances the level of the androgen receptor in the gland. Increase in the androgen receptor allows for androgen-mediated growth even in the face of declining androgen production in advanced age. (The American Journal of Medicine Volume 68, Issue 5, May 1980, Pages 745-756)
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** All data above are published as clinical trials and do not refer to EFSA claims. This means that they do not intend to be medical or therapeutical advice.