BPH

Everything You Need To Know About DHT

Hormones act as chemical messengers in the body, helping to ensure that several functions are executed.

These chemicals are produced and released by glands, which form part of the endocrine system.

DHT, or dihydrotestosterone, is one particularly important hormone that is found in more significant concentrations among men.

This androgen hormone is linked to testosterone and has a role to play from the time a person reaches puberty. Later in life, however, the hormone may not be as beneficial.

This post takes a closer look at what exactly DHT is, what it does in your body, and considers both the benefits and drawbacks of the hormone.

What Is DHT?

We started by taking a closer look at what DHT is. Dihydrotestosterone (DHT) is an androgen hormone that contributes to specific “manly characteristics,” such as hair on the chest and a deep voice.

Dihydrotestosterone is not one of the most commonly discussed sex hormones in the male body, however. When searching for information about androgen hormones, the most common one that will be mentioned is testosterone – and for a good reason.

Testosterone is considered the primary androgen hormone in the male body. From normal sexual function, the growth of facial hair, all the way to helping the body produce red blood cells, it plays a critical role in men’s health.

DHT is considered a metabolite of testosterone. 5a-reductase, or 5-alpha-reductase, is an enzyme in the body, which causes some testosterone to be converted to dihydrotestosterone.

The 5a-reductase enzyme is found, especially in hair follicles. This is one of the main reasons why men with high levels of DHT tend to find that they experience balding as they grow older.

It is essential, however, to note that the hormone does play critical roles in the body – especially during the puberty phase of a man’s life.

When a boy reaches puberty, dihydrotestosterone helps with the development of the scrotum, testes, and the penis. Pubic hair, as well as body hair, also starts to grow due to the conversion of testosterone to DHT, and muscle mass develops.

Furthermore, the prostate gland also starts to grow larger and become functional with the help of dihydrotestosterone during puberty.

While the emphasis is often placed on the fact that dihydrotestosterone plays a role in the male body, a small amount of this hormone is present in the female body too. The ovaries are responsible for converting testosterone to DHT in women.

What Is The Role Of DHT In Benign Prostatic Hyperplasia (BPH)?

Research has suggested that dihydrotestosterone plays a part in the development of benign prostatic hyperplasia (BPH).

This condition is sometimes also called an enlarged prostate and is more prevalent in older men.

A man with benign prostatic hyperplasia has a prostate gland that is bigger than it should be. The enlargement of the gland can cause many uncomfortable symptoms to develop.

Dihydrotestosterone has been found to play a role in the development of prostate cells. This is where the connection between the hormone and an enlarged prostate comes in.

During puberty, the body utilizes dihydrotestosterone to stimulate the growth of the prostate. This occurs due to the hormone’s impact on the production of prostate cells.

An adult man’s prostate has been fully developed, but the effect of this hormone may continue to cause a growth in prostate cells at this time.

As men age, DHT can overpower decreasing testosterone levels. At the same time, estrogen (female hormones) production starts to increase relative to testosterone.

This change in hormonal balance seems to be a key element in the development of prostate disease.

Some researchers suggest that too much estrogen can trigger inflammation in the prostate. What we do know is that when the ratio of estrogen to testosterone rises, the body responds by converting some testosterone to DHT in men.

When dihydrotestosterone levels become too high, it can cause the prostate gland to grow larger than it is supposed to be. The enlargement is caused by an overstimulation of the cells that make up the prostate gland.

Diagnosing Benign Prostatic Hyperplasia

Urinary symptoms in men are relatively common and can mean a lot of things.

Understanding the specific symptoms linked to benign prostatic hyperplasia is important. These will usually include a range of urinary symptoms, which may consist of the following:

  • The urine stream may be weak.

  • Some men may find that their urine stream also becomes slower than usual.

  • There may be an increase in the frequency of urination.

  • The man may have a constant urge to urinate.

  • Difficulty maintaining the urine stream.

  • The man may need to strain in order to start urinating.

  • It may feel like the bladder does not completely empty when urinating.

  • There may be dribbling after urinating.

Due to the complications associated with the condition, the patient needs to get a diagnosis from a doctor.

The doctor will usually need to conduct a digital rectal examination to feel for abnormalities in the prostate gland.

To determine if high DHT levels cause this issue, blood tests may be ordered to determine how much dihydrotestosterone the patient has in their system.

Treatment For BPH With DHT Blockers

An enlargement of the prostate caused by an increase in DHT levels can be effectively treated with a medication known as DHT blockers. Two of the most common are Finasteride and Dutasteride.

There are different types of these drugs available, depending on the accompanying symptoms that the man experiences. One of these drugs has been approved for the use of men who also experience hair loss due to dihydrotestosterone, causing shrinkage of their hair follicles.

Finasteride is a common drug prescribed to men with signs of benign prostatic hyperplasia. This drug is classified as a 5-alpha-reductase inhibitor. It blocks the activity of the 5-alpha-reductase enzyme.

What this means is that there is a reduction in the conversion of testosterone to dihydrotestosterone. In turn, this may help to prevent further stimulation in the growth of prostate cells.

A concern among men, however, is that the side-effects of Finasteride can be damaging and unpleasant.

Dutasteride is another option that the patient may be provided with. Similarly, this 5-alpha-reductase inhibitor may also lead to several side-effects that could be worrisome to the patient taking the drug.

A lot of research has focused on finding how supplements and natural remedies may aid in reducing symptoms of benign prostatic hyperplasia.

At the moment, some studies support the use of Saw Palmetto to help improve symptoms that are caused by an enlarged prostate. This supplement may help to block the conversion of testosterone to DHT.

Testosterone, Prostate Cancer, And Balding: Is There A Link?

We have already established the link between BPH and DHT. In addition to this particular association, it is important to take note that there also seems to be a link between androgen hormones and conditions like balding and prostate cancer.

First, let’s consider how levels of testosterone and DHT (dihydrotestosterone) are linked to baldness.

Male pattern baldness, also called androgenic alopecia, is one of the most common reasons that men lose hair as they get older.

Many people think that DHT is responsible for hair growth. There is some validity to this belief.

The hormone binds to follicles in some regions of the body in order to stimulate hair growth. This is why a boy going through puberty will suddenly start to grow hair in their pubic area, as well as on their chest and other regions of their bodies.

It is a completely different story when looking at how DHT affects the hair on a person’s scalp. When DHT binds to the hair follicles that are located on the scalp, it can actually harm hair growth in the area.

Hair follicles act as small capsules, each containing a single strand of hair. The hair continues to grow during a cycle. Each of these cycles can last for up to five years.

Even when the hair strand is cut off, the same hair will grow back due to the action of the hair follicle.

After the cycle, the hair will stop growing. It will remain in place in the follicle for a short period of time – after this “resting period,” the hair falls out of the follicle. At this time, the follicle will start growing a new strand of hair, and so begins a new cycle.

When DHT binds to the hair follicles on the scalp, it can actually cause the follicle itself to shrink. This usually happens gradually over time.

Some people are more susceptible to these effects of DHT on scalp hair based on variations in their androgen receptor (AR) gene. Androgen receptors are proteins that allow hormones like testosterone and DHT to bind to them.

However, variations in the androgen receptor gene can increase androgen receptivity in your scalp follicles, increasing your risk of male pattern hair loss.

As the follicle shrinks, the hair that comes out of the follicle will become thinner. This is when the first signs of balding are usually noted. The shrinkage of the follicle also shortens the cycle that the hair strand has to go through.

Eventually, the hair strand will not be able to grow as long as it used to. This is when balding becomes more visible.

Men who are experiencing balding due to an increase in DHT binding to their hair follicles might also be at risk of benign prostatic hyperplasia. But this is not the only prostate-related issue that needs to be taken into account here.

The Research..

A scientific publication in the Journal of Urology explains that in adult men, the presence of dihydrotestosterone has been linked to a pathologic growth of the prostate gland.

While the initial association here would be benign prostatic hyperplasia, due to the increased growth of this gland, there is some evidence that points to a potential increased risk of prostate cancer as well.

Harvard Medical School report that an Australian study was one of the first large-scale studies to make such a conclusion. In the study, a total of 1,446 men with prostate cancer were evaluated. These men were all diagnosed with this cancer before the age of 70.

The same study enrolled a total of 1,390 men who were not diagnosed with prostate cancer in the past. These men did not have any prostate-related conditions present at the time of the study.

The idea behind the study was to see if there might be a link between hair loss and prostate cancer. Researchers behind the study found that men with signs of male pattern hair loss might have an elevated risk of this cancer.

The men who had experienced signs of vertex baldness were found to have a 1.5x higher risk of developing prostate cancer compared to those men who did not experience these symptoms.

Vertex baldness is a term used to describe bald spots that develop at the upper region of the head.

It should be noted, however, that the researchers did not report the same findings among men with frontal baldness, which is a term used to refer to a receding hairline.

Men who had a receding hairline, but no signs of vertex baldness, did not appear to be at a higher risk of prostate cancer compared to healthy men with no balding.

Conclusion

Dihydrotestosterone is a converted form of testosterone that acts in several parts of the body. While it is often linked to male pattern hair loss, another important association that needs attention is the development of BPH.

Men who make experience male pattern balding, along with symptoms associated with benign prostatic hyperplasia, might want to get their serum DHT levels checked.

Sources

  1. Carson C, Rittmaster R.. (2013). The role of dihydrotestosterone in benign prostatic hyperplasia.. Urology. 61 (4), p2-7.
  2. Farthing MJ, Mattei AM, Edwards CR, Dawson AM.. (1982). Relationship between plasma testosterone and dihydrotestosterone concentrations and male facial hair growth.. The British Journal of Dermatology. 107 (5), p559-64.
  3. Fagelman E, Lowe FC. Saw Palmetto Berry as a Treatment for BPH. Rev Urol. 2001;3(3):134–138.
  4. Lepor H. Medical treatment of benign prostatic hyperplasia. Rev Urol. 2011;13(1):20–33.
  5. https://www.yourhormones.info/hormones/dihydrotestosterone/
  6. https://www.health.harvard.edu/mens-health/testosterone-prostate-cancer-and-balding-is-there-a-link-thefamilyhealth-guide

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