Understanding BPH

The normal prostate is a walnut-shaped gland that typically doesn’t cause problems for men until they’re older. As you age, your prostate begins to grow and may cause urinary symptoms.

Some men are more likely than others to develop benign prostatic hyperplasia (BPH) with symptoms.

You can’t avoid certain factors that contribute to BPH. But you can lower your risk for the condition. Read on to learn more about BPH and the common risk factors.

The prostate is part of a man’s reproductive system. It’s a gland located just below the bladder. Its main job is to add fluid and important substances to semen.

The prostate gets larger over time. If you have BPH, your enlarged prostate can squeeze on your urethra. The urethra is the tube your urine travels through to get from the bladder out of your body.

Pressure from the growing prostate makes it harder for urine to leave the body and prevents the bladder from completely emptying.

BPH causes your bladder to work harder to expel urine. That eventually can weaken the bladder. Over time, other symptoms develop, such as a frequent or urgent need to urinate and a weak urine flow.

Almost every man will develop an enlarged prostate. It’s rare for men in their early 40s or younger to have BPH. But by their 80s, up to 90 percent of men will have the condition.

There are other risk factors besides age that may make you more likely to develop BPH, including:

Family history

BPH can run in families. Studies have pointed to a variety of genes that may have a role in the development of BPH.

Ethnic background

BPH can affect men of all ethnic backgrounds. A study from 2007 found that BPH risk was higher in African American and Hispanic men than in Caucasian men.

Yet, more recent research suggests that there’s no clear evidence that ethnicity plays a role in the development of BPH.


Research suggests that diabetes has an important role in the development of BPH. High insulin levels can trigger prostate growth.

The hormone insulin normally moves sugar from foods out of the bloodstream to be used for energy or stored in cells. In people with type 2 diabetes, the body doesn’t respond as well to insulin. Insulin levels are high but ineffective. That causes a spike in blood sugar levels.

When the pancreas pumps out even more insulin to bring down blood sugar, that excess insulin stimulates the liver to produce more insulin-like growth factor (IGF). IGF is believed to trigger prostate growth.

Diabetes also leads to high levels of inflammation and can affect levels of sex hormones, which act on the prostate.

Heart disease

Heart disease doesn’t cause BPH. But, the same risks that contribute to heart problems also increase prostate growth, such as:


Men who carry around extra body fat have higher levels of estrogen, a sex hormone that can make the prostate grow.

Obesity is part of a larger group of symptoms called metabolic syndrome, which is also linked to prostate growth.


Being sedentary could lead to prostate problems. Men who are inactive are more likely to develop BPH. Staying active also helps keep off excess weight, which is another BPH contributor.

Erectile dysfunction

Erectile dysfunction doesn’t cause BPH — and BPH doesn’t cause erectile dysfunction. However, the two conditions often go hand in hand.

Many medicines used to treat BPH, including tamsulosin (Flomax) and finasteride (Proscar), can make erection problems worse.

You can’t prevent some BPH risks, like age and genetic factors. Others are under your control.

One of the best ways to avoid prostate problems is to exercise, which can help decrease inflammation. Exercise also helps your body use insulin more efficiently.

A half-hour of aerobic activities such as swimming, cycling, or walking on most days of the week might lower your likelihood of developing BPH symptoms.

Exercise, combined with a healthy diet, will reduce your chances of becoming overweight and developing diabetes, two other BPH risk factors.

It’s important to be open with your doctor about any concerns regarding your prostate health. Talk about your risks and discuss ways to reduce the factors you can control.

Ask plenty of questions and make sure you’re comfortable with the answers before you leave the doctor’s office.