What Causes Benign Prostatic Hyperplasia?

October 17, 2023

Benign prostatic hyperplasia (BPH) is the medical condition and term for an enlarged prostate. As a man ages, the prostate goes through two primary growth periods: first in puberty when it doubles in size then again beginning around twenty-five when the prostate continues to slowly grow for the rest of a man's life. Benign prostatic hyperplasia typically occurs during the later growth stage. An enlarging prostate squeezes the urethra while the bladder wall thickens, which can eventually cause the bladder to weaken and make it hard to empty fully. As the urethra narrows and the bladder becomes unable to empty completely, causing symptoms to develop such as incontinence, weak urinary stream, excessive nighttime urination, frequent urination, and a strong and frequent urge to urinate.

Benign prostatic hyperplasia is not cancer, and it's usually viewed as a normal part of aging. The following are the most common causes behind the condition.

Hormonal Changes

Hormonal changes that usually come with age are associated with the development of benign prostatic hyperplasia. It's known that BPH does not occur in men whose testicles were removed before puberty. Men produce testosterone throughout their life although testosterone levels begin to decline at a rate of about one percent after thirty. As the amount of active testosterone in the blood decreases, there is a higher proportion of estrogen. It's been suggested benign prostatic hyperplasia may be the result of this higher amount of estrogen in relation to testosterone in the prostate that increases the activity of a substance that promotes the growth of prostate cells.

There has also been a scientific focus on DHT, a male hormone that affects prostate growth and development. Some research indicates older men can continue to accumulate high DHT levels in the prostate even as testosterone levels decline. A build-up of DHT may encourage the prostate to grow. Research has found men who do not produce DHT do not develop benign prostatic hyperplasia.

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While the causes of benign prostatic hyperplasia aren't very well understood, the condition usually occurs in older men. As you age, your body naturally produces lower levels of testosterone. It's believed changing levels of testosterone and another male hormone called DHT plays a role in prostate growth that occurs with age.

The symptoms and occurrence of benign prostatic hyperplasia increase with age. Between the ages of thirty-one and forty, just one in twelve men has BPH. The condition affects about fifty percent of men between fifty-one and sixty. Around ninety percent of men older than eighty have benign prostatic hyperplasia.

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Family History

There is a strong hereditary element to benign prostatic hyperplasia. In one major study, a group of men between forty and seventy-nine answered a questionnaire that included a detailed family history. Twenty-one percent of the men in the study reported history in their family of an enlarged prostate. Men who had a known history in their family of an enlarged prostate were more likely to develop benign prostatic hyperplasia and more likely to have an impaired peak urinary flow rate. The risk is greatest for men who had relatives diagnosed with benign prostatic hyperplasia at a younger age.

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How you live can affect your risk of developing benign prostatic hyperplasia. Several lifestyle factors influence the development of BPH including obesity, a lack of physical exercise, and a high-sugar diet, which can lead to diabetes. There may also be an association between cigarette smoking and benign prostatic hyperplasia.

Exercise is one of the most vital factors in your control. Research has found regular exercise can reduce the risk of benign prostatic hyperplasia and reduce urinary tract symptoms. Moderate to vigorous exercise can even reduce the risk and symptoms by up to twenty-five percent, according to a Havard-based Health Professionals follow-up study. Physicians typically recommend a moderate exercise regimen to treat benign prostatic hyperplasia.

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Heart Disease And Diabetes

Two major diseases have a relationship with benign prostatic hyperplasia: heart disease and diabetes. While heart disease does not cause BPH, the same risk factors for heart disease like diabetes, high blood pressure, and obesity are also linked to benign prostatic hyperplasia, and heart disease can increase the risk of developing an enlarged prostate. Men with coronary artery disease often have symptoms of an enlarged prostate as well.

Diabetes is also a risk factor for an enlarged prostate as well as obesity, which can go hand-in-hand with type 2 diabetes. The higher a man's body mass index (BMI), the higher the risk of developing an enlarged prostate. Having diabetes also raises the risk of benign prostatic hyperplasia and may be one of the causes of the condition. One study found obesity, insulin resistance, and high glucose levels, all components of diabetes, can speed the progression of BPH. There may also be a link between benign prostatic hyperplasia and elevated insulin levels which work to trap blood sugar and move it into cells which can stimulate cell growth.

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