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BPH –Causes, Epidemiology and Medication

BPH, disease BPH, BPH condition, BPH medication, BPH cure

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BPH –Causes, Epidemiology and Medication

Epidemiology of BPH:

The study of the distribution and the determinants of diseases in human beings is called Epidemiology. BPH or Benign Prostatic Hyperplasia is a term used to indicate the inflammation or “hyperplasia” of the prostate gland. There being no globally accepted epidemiologic definition of BPH, the prevalence and incidence rates of this disease are usually viewed in context of the definitions chosen by the physician reporting the data. Prevalence of BPH is usually not compared based on clinical criteria, because clinical definitions have been found to vary greatly. So physicians usually choose autopsy or histological evidence to compare the prevalence of the disease.

Pathogenesis of BPH:

The development of BPH in men is usually attributed to testicular hormones and aging. Though the role of androgens as the causative factor for BPH is debated, they definitely have at least some role as a causative agent. It has been seen that men castrated before puberty do not develop BPH as compared to those in the same age group and belonging to the same strata of society. It has also been seen that men having diseases that inhibit the production of androgens are less likely to have BPH.

The principal prostatic androgen responsible for BPH is dihydrotestosterone or DHT. DHT is actually a derivative of testosterone – the male sex hormone. It has been seen that though the concentrations of DHT and testosterone in blood (plasma) decrease with age, they remain in normal concentration in the prostate with aging. There are different theories as to the exact cause of BPH. Though none of them have been proved to be conclusive singularly, yet the theory of DHT is probably the most referred to by physicians. The other most common theories are:

• The theory of interaction between stroma and epithelium
• The theory of reduction of the cellular death rate
• The theory of estrogenic synergy
• The theory of genetic and familial factors.

Role of DHT in BPH:

Though the levels of Testosterone and Dihidrotestosterone in serum decline with age, the concentration of DHT remains unchanged in the prostate. The reason for this is probably the fact

that DHT has a very high affinity for androgen receptors. For a better understanding of androgen receptors, we can consider the receptors to be something like magnets and the DHT molecules like iron filings. When Testosterone gets converted into DHT due to the intervention of a prostate specific enzyme called 5α-reductase, the DHT molecules rush off and get settled on the androgen receptors and then complex cellular reactions are initiated. Since this phenomenon is independent of the aging process, androgen dependent cell growth is maintained through out the aging process. Careful examination has shown that hyperplasic tissues (inflamed areas of the prostate) usually have higher concentrations of androgen receptors as compared to normal areas. These are supposed to be the major culprits for causing BPH.

Role of Stromal – Epithelial Interactions in BPH:

The prostate gland is histologically divided into two parts – Stroma and Epithelium. Experiments suggest that both the compartments communicate with each other and the growth of the prostate is highly dependent on the communication or regulatory signaling between them.

DHT is believed to act either in autocrine (secretes a chemical signal and binds to the same cell) fashion by binding with the stromal cells or by binding with neighboring epithelial cells in paracrine (opposite of autocrine) fashion. In both these instances DHT binds with androgen receptors and triggers the transcription (synthesis of RNA or ribo nucleic acid) of growth factors, which in turn cause prostatic tissue growth.

Medical treatment for BPH:

It has been seen that 5α-reductase inhibitor group of drugs like Finasteride, Dutasteride etc. are efficient in arresting BPH progression. These drugs inhibit the formation of 5α-reductase enzyme and thereby hinder the conversion of Testosterone into DHT. Though clinicians have reported of other causative agents of BPH, the fact that arresting DHT formation arrests BPH progression proves that DHT is one of the vital causative agents of BPH.
Published: 2009-02-25
Author: Pinaki Kar

About the author or the publisher
I'm a freelance writer with 9 years of writing experience. I have now metamorphosed into we and we are now The site is very new but as I told services are not younger than 9 years.

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