Prostate enlargement, which is also known as benign prostatic hyperplasia (BPH), is a medical condition common in men who are getting older1. While the condition could lead to a host of uncomfortable urinary symptoms, it can also cause various kidney, bladder, or urinary tract issues.
What is Prostate Enlargement?
Benign prostatic hyperplasia (BPH), commonly referred to as prostate enlargement, is a non-cancerous increase in the size of the prostate gland2. While not life-threatening, BPH can significantly impact quality of life and may lead to complications like urinary tract infections or kidney issues if untreated3.
The prostate is a small, walnut-shaped gland located beneath the bladder and in front of the rectum. It surrounds the urethra, the tube that carries urine and semen out of the body4. The prostate naturally grows with age in distinct phases: slow growth during childhood, rapid growth during puberty, and another phase of accelerated growth starting around age 505. This natural enlargement is influenced by hormonal changes, particularly involving testosterone and dihydrotestosterone (DHT)6.
BPH is not cancerous and does not increase the risk of prostate cancer. However, its symptoms can overlap with other serious conditions like prostate cancer or infections, so medical evaluation is important for proper diagnosis and management7.
BPH is extremely common in older men8:
- About 50 percent of men aged 51-60 experience BPH.
- This prevalence increases to 70 percent for men aged 60-69 and up to 80-90 percent for those over 70 years old.
While some men remain asymptomatic, approximately one-third of men over 50 develop noticeable urinary symptoms due to BPH.
What Are the Symptoms of BPH?
In general, an individual’s BPH symptoms will get worse with time. Common signs of the phenomenon include9:
- The inability to fully empty one’s bladder
- An urgent/frequent need to urinate
- Difficulty starting urination
- Nocturia, or increased urination at night
- The inability to fully empty the bladder
- Dribbling at the end of urination
- A non-uniform urine stream
- A weak urine stream
More rare signs of BPH may include:
- Hematuria, or blood in the urine
- Urinary tract infection
- The inability to urinate
It may be surprising to learn that the size of one’s prostate doesn’t dictate the severity of one’s symptoms2. It may be encouraging, however, to learn that some men may find that their symptoms will eventually stabilize or improve with time10.
What Causes Enlarged Prostate?
BPH is often caused by the fact that men experience continuous prostate growth throughout their lives; as life goes on, this continued growth can cause the prostate, which is located below the bladder, to block the flow of urine11. While it isn’t yet clear what exactly it is that causes the prostate to enlarge, experts suspect that changes in the balance of sex hormones could be the culprit.
While suspected changes in sex hormones with age are often responsible for BPH, other, often more sinister conditions could lead to the same urinary symptoms as those caused by BPH12:
- Kidney stones
- Bladder stones
- Urinary tract infection
- Prostatitis, or inflammation of the prostate
- Problems with the nerves controlling the bladder
- Urethral stricture, or narrowing of the urethra
- Scarring in the bladder neck from a previous surgery
- Cancer of the prostate or bladder
Because urinary symptoms could be caused by a host of different issues, it’s important to see a doctor as soon as you notice the development of such signs.
How Can I Reduce the Size of My Prostate?
Managing BPH involves a combination of lifestyle adjustments and medical interventions, depending on symptom severity. While lifestyle changes can alleviate mild symptoms and improve overall prostate health, medical treatment or surgery may be necessary for more significant cases.
Lifestyle Approaches
Dietary Changes13:
- Consume a diet rich in fruits, vegetables, whole grains, nuts, seeds, and fish with omega-3 fatty acids. These foods provide antioxidants and anti-inflammatory nutrients that may reduce prostate enlargement.
- Avoid processed foods, excessive saturated fats, and sugary items that contribute to inflammation.
Exercise14:
- Regular physical activity like walking, swimming, or cycling can help control body weight, which is linked to reduced risk of BPH.
- Yoga can help strengthen and support pelvic floor muscles.
- Other pelvic floor exercises can help improve bladder control.
- Improved circulation through exercise also supports better prostate health.
Stress Management15:
Chronic stress can worsen urinary symptoms by causing tension in pelvic muscles. Relaxation techniques such as meditation or yoga can help reduce stress levels.
- Limit Alcohol and Caffeine16:
- Excessive alcohol intake and caffeine consumption can irritate the bladder and worsen urinary symptoms.
Medical Approaches
Medications:
- Alpha-blockers (e.g., tamsulosin, alfuzosin) relax bladder muscles to improve urine flow17.
- 5-alpha reductase inhibitors (e.g., finasteride, dutasteride) shrink the prostate by blocking the effects of DHT18.
- Phosphodiesterase inhibitors (e.g., tadalafil) may also relieve urinary symptoms associated with BPH19.
Minimally Invasive Procedures20:
- Techniques like transurethral microwave thermotherapy (TUMT), water vapor, thermal therapy, or prostatic artery embolization (PAE) reduce prostate size with minimal recovery time.
Surgical Options2:
- Procedures such as transurethral resection of the prostate (TURP), laser therapy (e.g., GreenLight laser), or holmium laser enucleation (HoLEP) are effective for severe cases.
- UroLift implants can widen the urethra without removing tissue, offering relief with fewer sexual side effects.
Does Drinking Water Help an Enlarged Prostate?
Staying hydrated is essential for urinary and prostate health, especially for individuals with BPH. Drinking adequate water helps dilute urine, reducing bladder irritation and the risk of urinary tract infections (UTIs), which are more common in men with an enlarged prostate21. It also supports overall urinary function and helps flush toxins from the body, which can alleviate some symptoms of BPH.
While hydration is crucial, excessive fluid intake before bedtime can worsen nocturia (frequent nighttime urination), a common symptom of BPH. To minimize nocturia, it is advisable to reduce fluid consumption in the evening and avoid drinking fluids 2-3 hours before bed.
Ultimately, while it is good for prostate health, drinking more water won’t affect the size of your prostate.
How Do I Examine My Prostate?
Examining your prostate is an important aspect of men’s health, but it’s important to know that self-examination is not recommended. Instead, prostate examinations should be performed by trained healthcare professionals.
Professional Examination Methods
Digital Rectal Exam (DRE)
The DRE is a common and important method used by doctors to examine the prostate. During this procedure:
- A doctor inserts a lubricated, gloved finger into the patient’s rectum.
- The prostate gland is felt for any lumps, enlargements, or areas of hardness.
- The exam typically lasts less than a minute and should not be painful, though it may be uncomfortable.
Prostate Specific Antigen (PSA) Test
This blood test measures the level of PSA, a protein produced by the prostate gland. Elevated PSA levels can indicate prostate issues, including cancer, though other factors can also cause high PSA levels.
Imaging Tests
In some cases, doctors may recommend additional tests such as prostate ultrasound or MRI scans.
Summary: Prostate Enlargement: What Does It Mean?
Prostate enlargement, or benign prostatic hyperplasia (BPH), is a common condition in aging men that can cause urinary symptoms and complications like infections or kidney issues. While not cancerous, BPH shares symptoms with more serious conditions, making medical evaluation essential. Causes include hormonal changes, and symptoms range from frequent urination to weak urine flow. Management options include lifestyle changes, medications, and surgical treatments. Staying hydrated helps but doesn’t shrink the prostate. Prostate exams, like digital rectal exams and PSA tests, are crucial for diagnosis. Consulting a doctor is recommended for proper evaluation and treatment of BPH-related symptoms.
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