Prostate Health: Benign Prostatic Hyperplasia (BPH)
Prostate Health: Benign Prostatic Hyperplasia (BPH) is a noncancerous (benign) growth of the prostate gland. BPH is very common in men over 50 years old. It affects about 10% of men under the age of 40, and increases to about 80% by 80 years of age. BPH is more common among American and European men than Asian men.
What is benign prostatic hyperplasia?
The prostate gland is only in men. It is about the size of a walnut, and sits just below the bladder in front of the rectum. The urethra (a tube that carries urine) runs through the prostate. The role of the prostate gland is to manufacture a fluid that is part of the semen (the fluid that contains sperm).
As men reach their 40’s, the prostate gland begins to enlarge through a process called cell multiplication, also known as benign prostatic hyperplasia:
- Benign means noncancerous,
- Prostatic refers to the prostate, and
- Hyperplasia is defined as excess cell replication.
This overgrowth occurs in the central area of the prostate, unlike prostate cancer, which develops in the outer region where most of the glandular tissue is located.
What are the symptoms of benign prostatic hyperplasia?
When the prostate enlarges, it begins to block the flow of urine. Men may have difficulty urinating, either in starting urination or completing it. Men are often unable to empty their bladder completely and need to urinate frequently. This is the most serious complication and requires medication attention. Nocturnal (nighttime) urination is common. Men may also have unpredictable leakage, or they experience pain or irritation when urinating. The need to urinate becomes more urgent over time. Small veins of the urethra may burst when a man strains to urinate, and this can cause blood to appear in the urine.
The size of the prostate does not determine the severity of the symptoms. A very large prostate could have minimal symptoms and a small prostate could cause a great deal of discomfort.
What causes benign prostatic hypertrophy?
Although the actual cause is not completely understood, experts believe it may be due to an increase in the androgen (male) hormones. Testosterone is one type of androgen and is produced continuously in a man’s lifetime. The prostate converts testosterone to another hormone called dihyrotestosterone (DTH), which is much more powerful. DTH causes the cells in the prostate to grow and actually plays a role in prostate growth in puberty and young adulthood. It is believed that DTH also stimulates cell growth later in life, leading to BPH. Other experts suspect that estrogen may be involved – estrogen is also present in men. As they get older, testosterone levels decrease and the ratio of estrogen to testosterone increases, which may cause prostate enlargement.
What are the risk factors?
- Men over the age of 50 are at higher risk
- American or European men seem to have a higher rate of BPH than other regions
- Married men, for reasons unknown
- Possibly a family history, but this risk is slight
Is benign prostatic hypertrophy serious?
Although the symptoms can be quite distressing, BPH is usually a manageable condition. The severity of symptoms and how men react to them varies. Because the prostate grows very slowly, complications are quite rare. Obstructive symptoms causing urinary retention indicate an obstruction of the bladder. It may actually cause a complete blockage of urine flow. This is the most serious complication and requires emergency surgery. Other possible complications include bladder stones and urinary tract infections. BPH does not seem to impair sexual function.
Can benign prostatic hypertrophy increase my risk for prostate cancer?
Not likely, according to the latest research. BPH occurs in the central area of the prostate, while prostate cancer affects the outer region. One study found no relation between BPH and prostate cancer.
How is it diagnosed?
If BPH is suspected, a physical exam should be done that includes a rectal exam. A physician can determine if the prostate is enlarged, if there are any nodules (which could indicate cancer), or for any tenderness (which may indicate an infection). A blood test that measures the levels of prostate-specific antigen (PSA) is also taken. Results are high in about 30 to 50 percent of men with PBH, but this could also indicate prostate cancer. Further evaluation should be done to rule out cancer, such as an ultrasound examination.
Nutritional Supplements and BPH
Although diet and lifestyle habits do not seem to have any impact on the development of BPH, many studies have suggested Saw Palmetto (Serenoa repens). Although this herb does not help shrink the size of the prostate, it may help with some the common urinary problems that occur in the early stages of BPH.