BPH (or an enlarged prostate) is a very common condition men get with age. More than one in three of all men over 50 will have some sort of prostate enlargement.
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How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Genetic polymorphism and pathogenesis of benign prostatic hyperplasia. BJU international, 102(5), 536–544.
Enlarged prostate, benign prostate enlargement (BPE) or benign prostatic hyperplasia (BPH) is a condition that goes by many names. It mainly affects middle aged men. It’s where the prostate, a small gland found near a man’s bladder, is bigger than usual.
There can be numerous symptoms, but the main one is urinary problems (like not being able to pass urine easily).
Men with an enlarged prostate find it more difficult to empty their bladder completely, and at times may need to strain to pass urine. Sometimes this is accompanied by discomfort or a ‘reduced flow’, and in some cases blood may appear in the urine.
Men over the age of 50 are most likely to get an enlarged prostate. A lot of men don’t get any symptoms, or only get mild symptoms that don’t bother them.
It’s thought that a change in the balance of hormones as men get older may cause the prostate to grow. There isn’t much evidence to suggest hereditary factors will lead to an enlarged prostate, but some research says you’re more likely to get BPH if your father or brother has it. Some studies also suggest that obese or diabetic men could be more likely to get an enlarged prostate, but it’s not a conclusive link.
BPH is much more common if you’re over 40, and increases the older you get. According to the Urology Care Foundation, it’s thought that about half of men between 51 and 60 will get it, rising to 90% of men over the age of 80.
It’s estimated that a third of men over 50 are thought to get moderate to severe LUTS (which stands for lower urinary tract symptoms) related to the condition.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
The exact cause of prostate enlargement is unknown, but it’s believed to be linked to hormonal changes as a man gets older. The balance of your hormones in your body changes with age, and this may cause your prostate to grow. There is also some evidence that healthy lifestyle changes like increasing exercise and eating more fruit and vegetables can reduce your risk of developing BPH symptoms.
Research suggests that there may be a connection between testosterone and an enlarged prostate. Testosterone naturally converts in the body to dihydrotestosterone. This is a much more potent hormone than testosterone, and it’s thought that this causes the prostate to grow.
Over time this growth causes pressure to build on the urethra, which makes it harder to pass urine.
If you have BPH, you might notice:
If you have BPH, you may only get some of these symptoms, or you may not get any at all. They can also be caused by other health problems or lifestyle factors, so if you get them, it’s not necessarily an enlarged prostate.
If you do notice any of these symptoms, then always contact a clinician for further advice. If an enlarged prostate is left untreated this can lead to more serious problems.
Having an enlarged prostate isn’t considered particularly serious. But if left untreated, it can cause complications, and most of these are related to not being able to pass urine. Bladder or kidney problems (like infections) are examples, and sometimes surgery may even be required to remove the prostate completely.
Contrary to what some people think, there’s no link between having an enlarged prostate and prostate cancer.
Benign Prostatic Hyperplasia (BPH): Symptoms, Diagnosis & Treatment - Urology Care Foundation. [online] www.urologyhealth.org.
There are a range of treatments available to help treat BPH, and the symptoms it causes. These include alpha blockers like Tamsulosin, which relax the muscles in the prostate and around the opening of the bladder, making it easier to urinate.
There’s also a type of treatment called 5-alpha-reductase inhibitors. Finasteride and Dutasteride are examples. These work by stopping the conversion of testosterone into dihydrotestosterone and this helps to shrink the prostate so that it stops pressing on the urethra. They take a few months to become fully effective, but can shrink the prostate by up to a quarter after six to 12 months, and sometimes shrink it even more if taken for longer. You can get these as generic medicines (Finasteride and Avodart). You might know Finasteride as Propecia, a lower dose version of Proscar used in hair loss.
Diuretics can also help with an enlarged prostate. Usually taken in the form of water tablets during the afternoon, these speed up urine production, making it less likely that you will need to get up during the night.
The best option for BPH depends on the severity of your symptoms. Some men manage to ease symptoms by making lifestyle changes. But sometimes medicines are needed if these don’t help.
Because the treatments work in different ways, it’s difficult to compare them directly. Some treat the root cause of the problem by reducing the size of the prostate, while others help to relax muscles around the bladder, and others help to speed up urine production.
So the best treatment really, is the one you find works best.
An enlarged prostate doesn’t always need treatment. Sometimes making lifestyle changes can help to ease symptoms. For example:
There are absorbent pads you can use to help mop up leaks as well.
But if you try changing things yourself and it doesn’t make a difference, you should let a clinician know so they can go through treatment options with you.
The management of lower urinary tract symptoms in men. BMJ (Clinical research ed.), 348, g3861.
Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors. Current Bladder Dysfunction Reports, 5(4), pp.212-218.
Testosterone Replacement Therapy and BPH/LUTS. What is the Evidence? Current Urology Reports, [online] 17(6), p.46.
Proscar 5mg film-coated Tablets - Patient Information Leaflet (PIL) - (emc).
Tamsulosin Zentiva 400 microgram prolonged-release hard capsules - Summary of Product Characteristics (SmPC) - (emc).
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