Low testosterone levels linked to nocturia in men

Research from South Korea indicates that low testosterone levels are associated with nocturia in men, independent of both age and prostate volume.

Du Geon Moon (Korea University Medical Center Guro Hospital, Seoul) and colleagues studied 2180 patients who attended their outpatient urologic clinic between July 2011 and August 2012 for lower urinary tract symptom complaints.

Overall, 148 (6.8%) patients had overt testosterone deficiency (<2.50 ng/mL) and 1399 (63.7%) reported voiding more than once during the night (nocturia) on 3-day frequency volume charts.

In a multivariate linear regression model that also included age, body mass index, and prostate volume, there was a dose–response relationship so that every 0.142 ng/mL decrease in testosterone was associated with an increase in the number of nocturia episodes per night.

And, in a full model, incorporating the presence of comorbidities, testosterone level was significantly associated with nocturia, such that those with overt testosterone deficiency were 60% more likely to experience the condition than those with higher testosterone levels. In particular, decreased testosterone level was associated with a 93% greater odds for nocturnal polyuria.

Additionally, the team investigated disrupted circadian control of voided volume, frequency, and functional bladder capacity by plotting their values over time. They found in multivariate analysis that men with serum testosterone deficiency had significantly different changes in 8-hour voided volume than men with higher testosterone levels, but there was no significant difference in frequency or bladder capacity.

“The clarification of etiology is significant,” comment Moon et al in the International Journal of Urology, “as it shows that urine production rather than frequency is associated with testosterone deficiency.”

They add that this contradicts the theory of reverse causation, in which nocturnal voiding frequency leads to a disrupted circadian rhythm and, in turn, decreased testosterone production. More likely, they suggest, a disrupted circadian rhythm of testosterone release is a common factor in both nocturnal urine production, and decreased overall testosterone levels.

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