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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20361
Experience:  I am fellowship trained specializing in general urology and reconstructive urology.
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Im a 61 year old male with a recent testosterone level of

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I'm a 61 year old male with a recent testosterone level of 226. Never had my testosterone tested before. My PSA recently was tested at 3.2 which was elevated over previous years. Had a rectal ultrasound that came back fine with the comment that I thicking in area that is consistent with BHP. I have for five years had symptoms of BHP. Also have been borderline osteoporoatic for 10 years and take a weekly pill. My internist wants to put me on testosterone patch.
How could I develop enlarged prostate when I have low testosterone?
Should I retake testosterone test?
Would having enlarged prostate preclude testosterone therapy?
Submitted: 6 years ago.
Category: Urology
Expert:  Dr. Y. replied 6 years ago.
Hi there,

Let me ask you a few questions so I can better help you.

1. How elevated was your PSA previous to the 3.2 level?
2. Did the transrectal ultrasound include a biopsy of the prostate?

Men can develop an enlarged prostate regardless of what the testosterone levels is, so you do not need to have your testosterone level rechecked. You don't need to be on testosterone replacement unless you are having symptoms of low libido or low energy levels.
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Customer: replied 6 years ago.

Ultrasound did not include biopsy. Don't know what level the PSA was a year earlier. But DR also did a digital rectal exam at time of last PSA test and said it was normal except for enlarged prostate.

Radiologist reported nothing suspicious and noted (Call patient looks OK). Only comment was ultrasound was consistent with location and shape of BHP.

I have in additon to borderline osteoporosis some of the symptoms of low testosterone ie low libido which prompted internist to check testostrone in first place, anxiety and depression and trouble focusing and concentrating. Have had these for years and have been seeing a phyciatrist for 15 years. Currently on lexapro and xanax for years. Does not seem to really help. Wondering if this could all be related to low testosterone which has existed for many years. Also have always had flabbly breasts nothing obscene but just out of proportion to rest of build for many years.

Expert:  Dr. Y. replied 6 years ago.
Yes, your symptoms can be related to your low testosterone level. However, before you are started on testosterone ,I would want you to see your urologist to discuss havinga prosate biopsy done to rule out prostate cancer first as the cause of your elevated PSA. The reason for this is that if you have prostate cancer that is undetected, then the testosterone that you will be placed on will make an unknown cancer grow faster. Hope this helps.
Customer: replied 6 years ago.

Just curious that radiologist did not recommend an ultrasound with a biopsy after reviewing the ultrasound. She saw nothing in the ultasound that would indicate prostate cancer. Only conclusion was reading consistent with BHP.

Expert:  Dr. Y. replied 6 years ago.
Well an ultrasound cannot detect cancer, it can only tell you if the prostate is enlarged or not. You need to see a urologist to have a biopsy done.
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