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Dihidrotestosteron

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  • In men, up to 70% of DHT is formed from free testosterone in peripheral tissues under the influence of 5-alpha reductase, while the remainder is directly synthesized in the testes.
  • In women, DHT is mainly synthesized from androstenedione.

DHT binds to androgen receptors in tissues more strongly than testosterone, resulting in a more pronounced androgenic effect, despite its lower concentration.

  • DHT stimulates prostate cell proliferation far more effectively than testosterone, making it one of the main contributors to benign prostatic hyperplasia (BPH).
  • This is why 5-alpha reductase inhibitors are commonly used to treat BPH.
  • Excess DHT elevation, particularly due to testosterone therapy, can lead to prostate enlargement.
  • During treatment with 5-alpha reductase inhibitors, DHT levels should be monitored, as they correlate with prostate size.
  • Fasting for at least 8 hours before the test (only plain, non-carbonated water is allowed).
  • Avoid physical and emotional stress for 30 minutes before the test.
  • Do not smoke for 30 minutes before the test.

Indications for Testing

  • Diagnosis of:

    • Benign prostatic hyperplasia (BPH)
    • Androgenetic alopecia (male and female pattern hair loss)
    • Primary and secondary hypogonadism in men
    • Age-related androgen deficiency (characterized by decreased libido and erectile dysfunction in men)
    • Morris syndrome (testicular feminization syndrome), resulting from androgen insensitivity
    • Congenital 5-alpha reductase deficiency

  • Monitoring the effectiveness of 5-alpha reductase inhibitors in the treatment of BPH or androgenetic alopecia.

  • Evaluating causes of hyperandrogenism in women, particularly in cases of hyperandrogenic dermopathy.

Additional Clinical Situations:

  • Men:

    • Symptoms of BPH (prostate enlargement, urinary tract issues).
    • Hair loss (male-pattern baldness).
    • Monitoring the effectiveness of 5-alpha reductase inhibitors.
    • Decreased libido and erectile dysfunction.
    • Absent or reduced testicular size, cryptorchidism (undescended testes), abnormally small genitalia, absence of pubic and axillary hair.
    • Puberty evaluation in adolescent boys.

  • Women:

    • Hirsutism (excessive hair growth).
    • Acne and seborrhea.
    • Menstrual irregularities.

Causes of Increased DHT Levels

  • Benign prostatic hyperplasia (BPH)
  • Androgenetic alopecia (pattern baldness)
  • Testosterone therapy
  • Androgen-producing adrenal or gonadal tumors
  • Hyperandrogenic syndrome in women
  • Pregnancy

    Causes of Decreased DHT Levels

  • Primary and secondary hypogonadism in men
  • Age-related androgen deficiency in men
  • Use of 5-alpha reductase inhibitors
  • Morris syndrome (testicular feminization syndrome)
  • Congenital 5-alpha reductase deficiency
  • Postmenopause

    Factors That May Influence Test Results

  • Testosterone therapy (hormone replacement therapy - HRT)
  • Use of 5-alpha reductase inhibitors