It is a short questionnaire that asks about common urinary problems. They check how severe the BPH is and whether the prostate is already causing major symptoms. The relationship between testosterone and the prostate is more balanced than once thought. However, even when DHT levels rise, this does not always lead to more prostate problems. Not all forms of testosterone therapy raise DHT in the same way. Once those receptors are full, the prostate doesn’t keep growing even if hormone levels rise further. The androgen receptors in prostate cells can only "use" a certain amount of testosterone or DHT. Careful monitoring helps keep treatment safe and effective. Testosterone Replacement Therapy (TRT) can help men with low testosterone feel stronger, more energetic, and improve mood and sex drive. With the right care, most men can get the benefits of TRT without making their prostate problems worse. Managing BPH the right way makes it much safer to take testosterone. An endocrinologist focuses on hormones, including testosterone. Men with both low testosterone and BPH may need care from more than one doctor. In more serious cases, surgery may be needed to remove part of the prostate. Regular vigorous exercise may reduce one's chance of developing advanced prostate cancer, as can several dietary interventions. In contrast to men of African descent, East Asian men have among the lowest rates of prostate cancer globally. Together, known gene variants are estimated to cause around 25% of prostate cancer cases, including 40% of early-onset prostate cancers. Some forms of TRT may cause the body to make more dihydrotestosterone (DHT). They tend to get worse slowly over time if the prostate keeps growing. Some symptoms overlap, making it hard to tell the difference without a proper medical check-up. It’s important to understand which symptoms are linked to BPH and which may be caused by TRT. Because of this, some men wonder whether their symptoms are caused by BPH, by TRT, or by both. Testosterone Replacement Therapy (TRT) can sometimes affect the urinary system as well. That’s why it’s so important to screen for cancer before starting TRT and to keep checking while on treatment. They also ask about urinary symptoms and may repeat the IPSS. In some cases, slower and more steady hormone levels may reduce the chance of prostate side effects. One of the most important things we’ve learned is that testosterone itself is not always the cause of prostate problems. One common tool is the IPSS, or International Prostate Symptom Score, which helps track how bad a man’s BPH symptoms are. That’s why doctors take time to check each patient before starting treatment. Not every man is a good candidate for TRT, and not every man with BPH will have problems if he starts testosterone therapy.
