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You have full access to this open access article. Due to late onset hypogonadism LOH , there is an increased usage of testosterone replacement therapy TRT in the aging male population. Since prostate is a target organ for androgens and anti-androgenic strategies are used to treat and palliate benign prostate hyperplasia BPH and prostate cancer PC , the prevalence of both increases with age, the possible influence of TRT on prostate health becomes highly relevant.

The present review summarizes existing data on the associations between endogenous hormone concentrations and prostate growth and concludes that circulating concentrations of androgens do not appear to be associated with the risks of development of BPH or initiation or progression of PC.

The explanation for these findings relates to an apparent insensitivity of prostatic tissue to changes of testosterone concentrations within the physiological range. One reason for this is the awareness that LOH is associated with several significant health problems such as metabolic disorders, sexual dysfunction, osteopenia, and psychological stress [ 2 ]. Testosterone replacement therapy TRT has been used with the purpose to improve or even reverse these symptoms [ 3 , 4 ].

TRT for LOH has however been questioned by the US food and drug administration FDA concerning the large increase in testosterone prescriptions, and how to define the group of patients with LOH in order to make more strict treatment recommendations. FDA also had concerns because of some support for an increased risk of cardiac problems, but not due to possible risks for prostate diseases [ 5 ], although conclusive evidence for its safety is still largely lacking.