The normal functioning of the prostate is influenced by hormonal secretions from the hypothalamus, pituitary gland, and testes. Luteinizing hormone releasing hormone (LHRH) (also known as gonadotropin releasing hormone) secreted by the hypothalamus stimulates the secretion of luteinizing hormone (LH) and follicle stimulating hormone from the anterior pituitary. LH stimulates the secretion of testosterone by the testes. Testosterone is metabolized in the prostate to dihydrotestosterone (DHT), which binds to androgen receptors, and which in turn bind to DNA sequences influencing gene expression, leading to the synthesis of proteins such as PSA, and triggering cell proliferation. The production of adrenocorticotropic hormone (ACTH) from the pituitary is also increased, resulting in secretion of inactive androgen precursors from the adrenal gland, which may also activate androgen receptors in the prostate gland.¹⁴