Administration of therapeutic estrogen to postpu-bertal men results in a marked reduction in serum T by inhibiting LH production in the anterior pi-tuitary.55,56 Also, estrogens may have direct cytotoxic effects on prostate cancer cells in vitro. The efficacy of estrogen therapy, usually given as oral diethylstilbestrol, is limited by its side effects, such as painful gynecomastia and increased propensity for venous thromboembolic, cardiovascular, and cerebrovascular disease.14,43,57,58

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