Benign Prostatic Hyperplasia (BPH)
What is Benign Prostatic Hyperplasia (BPH)?
Benign prostatic hyperplasia is a noncancerous enlargement of the prostate gland. The prostate is a small gland that sits below the bladder and surrounds the urethra, the tube that carries urine out of the body. As men age, the prostate naturally grows larger. This growth can squeeze the urethra and make it harder to urinate.
BPH is one of the most common health issues for men over 50. About half of men in their 60s have some degree of prostate enlargement. By age 85, that number rises to about 90 percent. The condition develops slowly over many years and is not related to prostate cancer.
While BPH is not dangerous on its own, it can significantly affect quality of life. The urinary symptoms can interfere with sleep, work, and daily activities. Understanding your prostate health through regular testing helps you catch changes early and manage symptoms before they become severe.
Symptoms
- Difficulty starting urination or weak urine stream
- Frequent urination, especially at night
- Sudden urgent need to urinate
- Feeling like the bladder is not fully empty after urinating
- Stopping and starting during urination
- Dribbling at the end of urination
- Straining to urinate
- Blood in urine in some cases
Many men with mild BPH have no symptoms at first. The prostate can enlarge gradually without causing noticeable problems. Symptoms typically develop slowly over time as the enlargement progresses and puts more pressure on the urethra.
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Causes and risk factors
The exact cause of benign prostatic hyperplasia is not fully understood, but hormones play a key role. As men age, the balance of sex hormones in the body changes. Testosterone levels decline while other hormones like estrogen remain steady or increase. These hormonal shifts may trigger prostate cell growth. Dihydrotestosterone, a more potent form of testosterone, also accumulates in the prostate with age and promotes cell multiplication.
Age is the biggest risk factor for BPH. The condition rarely causes symptoms before age 40 but becomes increasingly common after 50. Family history matters too. Men with a father or brother who had BPH are more likely to develop it. Other risk factors include obesity, lack of physical activity, diabetes, and heart disease. Some research suggests that diet and lifestyle choices may influence prostate growth over time.
How it's diagnosed
Doctors diagnose benign prostatic hyperplasia through a combination of physical exam, symptom review, and blood tests. A digital rectal exam allows the doctor to feel the size and shape of the prostate. Urine tests check for blood or infection that might explain urinary symptoms. Blood tests measuring prostate markers help rule out other conditions and track prostate health over time.
Prostate-specific antigen or PSA is a protein produced by the prostate that increases when the gland is enlarged. Both total PSA and free PSA levels provide insight into prostate health. The PSA free to total ratio helps distinguish between BPH and other prostate issues. Prostatic acid phosphatase can also be elevated in BPH. Rite Aid offers testing for PSA total, PSA free, PSA free to total ratio, and other prostate markers to help you monitor your prostate health throughout the year.
Treatment options
- Watchful waiting with regular monitoring for mild symptoms that do not interfere with daily life
- Limiting fluids before bedtime and reducing caffeine and alcohol intake
- Urinating on a schedule and practicing double voiding to empty the bladder completely
- Maintaining a healthy weight through balanced nutrition and regular physical activity
- Alpha blockers like tamsulosin or doxazosin to relax prostate and bladder muscles
- 5-alpha reductase inhibitors like finasteride or dutasteride to shrink the prostate
- Combination therapy using both types of medications for better symptom control
- Minimally invasive procedures or surgery for severe symptoms that do not respond to medication
Concerned about Benign Prostatic Hyperplasia (BPH)? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
BPH is a noncancerous enlargement of the prostate gland, while prostate cancer involves malignant cell growth. BPH does not increase your risk of developing prostate cancer. However, both conditions can cause elevated PSA levels and similar urinary symptoms, which is why proper testing and medical evaluation are important.
Most men should begin discussing prostate health with their doctor around age 50. Men with a family history of prostate problems or other risk factors may benefit from starting earlier, around age 40 to 45. Regular PSA testing helps establish a baseline and track changes over time as you age.
There is no guaranteed way to prevent BPH since aging and genetics play major roles. However, maintaining a healthy weight, staying physically active, and eating a diet rich in vegetables and fruits may help reduce risk. Limiting red meat, managing diabetes, and avoiding excessive alcohol may also support prostate health.
BPH typically develops slowly over many years. Some men experience gradual worsening of symptoms, while others remain stable for long periods. Regular monitoring through blood tests and symptom tracking helps you and your doctor understand your individual progression and decide when treatment is needed.
An elevated PSA can indicate several conditions including BPH, prostate infection, or prostate cancer. Higher PSA levels are common with benign prostate enlargement because the gland produces more of this protein as it grows. Your doctor will consider your age, symptoms, and the PSA free to total ratio to interpret results and determine if further testing is needed.
Not everyone with BPH needs medication. If your symptoms are mild and do not significantly affect your quality of life, watchful waiting may be appropriate. Lifestyle changes like limiting evening fluids and reducing caffeine can help manage minor symptoms. Medication becomes necessary when symptoms interfere with sleep, work, or daily activities.
In rare cases, severe untreated BPH can lead to kidney problems. When the enlarged prostate blocks urine flow for extended periods, pressure can build up in the bladder and kidneys. This is why monitoring symptoms and getting regular checkups is important. Most men who receive appropriate treatment do not experience kidney complications.
Several lifestyle adjustments can reduce BPH symptoms. Limit fluid intake in the evening to decrease nighttime urination. Reduce or avoid caffeine and alcohol, which can irritate the bladder. Stay physically active to support overall health and maintain a healthy weight. Practice double voiding by urinating, waiting a moment, then trying again to empty your bladder more completely.
Testing frequency depends on your age, symptoms, and baseline PSA levels. Many doctors recommend annual PSA testing for men over 50 with no symptoms. If you have BPH or elevated PSA, your doctor may want more frequent monitoring, such as every 6 months. Regular testing helps track changes and catch potential problems early.
Some men use supplements like saw palmetto or beta-sitosterol for BPH symptoms, but research on their effectiveness is mixed. Some studies show modest benefit while others find no significant improvement compared to placebo. If you are considering supplements, discuss them with your doctor first, especially if you are taking other medications.