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Summary

  • BPH (or BPE) is a condition that causes the prostate to expand and become enlarged.
  • It commonly affects men over 50 and can create urinary problems.
  • It’s managed with medication or lifestyle changes, depending how severe symptoms are.
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Benign prostatic hyperplasia (BPH)

What is BPH?

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.

Who gets BPH?

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.

How common is BPH?

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.

Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on August 02, 2022.
Meet Daniel  
Daniel
This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on August 02, 2022. Next review due on August 01, 2025.

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.

Benign prostatic hyperplasia (BPH)

What causes BPH?

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.

What are the symptoms of an enlarged prostate?

If you have BPH, you might notice:

  • your flow of urine becoming weaker
  • having a feeling that your bladder isn’t empty
  • not being able to start urinating easily
  • dribbling urine after you finish
  • stopping and starting as you pee
  • needing to go to the toilet often and going at night
  • urgency
  • leaking urine before you can make it to the toilet.

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.

Can BPH lead to other 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.

Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on August 02, 2022.
Meet Daniel  
Daniel
This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on August 02, 2022. Next review due on August 01, 2025.

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.

Benign prostatic hyperplasia (BPH)

What medications are there for BPH?

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.

Is there a ‘best’ treatment for BPH?

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.

Does BPH always need treatment?

An enlarged prostate doesn’t always need treatment. Sometimes making lifestyle changes can help to ease symptoms. For example:
  • Reducing how much coffee, alcohol, fizzy drinks and artificial sweeteners you have
  • Drinking less fluids in the late afternoon and evening, so you don’t need to go to the toilet as much at night (and drinking more fluids in the morning instead)
  • Go to the toilet before you leave the house
  • Try not to strain when passing urine
  • Talking to your clinician about any medication you’re using
  • Eating plenty of fibre so you don’t become constipated (being constipated can put pressure on the bladder)
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.
Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on August 02, 2022.
Meet Daniel  
Daniel
This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on August 02, 2022. Next review due on August 01, 2025.

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.

Benign prostatic hyperplasia (BPH)

FAQ: Benign prostatic hyperplasia (BPH)

Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.

How is BPH diagnosed?

Answer:
If you get symptoms like pain when passing urine, or difficulty going to the toilet, you should let a doctor know. If they think you might have an enlarged prostate, they’ll examine you and might do some blood tests to see that your kidneys are working properly. Sometimes, you might be referred to a specialist (urologist) for more in-depth tests.

Are there tests for BPH?

Answer:
There are some tests to check that the problem causing symptoms is enlarged prostate, and these help to rule out other causes. For example, you’ll probably have a kidney function test to make sure your kidneys are working as they should. This is done with a blood sample.

Another test they might do is a urine test, to see if there’s sugar or blood. If there is, it may mean that the problem is being caused by diabetes or an infection.

Sometimes you might also be recommended to take a PSA test, to check that you don’t have prostate cancer.

Can you get side effects from BPH treatment?

Answer:
You can get side effects from BPH treatment. More common side effects of alpha blockers are dizziness or ejaculation problems. Some men who use 5 alpha-reductase inhibitors like Proscar can sometimes get erectile dysfunction or loss of libido, but these tend to go away after a time. Sometimes they persist, but usually stop after stopping treatment.

Does BPH treatment always work?

Answer:
For some men, just making lifestyle changes to make urination easier can be enough. But beyond this, treatments like Proscar and Avodart have shown in clinical trials that they can effectively stop BPH from getting worse, by stopping the prostate from growing. And alpha blockers like Tamsulosin have shown to be effective in increasing urinary flow.

But if you take treatment and feel like it isn’t working, it’s best to let us know, so we can discuss other options with you.

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This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on August 02, 2022. Next review due on August 01, 2025.
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