What Every Man Should Know About BPH

The most common male-specific health condition in the U.S. is benign prostatic hyperplasia or simply known as BPH. Up to one-third of all men in the U.S. will experience BPH by the time they reach age 60. This figure jumps to 90% for men 80 years or older and many of them will have no idea they have it due to a lack of symptoms.

According to urologist Dr. David Samadi, Benign prostatic hyperplasia (BPH) is a condition that appears when the prostate gland is enlarged. This gland about the size of a small apricot is what produces fluid in semen and which surrounds the urethra that carries urine from the bladder to the penis. With age, it has a tendency to grow, putting a squeeze on the flow of urine along with other symptoms.

Here are the facts Dr. Samadi thinks all men should know about their prostate and BPH:

What does “hyperplasia of the prostate” mean?

Sometimes a man may hear the term “hyperplasia of the prostate.” This simply means the same thing as BPH or an enlarged prostate. The word “hyperplasia” means an enlargement of an organ or tissue caused by an increase in the reproduction of its cells. Hyperplasia of the prostate indicates the walnut-shaped gland has grown possibly affecting the male urinary and reproductive systems.

The word benign means “not cancerous.” BPH is not linked to cancer of the prostate and does not increase a man’s risk of developing prostate cancer, even though the symptoms of BPH and prostate cancer are similar.

What causes BPH?

The causes of BPH are not completely understood making it difficult to recommend certain lifestyle practices men should be following to reduce their risk. What is known is that BPH does not develop in men whose testicles were removed before puberty. This has led some researchers to believe factors related to aging and the testicles may cause benign prostatic hyperplasia.

One thing we know for certain is that BPH is much more common in older men than younger men. Changes that occur with male sex hormones as part of the aging process appear to play a role in the enlargement of the prostate gland. Androgens (male hormones) affect prostate growth.

The most important androgen is testosterone, which is produced in the testes throughout a man’s life. During the course of their lives, men produce the male hormone, testosterone, and small amounts of a female hormone called estrogen.

As men grow older, the levels of active testosterone in their blood decreases, leaving a higher proportion of estrogen. Scientific studies suggest that there is a link between higher levels of estrogen within the prostate and the occurrence of BPH.

Researchers have also speculated on another theory focusing on a different male hormone as a possible reason for prostate enlargement. The prostate converts testosterone to another powerful androgen called dihydrotestosterone (DHT). DHT stimulates cell growth in the tissue that lines the prostate gland (the glandular epithelium) and is the major cause of the rapid prostate enlargement that occurs between puberty and young adulthood. DHT can also be a cause of prostate enlargement for older men.

According to research, even when the testosterone levels drop, older men still produce and accumulate high amounts of DHT in the prostate, which can encourage prostate cells to grow. Benign prostatic hyperplasia does not appear in men who do not produce DHT.

What are the most common symptoms of BPH?

Most men do not know they have BPH until the symptoms start bothering them. Dr. Samadi states that frequent signs of the disease can include an urgent or frequent need to urinate, slow flow, difficulty starting a urine stream, dribbling or not being able to completely empty the bladder or having to wake up frequently during the night to go to the bathroom. All men are unique and therefore not all men with BPH will experience these symptoms. Depending on which area of the prostate grows, there will or won’t be urinary obstructions.

Can BPH be prevented?

While there is no definitive answer to exactly how to prevent BPH, one of the best things any man can do is to remember that heart health leads to prostate health. Any lifestyle change a man is considering in order to protect his prostate and reduce the risk of BPH needs to be focused on reducing the risks of heart disease. This includes maintaining normal blood pressure, blood sugar, and cholesterol level, along with a healthy weight and waist size.

Speaking of healthy weight and waist size, research has shown that besides age, men who are overweight and obese are more likely to develop BPH than men in a normal weight range.

When men carry excess weight, especially on their hips or waist, this can play a role in increasing the risk of BPH. Men can determine if they are carrying excess weight by calculating their body mass index (BMI), a measure of their weight in relation to their height. Here is how to calculate BMI:

Formula: weight (lb) / [height (in)]² x 703

• Step 1 – Multiply weight in pounds by 703
• Step 2 – Multiply height in inches by itself
• Step 3 – Divide the result in step 1 by the result in step 2

Here is an example of doing the math using a man who weighs 215 pounds and is 5‘10” inches tall or 70 inches:

Step 1 – 215 x 703 = 151,145

Step 2 – 70 x 70 = 4,900

Step 3 – 151,145 divided by 4,900 = 30.8 or 31 BMI (obese)

The weight categories for BMI are:

Less than 18.5 – underweight

18.5 to 24.9 – normal weight

25 to 29.9 – overweight

30 or higher – obese

There is also an online BMI calculator, such as the one provided by the National Heart, Lung, and Blood Institute

There is no magic solution for losing excess body weight, but there are many tips and diets that can take you on the journey of losing pounds in order to reach a healthier body weight, reduce men’s risk of developing BPH and other health conditions.

Reducing waist size is imperative to reducing the risk of chronic health conditions. It won’t happen overnight but slow, steady progress can help whittle waist weight gain lessening the likelihood of BPH. Here are smart, sustainable ideas putting men on the right path toward successful weight loss:

• Eat regular nutritious meals – Avoid skipping meals and keep mealtimes as consistent as possible. This reduces hunger pangs causing you to crave high-calorie, convenience foods such as chips, sweets, or other foods and beverages high in fat, sugar, and calories. Going no more than 4 hours without eating, helps stabilize blood sugars and keeps the metabolism running smoothly. Also, consume between 25-30 grams of protein and at least 10 grams of fiber at each meal. Both protein and fiber slow down digestion, keeping hunger at bay. Protein also helps men maintain muscle mass while pounds come off.
• Keep portion sizes in check – Even when making healthy choices, calories can add up. A good place to start on knowing proper portion sizes is to plan meals using the MyPlate method – half of the plate filled with vegetables, one-fourth with a lean protein and the other one-fourth filled with a healthy starch or whole grain.
• Replace sugary beverages – Drink water or unsweetened tea instead of soda, sports drinks, energy drinks, lemonade, or any other drink with sugar in it.
• Limit alcohol intake – It’s not necessarily that beer or any other beverage containing alcohol can turn a trim waistline into a beer belly. Any kind of calories – whether from alcohol, sugary beverage, or oversized portions of food – can increase belly fat. However, alcohol intake is associated with bigger waists, because when you drink alcohol, the liver burns alcohol instead of fat. Also, a typical beer has 150 calories and if a man downs several in one sitting, that’s a serious calorie overload. And don’t forget calories from food men use to wash down with alcohol – pizza, wings, and other fried foods. It all adds up very quickly.
• Focus on 30 grams of fiber daily – Choose more fruits, vegetables, whole grains, nuts, and beans. These foods are full of fiber taking longer to digest giving a feeling of fullness. Aim to eat at least 2 fruits and 2 vegetables, a small handful of nuts and use beans in at least one meal each day.
• Exercise regularly – Aim for at least 150 minutes of moderate to vigorous exercise each week of about 30 minutes, 5 days a week. The greater the frequency, duration and intensity of physical activity, the more it enhances weight loss particularly in the abdominal area.

By putting these ideas into practice, most men should find themselves reaching a healthier body weight without losing muscle mass and without going on fad diets.

Dr. Samadi’s advice on what men can practice every day to manage BPH symptoms

There are some things men can do that may help reduce how much BPH affects their quality of life:

• Men should take their time and relax when urinating.
• Practice “double voiding” which means emptying the bladder as much as possible the first time, relaxing for a few moments, and then urinating again.
• Spread fluid intake throughout the day. Limit fluid intake in the evening if night time urination is a problem.
• If possible, avoid medications that can worsen the symptoms. These might include decongestants, antidepressants, antihistamines, allergy pills, pain medicine and any form of testosterone intake. You should always discuss with your doctor if the medicine you need to take affects your BPH.