EFFECTS OF ESTROGEN DEPRIVATION ON HUMAN BENIGN PROSTATIC HYPERPLASIA

Sex steroids are thought to play an essential role in the pathogenesis of human benign prostatic hyperplasia (BPH). Since recent studies in animal models and in men have shown that estrogens might be causally l inked to the onset and maintenance of BPH, we examined the effect of 1 -methyl-androsta-1,4-diene-3,17-dione (Atamestane), a newly developed aromatase inhibitor, in men with BPH. In an open multicenter study 49 men (mean age 70.1 years, range 55 to 84) with obstructive BPH were tr eated with atamestane (3 x 200 mg/day) for 3 months. Of the 49 patient s 44 completed the treatment period; the other patients discontinued t he study for reasons unrelated to treatment. With treatment BPH-relate d symptoms such as daytime voiding frequency, nycturia, peak flow and residual urine improved considerably; however, these parameters did no t reach statistical significance. The mean prostatic volume decreased significantly from 74.2 +/- 31.7 to 64.0 +/- 31 ml (mean +/- SD). Seru m estrogen levels decreased markedly during treatment. In addition int raprostatic estrogen concentration decreased with treatment as compare d to estrogen levels in hyperplastic prostates from untreated patients . The following conclusions can be drawn from this study: first, estro gens appear to have an important supportive role in established BPH, a nd second, estrogen deprivation improved BPH-related symptoms and redu ced significantly prostatic volume.