BPH in Men

April 25, 2023
Benign prostatic hyperplasia or BPH, enlarged prostate, or prostatic hyperplasia, occurs when prostate tissue continues growing unchecked as most men age.  BPH is not prostate cancer and doesn’t lead to prostate cancer, but BPH in men does become more prevalent the older a man gets.  So much so that over half of all men will have BPH by the time they reach the age of 60.  And this percentage continues increasing to the point where nearly all men will develop benign prostatic hyperplasia if they live long enough. The dictionary’s definition of prostatic hyperplasia is “The enlargement of the prostate or prostate tissue caused by an increase in the reproduction rate of its cells.”  And benign means that the condition is non-cancerous. Many men don’t want to talk about BPH, so it often goes untreated and fewer treatments are available once it is finally discussed.  Many men will also experience BPH symptoms as their prostate gets larger and begins to encroach on their urethra and possibly their bladder. The main cause of benign prostatic hyperplasia has not been definitively determined, but it is thought to stem from hormonal changes men experience as they get older.  With naturally decreasing testosterone levels as a man ages, comes comparatively higher levels of dihydrotestosterone (DHT).  This change in hormonal percentages may be a key factor that helps lead to BPH.  DHT proves beneficial to the developing prostate, but in older men, this benefit turns into a detriment.  Benign prostatic hyperplasia typically develops undetected until urinary symptoms begin to show up.  Lower urinary tract symptoms (LUTS) in men are the result of the enlarged prostate placing increasing pressure on the urethra and possibly the bladder, and restricting the flow of urine out of the bladder.  

5 Warning Signs of BPH

BPH can arise because of many factors, including age (40 and over), family history (of benign prostatic hyperplasia), race and ethnicity, exercise levels, heart disease, circulatory issues, type 2 diabetes, and ED.  The key takeaway is to seek guidance from a doctor right away if any of the symptoms below begin to appear.  The sooner these issues are addressed, the easier and better the outcome.  If an enlarged prostate is left untreated for too long, sexual side effects, urinary retention, or bladder failure can take place. Although there are many observable signs that prostatic hyperplasia is present, 5 warning signs of BPH that are common include:
  • Weak urine stream
  • Frequent urination/urgency to urinate
  • Starting & stopping/incomplete bladder emptying
  • Nocturia (frequent & chronic urination at night)
  • Difficulty in going/urinary retention

Maintaining Prostate Health

A healthy prostate has a better chance of either not experiencing BPH symptoms at all, having milder indications, or not developing issues until later.  For most men, prostatic hyperplasia can be expected as they age.  However, some factors can accelerate prostate tissue growth, including diet and lifestyle choices. There are many ways to keep one’s body and prostate healthy and minimize benign prostatic hyperplasia and its symptoms, but it all begins with a nutritious diet, maintaining a healthy weight, and participating in regular exercise.  Here are 10 tips for a healthy prostate:1,2
  • Reduce red and processed meat consumption
  • Enjoy 5 servings of fruits and vegetables daily, especially those with dark, or bright colors which likely have more antioxidants
  • Consume healthy fats such as olive and avocado oil, and nuts like almonds, pistachios, pecans, walnuts, and Brazil nuts
  • Avoid drinking too much in the evening before bed, especially beverages containing alcohol or caffeine since they are diuretics and stimulate the bladder even more
  • Keep a handle on stress (think meditation)
  • Stop smoking
  • Drink plenty of water to stay hydrated well each day
  • Know your prostate risk factors and get regular checkups
  • Relegate sugary drinks, such as concentrated fruit juice and sodas, to special treats
  • Opt for whole-grain bread, pasta, and cereal over their white counterparts

Shrinking an Enlarged Prostate

Getting an enlarged prostate to go back to its normal size by shrinking it can be a tall task without the right medication or surgery.  Men have been trying to shrink their prostate since the beginning of time, and although benign prostatic hyperplasia is a condition all its own, other afflictions can lead to prostatic hyperplasia.  Those conditions include prostatitis (a frequently painful inflammatory disorder) and prostate cancer.  A thorough examination and work-up by a urologist are necessary to determine whether the enlarged prostate is the result of BPH, prostatitis, cancer, or something else. The normal prostate size by age across a wide spectrum of racial and ethnic groups is as follows:3 25g to 30g for men in their 40s 30g to 40g for men in their 50s 35g to 45g for men in their 60s The transition zone of the prostate, which is the source of prostate size enlargement, slowly expands with age and starts compressing the peripheral zone of the prostate.  The transition zone is quite small at about 15g in men in their 40s but increases to approximately 25g for men in their 60s and 70s.3 Even though the prostate sizes, by age, described above are typical, some men can achieve prostate sizes of a few hundred grams. There are some choices from which to choose for shrinking or managing enlarged prostate tissue before surgery is considered.  A few of the common methods are listed below as either proven or yet-to-be-proven ways to shrink the prostate:   Proven to shrink the prostate
  • 5-alpha reductase inhibitors. This class of medication is clinically proven to shrink the prostate to help deal with prostatic hyperplasia.  They can take up to 6 months to start shrinking the prostate effectively, but they work by blocking the hormone changes that lead to benign prostatic hyperplasia.4 Medications such as dutasteride (Avodart) or finasteride (Proscar and Propecia) are utilized to shrink the prostate.  However, sexual side effects are common when using these medications.
  Yet-to-be-proven to shrink the prostate (but may help)
  • Healthy Diet – Nutritious foods such as fruits and vegetables (especially ones that are dark or bright colored), nuts, legumes, fish, and other sources of Omega-3 fatty acids can help maintain a proper weight and provide the essential minerals needed by the prostate to function optimally.5 Fruits and vegetables such as tomatoes (lycopene), cruciferous vegetables (sulforaphane), citrus (vitamin C), berries (antioxidants), and garlic and onion (anti-inflammatory) can be very beneficial. The Mediterranean diet is a good example of a healthy diet that may also help maintain or shrink the prostate as well.5
  • Natural Remedies – Herbal supplements such as saw palmetto (inflammation), stinging nettle (urge to urinate), pygeum (urine flow), beta-sitosterol (urine flow strength), and ryegrass pollen extract (inhibits the growth of pro-inflammatory molecules), may help with benign prostatic hyperplasia and its symptoms.5
  The occurrence of BPH in men varies according to age.  The older a man is, the more prevalent BPH becomes.  Most men will display BPH symptoms by the time they reach their 60s and if a man lives long enough, he is virtually guaranteed to get prostatic hyperplasia.  Benign prostatic hyperplasia is an equal opportunity condition that strikes men of all races and nationalities, but medication is proven to help BPH symptoms and shrink the prostate, and a healthy diet, regular exercise, and natural remedies may also help.  An enlarged prostate is virtually inevitable for most men, but fortunately, scientific advances have caught up with this condition and many therapies are now available to address BPH for good.   References
  1. https://www.health.harvard.edu/mens-health/10-diet-and-exercise-tips-for-prostate-health
  2. https://healthmatters.nyp.org/tips-for-better-prostate-health/
  3. Roehrborn CG. Benign prostatic hyperplasia: an overview. Rev Urol. 2005;7 Suppl 9(Suppl 9):S3-S14. PMID: 16985902; PMCID: PMC1477638.
  4. https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/diagnosis-treatment/drc-20370093#:~:text=5%2Dalpha%20reductase%20inhibitors.,can%20cause%20sexual%20side%20effects.
  5. https://www.bensnaturalhealth.com/blog/how-to-shrink-your-prostate/

All surgical treatments have inherent and associated side effects. Individual’s outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience. The most common side effects are mild and transient and may include mild pain or difficulty when urinating, discomfort in the pelvis, blood in the urine, inability to empty the bladder or a frequent and/or urgent need to urinate, and bladder or urinary tract infection. Other risks include ejaculatory dysfunction and a low risk of injury to the urethra or rectum where the devices gain access to the body for treatment. Further, there may be other risks as in other urological surgery, such as anesthesia risk or the risk of infection, including the potential transmission of blood borne pathogens. For more information about potential side effects and risks associated with Aquablation therapy for Benign Prostatic Hyperplasia (BPH) treatment, speak with your urologist or surgeon. Prior to using our products, please review the Instructions for Use, Operator’s Manual or User Manual, as applicable, and any accompanying documentation for a complete listing of indications, contraindications, warnings, precautions and potential adverse events. No claim is made that the AquaBeam Robotic System will cure any medical condition, or entirely eliminate the diseased entity. Repeated treatment or alternative therapies may sometimes be required.

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