An enlarged prostate is a very common condition for men over the age of 50. It often leads to symptoms like a weak urinary stream, difficulty starting to urinate, or a frequent urge to go during the day and night.
In most cases, this growth is caused by benign prostatic hyperplasia (BPH), which is a non-cancerous condition linked to hormonal changes. This process is typically a natural part of the aging process for many men.
However, factors such as family history, chronic inflammation, and lifestyle choices also play a role in prostate health. A urologist can evaluate your symptoms and suggest treatments ranging from lifestyle adjustments to medication or surgery.
Main symptoms
The primary symptoms associated with an enlarged prostate include:
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A weak or interrupted urine stream
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Difficulty starting to urinate
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Straining or pushing to pass urine
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A sensation that the bladder is not completely empty
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Frequent urination during the day and several times at night
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A sudden, urgent need to urinate that is hard to control
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Spending more time in the bathroom to finish urinating
In more severe cases, an enlarged prostate can cause a total inability to urinate or the presence of blood in the urine. These symptoms require immediate medical attention.
The symptoms usually develop gradually as the growing prostate presses against the urethra. This pressure makes it harder for the bladder to push urine out, a change that becomes increasingly common after age 50.
Does an enlarged prostate cause erectile dysfunction?
Generally, an enlarged prostate does not directly cause impotence. However, some men may experience erectile dysfunction as a side effect of certain medications used to treat benign prostatic hyperplasia.
Additionally, some surgical procedures can affect ejaculation and, in rarer cases, erectile function. If you notice any changes in your sexual health, it is important to discuss them with your urologist.
Online symptom test
To help determine your risk for prostate issues, select the symptoms you are currently experiencing:
This symptom test is intended for initial guidance only; it is not a diagnosis and does not replace a formal evaluation by a medical professional.
How a diagnosis is confirmed
A urologist diagnoses an enlarged prostate by reviewing your symptoms and medical history. They often use standardized questionnaires to measure the frequency and severity of your urinary issues.
The doctor may then perform a physical examination, which typically includes a digital rectal exam (DRE) to check the size and texture of the prostate.
Blood tests, such as a PSA (Prostate-Specific Antigen) test, and urine tests may be ordered to rule out infections or other conditions. In some instances, imaging like an ultrasound is used to measure prostate size and check how well the bladder is functioning.
Possible causes
An enlarged prostate can be triggered by several factors:
1. Aging
Prostate growth is closely linked to the aging process. Starting around age 50, many men experience a gradual increase in prostate cells, known as benign prostatic hyperplasia (BPH). This is a natural result of the hormonal shifts that occur as men get older.
2. Genetics
Some men are more likely to develop an enlarged prostate due to their family history. Having close relatives with BPH increases your risk, suggesting that inherited traits influence how the gland develops over time.
3. Inflammation or recurring infections
Chronic prostate inflammation or frequent urinary tract infections (UTIs) can change the structure of the gland. While not the primary cause, these conditions can worsen symptoms or speed up prostate growth.
4. Lifestyle factors
Habits such as a poor diet, excessive alcohol use, smoking, and physical inactivity can contribute to gland enlargement. Furthermore, conditions like obesity, insulin resistance, and metabolic syndrome are linked to a higher risk of prostate hypertrophy.
Treatment options
Urologists tailor treatment based on the cause of the enlargement and the severity of the symptoms. Options include:
1. Medications
Doctors usually begin treatment with medication. Common FDA-approved options include:
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Alpha-blockers: These relax the muscles in the prostate and bladder neck to make urination easier (e.g., tamsulosin, doxazosin).
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5-alpha reductase inhibitors: These help shrink the prostate by blocking hormonal signals (e.g., finasteride, dutasteride).
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Antibiotics: These may be prescribed if the enlargement is complicated by bacterial inflammation (e.g., ciprofloxacin).
2. Surgery
If symptoms are moderate to severe or medications do not provide relief, surgical procedures may be recommended. Modern, minimally invasive options include UroLift (which holds the urethra open), Rezum (which uses water vapor to reduce tissue), and iTIND (which reshapes the urethral opening).
Traditional surgeries, such as a Transurethral Resection of the Prostate (TURP), involve removing excess tissue through the urethra. For very large prostates, an open or laparoscopic prostatectomy may be performed to remove the inner part of the gland through an abdominal incision.
3. Complementary care and habits
Specific lifestyle adjustments can significantly improve daily comfort:
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Avoid "holding it" for too long and take your time to empty your bladder completely.
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Limit caffeine and alcohol, especially in the evening, to reduce nighttime bathroom trips.
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Stay active with regular exercise to improve circulation and aid weight management.
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Be cautious with over-the-counter decongestants and certain antihistamines, as they can make it harder to urinate.
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Manage stress to help reduce the frequency of urgent bathroom visits.
While some individuals explore natural extracts like saw palmetto, Pygeum africanum, or stinging nettle, these are not FDA-approved to treat or cure BPH. Instead, doctors may suggest FDA-approved daily medications like low-dose tadalafil (Cialis) to help improve urinary flow and reduce urgency.
Is there a cure for an enlarged prostate?
Since an enlarged prostate is typically a part of the natural aging process, there is no permanent "cure" that stops the gland from growing entirely. However, modern treatments are highly effective at managing the condition and maintaining a high quality of life.