WHY DOES TESTOSTERONE BUT NOT DIHYDROTESTOSTERONE TREATMENT INCREASE A MAN’S PSA LEVELS?

A man’s prostate gland siphons testosterone from his bloodstream. Then an enzyme within the prostate gland converts the trapped testosterone to DHT. It is this DHT made by and retained within the prostate that is one of the factors responsible for prostate gland growth. As far as we know, the prostate gland does not pluck DHT from a man’s bloodstream. Further, when blood DHT levels rise, testosterone levels decline, making less testosterone available for the prostate gland to ensnare. With less testosterone to trap, DHT levels within the prostate gland decline; and prostate growth can be held in check. How do we know this?

Older men given testosterone usually have a slight but significant increase in their prostate specific antigen (PSA) levels. But when similarly aged men are given large doses of DHT, their PSA levels do not change. There are probably two reasons for this. When men receive testosterone supplements, their blood testosterone levels increase, making more testosterone available for the prostate to trap and convert to DHT. But when men receive large doses of DHT, their testosterone levels actually decline. There is not as much bloodstream testosterone for the prostate gland to trap, so less is available for conversion to DHT within the prostate gland.

There is a second and more subtle sequence of events that explains why testosterone, but not DHT, stimulates the prostate to generate more PSA. A female hormone, estradiol, is one of the natural by-products of testosterone metabolism. It turns out that estradiol is yet another stimulus to prostate gland growth. Dihydrotestosterone cannot be further metabolized to estradiol or any other prostate-stimulating estrogen. Thus, giving a man more testosterone will raise blood testosterone, estradiol, and dihydrotestosterone levels. The increases in blood testosterone and blood estradiol provide the prostate with two potent hormonal stimuli to prostate growth. Testosterone does this by being trapped by the prostate gland, and after being transformed to DHT, it can increase the growth of the prostate gland. Estradiol then is free to exert a direct stimulatory impact on other prostate cells.

DHT, on the other hand, does not enter the prostate gland and cannot be transformed into another male hormone or estradiol and therefore deprives the prostate of both testosterone and estradiol, nullifying the growth-promoting impact of these two hormones. As a consequence, neither PSA levels nor prostate size increase during DHT treatment.

The ability of DHT to maintain a male hormone presence while simultaneously lowering estradiol levels is what makes DHT an ideal hormone to treat young boys who develop breast enlargement (gynecomastia). DHT has not yet been approved for this use in this country, but in France, where DHT is approved, teenage boys with gynecomastia have benefited from DHT treatment. Published reports indicate that boys’ breast size returns to normal with DHT treatment.

2 Responses to “WHY DOES TESTOSTERONE BUT NOT DIHYDROTESTOSTERONE TREATMENT INCREASE A MAN’S PSA LEVELS?”

  1. Vijesh says:

    I really appreciate your scientific and analytical study on DHT and T.Your report has been the most logical vis-a-vis the other reports available on the net.Please keep up the good work.Thanks.

  2. David Fogg says:

    I pose a question to those who can answer. Injected testosterone will cause the male’s body to cease producing internal natural testosterone. If the amount of testosterone injected essentially replaces the natural level to where the testosterone levels remain mostly the same, why would PSA go up only with the injected testosterone and not from the internally produced testosterone. I was prescribed 250 mg per week of testosterone cypionate and anestrazol the etstrogen inhibitor, and I was taking propecia. My PSA increased from 2.5 to 5.3, then went back down to 2.5 when off testosterone injections. So i was taking the anti estrogen and finesteride plus injecting a rather minimimal amount of testosterone and still my PSA increased, I am curious to find out why this may have happened. Dave

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