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One of the most common ailments that men have to deal with – and the one they least want to talk or think about – involves the prostate. By the time they are 80 years old, 80 percent of men will have experienced some sort of prostate condition. But it should be reassuring to know that the most common prostate problems do not pose serious health risks – and all prostate problems are better handled when detected early. Here’s what you need to know to relax and stay healthy.

Benign Prostatic Hyperplasia (BPH) is a benign (non-cancerous) enlargement of the prostate gland. BPH is very common in men over 50 years old. It affects about 10 percent of men under the age of 40, and increases to about 80 percent by 80 years of age. BPH occurs more frequently among men of American and European decent, and is less common in men with Asian heritage.

The prostate gland is found only in men. It is about the size of a walnut, and sits just below the bladder in front of the rectum. The urethra (the tube that carries urine from the bladder) runs through the prostate. The role of the prostate gland is to manufacture a viscous liquid that is part of semen (the fluid that contains sperm).

Enlargement of the prostate occurs in the central area of the gland, unlike prostate cancer, which typically develops in the outer region where most of the glandular tissue is located.

Causes and Symptoms

Although the actual cause of BPH is not completely understood, experts believe it is closely tied to hormone levels. There are two leading theories. One is that BPH is from a relative excess of testosterone, an androgen or male hormone. Testosterone is produced continuously during a man’s lifetime, and the prostate converts testosterone to another hormone called dihydrotestosterone (DHT), which has powerful effects in the gland. DHT influences the activity of cells in the prostate and plays a crucial role in prostate growth during puberty and young adulthood. It is believed that DHT may continue to stimulate cell growth later in life, leading to BPH.

Other experts suspect that estrogen may be involved, as estrogen is also present in men. As men get older, testosterone levels decrease and the ratio of estrogen to testosterone increases. Estrogen may act in combination with other hormones to stimulate prostate cells and cause enlargement of the gland. Other factors include:  

• Age. Men over 50 are at a higher risk.
• American or European descent. These men seem to have a higher rate of BPH than other regions of the world.
• Marriage. Married men, for reasons unknown, are at a higher risk.
• Family history. This risk is slightly higher if close male relatives have BPH.

Symptoms of BPH include:

• Difficulty urinating, either in starting urination or completing it. (When the prostate enlarges, it begins to block the flow of urine.) Men are often unable to empty their bladder completely and need to urinate frequently. This is the most troubling symptom and may require medical attention.
• Excessive nocturnal (nighttime) urination is common.
• Unpredictable leakage, or pain or irritation when urinating.
• Blood in the urine (due to small veins of the urethra bursting when a man strains to urinate).

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. 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. However, continued growth of the gland may eventually cause a complete blockage of urine flow. This is the most serious complication and often requires surgery. Other possible complications include bladder stones and urinary tract infections. BPH does not seem to impair sexual function.

BPH is not likely to increase the risk of prostate cancer, as BPH occurs in the central area of the prostate, while prostate cancer occurs in the outer region of the gland. One study found no relation between BPH and prostate cancer. The symptoms of BPH and prostatic cancer can be similar, however, and having one does not preclude you from having the other.

If BPH is suspected, a physical exam (including a digital rectal exam to palpate the prostate) should be done. A physician can determine if the prostate is enlarged, if there are any nodules (which could indicate cancer), or if there is tenderness (which may indicate an infection). A blood test that measures the level of prostate-specific antigen (PSA) is also taken. Levels are elevated in about 30 to 50 percent of men with BPH, but increased PSA levels can also indicate prostate cancer. Further evaluation, including an ultrasound, should be done to rule out cancer.

Suggested Lifestyle Changes

The following can help to reduce the risk of developing BPH, and minimize its symptoms:

• Get regular exercise. Regular aerobic exercise, such as daily walking, can cut the risk of developing BPH by 25 percent, as well as reduce the risk of prostate cancer.
• Avoid symptom triggers such as caffeine and alcohol which increase the need to urinate and may irritate the bladder. Avoid constipation by increasing fiber in your diet. The pressure from constipation may worsen the symptoms of BPH.
• Get regular check-ups. The National Institute on Aging recommends that men get regular medical checkups including a prostate exam. 

Nutrition and Supplements

The following nutritional changes and supplements may may help address the symptoms of BPH. Keep in mind that it may take at least eight weeks of using supplements before you see improvement of symptoms.

• Avoid saturated fats and trans-fats, focusing instead on the healthier monounsaturated and omega-3 fats.
• Eat more soy. Asian men have a lower risk of BPH and some researchers believe it is related to their intake of soy foods.
• Try Saw palmetto (Serenoa repens). There is clinical evidence that Saw palmetto can help shrink the size of the prostate, and it may help promote healthy prostate function. You should inform your health care practitioner you are using this product.
• Other herbs and nutrients. Pygeum (Pyguem africanum) and stinging nettle root (Urtica dioica) may be helpful in addressing the symptoms of BPH. Green tea extract, selenium and lycopene have also been shown to help maintain and promote normal prostate function.