The effects of exogenous androgen therapy on the prostate are not well defined. Because severe androgen deficiency prevents prostate development and disease, exposure to adult male testosterone concentrations for decades must establish the origins of prostate disease (11). Yet the effects of androgen deficiency and administration during midlife on risk of late-life prostate disease is unclear. Although men who are androgen deficient have reduced prostate volume (112,113), testosterone administration for androgen replacement therapy restores prostate volume, either in part (113) or fully (112); however, even massive androgen doses don't cause significant prostatic hyperplasia at least during midlife (114). Although the effects of androgen therapy on prostate size or cancer risk are not reported in men with chronic renal failure, prolonged pharmacological androgen therapy (nandrolone decanoate 200 mg/wk for up to 24 mo) had no significant effects on blood levels of prostate markers prostate-specific antigen and prostatic acid phosphatase in elderly men on hemodialysis (115).
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