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Management of Benign Prostatic Hyperplasia with Metformin, Letrozole and Scheduled Growth Hormone Injections: A Pathophysiology Oriented

Abbas Tavakolian Arjmand

Benign prostatic hyperplasia (BPH) is a common and bothersome condition characterized by prostate overgrowth causing slowly progressive lower urinary tract symptoms. It is highly prevalent in old age, and somewhat inescapable stigma of senility. Due to its major urologic manifestations, BPH has been conventionally assigned as a urologic disorder. Hence, it has remained an orphan medical entity in terms of pathogenesis and management. In fact, BPH, as a true metabolo-proteomic disorder, demands some relevant management strategies. Despite the known impacts of age, inheritance, senile changes in androgen to estrogen ratio, obesity, and metabolic disorders on development of BPH, the core pathogenic mechanisms that logically link and reasonably bring all those scattered findings together has not yet been meaningfully addressed. We believe that almost all informative pieces of BPH pathogenesis have been identified already. Thus, to revolutionize our understanding and to pave a definitely novel path towards medical therapy of BPH with a protocol consisting of metformin, letrozole and scheduled growth hormone injections, we only need to sort the available data out into the jigsaw of BPH pathogenesis picture.