ANDROGEN REGULATION OF LOWER URINARY TRACT FUNCTION: GENDER DIFFERENCES AND CLINICAL SIGNIFICANCE

Androgens play a critical role in the development, maintenance, and functional regulation of the lower urinary tract (LUT) in both males and females. Beyond their well-known effects on reproductive organs, androgens influence bladder function, urethral tone, pelvic floor integrity, and neural control mechanisms involved in micturition. Gender-related differences in androgen levels, receptor distribution, and downstream signaling pathways contribute to distinct patterns of lower urinary tract symptoms (LUTS) across the lifespan. This article provides a comprehensive review of androgen regulation of lower urinary tract function, emphasizing molecular mechanisms, gender differences, and clinical implications. Understanding these interactions is essential for improving diagnostic strategies and developing targeted therapies for LUT disorders such as benign prostatic hyperplasia, overactive bladder, urinary incontinence, and age-related voiding dysfunction.
Androgens are steroid hormones traditionally associated with reproductive physiology, yet their influence extends significantly to the lower urinary tract, encompassing bladder function, urethral dynamics, pelvic floor integrity, and neural regulation of micturition. Recent studies indicate that androgen signaling is not limited to males but plays a crucial role in female urinary physiology as well. Variations in circulating androgen levels, receptor expression, and intracellular signaling pathways contribute to gender-specific manifestations of lower urinary tract dysfunction. This review synthesizes evidence from molecular biology, animal experiments, and clinical investigations to elucidate androgen-mediated mechanisms affecting urinary storage and voiding. It highlights the clinical relevance of hormonal modulation in conditions such as benign prostatic hyperplasia, overactive bladder, stress urinary incontinence, and age-associated urinary disorders. Recognition of these processes underscores the importance of personalized approaches that consider hormonal status alongside anatomical and neurological determinants, providing new avenues for therapeutic intervention and improved patient outcomes.