Mixed Results on Prostate Medications Harmful Affect on Bones

Millions of men suffer each year from an enlarged prostate gland. There are multiple medications available on the market today for treatment, but what price do men pay for their use? What effects do these medications have on the health of their bones?
Some researchers have estimated that more than 8 million men in the United States between the ages of 50-79 will have to deal with an enlarged prostate gland by the year 2010. Prescription medication is the primary course of treatment. The medications that treat an enlarged prostate, or benign prostatic hyperplasia (BPH), come in two different groups: alpha blockers and 5-alpha reductase inhibitors. The medications are used to treat BPH in part by blocking testosterone from converting to dihydrotestosterone.
Steven J. Jacobsen, MD, of Kaiser Permanente Southern California, led researchers in finding out if there is any connection between the 5-alpha reductase inhibitors—such as Avodart and Proscar—and the occurrence of hip fractures. The researchers stated that other studies conducted “suggest that dihydrotestosterone might have a role in bone metabolism, but no clear evidence exists to support this theory.”
The researchers gathered information on 7,076 men that were ages 45 and older, from the year 1997 to 2006, all of which did have hip fractures. They then compared these men with another group of 7,076 similar men that did not have hip fractures.
A similar percentage of men from each of these groups had benign prostatic hyperplasia. The researchers found out that:Approximately 109 men with hip fractures had taken a 5-alpha reductase inhibitorApproximately 141 men without hip fractures had taken the same 5-alpa reductase inhibitor
The researchers concluded that the 5-alpha reductase inhibitors were not liked to an increased risk of hip fracture; instead, they may actually decrease the risk of a hip fracture.
Interestingly, the research team also found that there was a modest increase in the risk for a hip fracture in the men who took alpha-blockers (such as Cardura, Flomax, Hytrin, and Uroxatral). There was more use of alpha-blockers (32%) in the men that had hip fractures vs. the men that did not have hip fractures (30%). Since this was not the primary focus of the study, the researchers write that this information warrants further investigation.
The researchers also noted that they only studied older men and that more research need to be conducted on the long term risks of these medications in younger men.
This study appears in the October 8 issue of The Journal of the American Medical Association.