Safety Aspects of Androgen Treatment with 5α-Dihydrotestosterone

5α-Dihydrotestosterone (DHT) was noted to be a potent androgen with three to six times the biopotency of testosterone, yet it appeared to be prostate-sparing. Unlike testosterone, DHT did not undergo further amplification in the prostate and likely led to less aromatisation to oestradiol, potentially reducing the risk of benign prostate hyperplasia and prostate cancer. Despite reducing circulating oestradiol levels, DHT maintained levels sufficient for bone mineral density. Its effects on erythropoiesis and lipids were similar to testosterone, and safety concerns were comparable, though DHT's impact on the prostate was likely less potent.