Testosterone Supplementation and Prostate Enlargement Issues

Information on testosterone supplementation in men and issues related to benign prostatic hyperplasia (BPH)?

Dear Dr.
Hsu,
Many years ago, I was diagnosed with benign prostatic hyperplasia (BPH) by a doctor.
I took medication for a period of time, but the effects were not significant.
I have not taken any such medication in the past five years.
My urination is slightly slow, and sometimes I experience a feeling of incomplete emptying and residual urine.
However, I have not resumed medication and have instead opted for exercise, such as playing sports and brisk walking, to improve my overall health and prevent aging.
Given this situation, do I need to see a doctor or take medication again?
Another question I would like to ask is regarding "testosterone deficiency and supplementation." I have read some medical reports suggesting that daily supplementation of 50 mg of DHEA may increase bone density, muscle strength, and libido.
Clinical trials on anti-aging showed that after two months, 67% of men and 84% of women reported increased physical and psychological well-being without adverse effects.

Patients treated with 50 mg of DHEA were assessed using the International Index of Erectile Function (IIEF), and the results indicated that after six months of treatment, there were significant improvements in erectile function, orgasmic function, sexual desire, satisfaction with intercourse, and overall satisfaction compared to the placebo group.
Additionally, patients taking DHEA showed a slight reduction in prostate volume, while those on placebo exhibited slight prostate enlargement.
It is said that this is a dietary supplement and not a medication, and I am unsure if health insurance covers it.
Can you advise if this supplement is safe to take? Are there any potential side effects or long-term consequences?
I hope you can clarify these questions for me.
I look forward to your response.
Wishing you all the best!
Sincerely,
Doctor Q&A Teams

Zhongshang, 60~69 year old female. Ask Date: 2013/02/28

Dr. Xu Weikai reply Urology

Hello, DHEA is currently classified as a dietary supplement, and the National Health Insurance only covers medications.
Unlike drugs, supplements generally have fewer side effects.
However, this also means that their effects may be slower to manifest.
Additionally, consuming excessive amounts of anything can lead to side effects.
For example, eating too much oil can lead to weight gain.
I am not sure about the specific side effects of taking too much DHEA; you may want to refer to the product's instructions.
If you have any further questions or need clarification, feel free to ask, and we can discuss and research together.
Please remember that information found online should only serve as a reference, and it is essential to seek medical attention at healthcare facilities when necessary.
This message is from Dr.
Hsu Wei-Kai, Head of the Urology Department, Taitung Hospital, Department of Health, Executive Yuan, who cares about your health.

Reply Date: 2013/02/28

More Info

Dear Patient,
Thank you for your inquiry regarding testosterone supplementation and prostate enlargement issues. It’s great to hear that you are actively engaging in physical activities like playing sports and walking to maintain your health. Let’s address your concerns step by step.

Prostate Enlargement and Symptoms
You mentioned a previous diagnosis of benign prostatic hyperplasia (BPH), which is a common condition in older men. Symptoms such as slow urination and the feeling of incomplete bladder emptying can indeed be bothersome. While lifestyle changes, including exercise, can help improve overall health and may alleviate some urinary symptoms, it is essential to monitor your condition. If your symptoms worsen or significantly impact your quality of life, it would be prudent to consult a urologist. They can evaluate your prostate health and determine if medication or other interventions are necessary.

Testosterone Supplementation
Regarding testosterone supplementation, particularly with DHEA (Dehydroepiandrosterone), it is important to approach this topic with caution. DHEA is a hormone that the body converts into testosterone and estrogen. Some studies suggest that DHEA supplementation may improve bone density, muscle strength, and libido, and it has been associated with increased feelings of well-being in some individuals. However, the evidence is mixed, and not all studies show significant benefits.

1. Dosage and Administration: The suggested dosage of 50 mg of DHEA is commonly referenced in studies, but individual responses can vary. It’s crucial to consult with a healthcare provider before starting any supplementation, as they can assess your specific health needs and monitor your hormone levels.

2. Potential Side Effects: While DHEA is often marketed as a supplement with minimal side effects, it can still cause hormonal imbalances. Possible side effects include acne, hair loss, mood changes, and alterations in menstrual cycles for women. Additionally, there is a concern that DHEA supplementation could exacerbate prostate issues, particularly in men with a history of prostate enlargement or prostate cancer.
3. Prostate Health: The studies you referenced indicate that DHEA may have a slight effect on reducing prostate size, but this is not universally accepted. Regular monitoring of prostate-specific antigen (PSA) levels and prostate health is advisable, especially if you decide to take DHEA.

4. Insurance Coverage: As for insurance coverage, DHEA is typically considered a dietary supplement rather than a medication, which means it may not be covered by health insurance plans. It’s best to check with your insurance provider for specific details.

Conclusion
In summary, while lifestyle changes like exercise are beneficial, it’s essential to keep an eye on your urinary symptoms and consult a healthcare provider if they persist or worsen. Regarding DHEA supplementation, it may offer some benefits, but it is crucial to discuss this with your doctor to weigh the potential risks and benefits, especially concerning your prostate health.

Please feel free to reach out if you have further questions or need clarification on any points. Wishing you good health and well-being!
Best regards.

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