2 groups of men are impervious to BPH:

• Men who have been castrated.

• Men with 5-alpha-reductase deficiency.

Thus, the presence of DHT has been shown to induce hyperplasia in prostate cells via the stimulation of growth factors.

Although men produce less testosterone with age, they continue to produce DHT in the prostate.

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There is less circulating androgen late in life, but a higher concentration of circulation estrogens. Estrogens are thought to upregulate the expression of androgen receptors, allowing for increased capture of existing androgen.