Benign Prostatic Hyperplasia (BPH) -

What is BPH?

BPH Diagram

Benign Prostatic Hyperplasia, or BPH for short, is a condition in which the prostate gland gradually enlarges over time. This is a common occurrence in older men, and in many cases is nothing to be overly concerned about. The prostate actually starts enlarging in a man’s early 30’s, but does not often progress to the stage where the man will display symptoms until he nears or passes his 50’s.

Symptoms are often mild enough that they can be tolerated and lived with, though they can certainly prove rather annoying. BPH can also grow to be far more severe in some men though, and in these cases, there’s no choice but to take steps to either lessen the size of the prostate gland, or counter the effects that enlarged gland can have in other ways.

What this enlargement of the prostate does is compress the pathways of the urethra, making the pathways less suitable for carrying the urine from the bladder, through the middle of the prostate gland, and finally to the penis.



Causes of BPH

The causes of BPH are mostly related to the natural growth cycle of men. Testosterone gets converted into DHT (think of it as a more powerful form of testosterone), and this DHT can then travel into the prostate, which speeds up its natural growth. Most men convert 5% of their testosterone into DHT. Men who have had their testicles (where testosterone is produced) removed early in their lives, have a much lower incidence rate of BPH as a result; in fact it’s quite rare in these men.

Other than the DHT connection, there are no other known causes that can lead to BPH, and therefore, no real way to prevent its occurrence either, short of taking a 5-alpha reductase inhibitor before BPH every strikes. This inhibitor prevents the conversion of testosterone into DHT, and therefore stops excess prostate growth.


BPH Tests and Diagnosis

There are several tests and procedures which can help lead to a positive diagnosis of BPH. Men suffering from any form of urinary problems may be asked to fill out the AUA Prostate Symptom Index questionnaire, a series of 7 graded questions which can give the doctor a better idea of what may be causing said problems.
If the doctor suspects BPH, the easiest way for them to test for it is to perform a digital rectal exam, during which they can actually feel the size of the prostate gland for themselves. While the thought of undergoing the rectal exam is not a pleasant one for men who haven’t yet gone through it, the reality is probably not quite as bad as the mind’s conjured images would have us believe. It usually takes no more than a minute, and the actual process should not result in any undo discomfort.

Lastly, blood tests and PSA (prostate specific antigen) tests should be able to confirm that the condition is indeed BPH, and not prostate cancer. These tests are designed to measure the amount of PSA in the blood, as highly elevated PSA levels usually indicate BPH, while normal levels are more commonly associated with prostate cancer.

This test can produce false positive and false negative results though, and is not a guarantee of complete accuracy. Because of this, tests that generate a high PSA count will usually lead the doctor to order further tests to help conclusively rule out prostate cancer before they declare the condition as BPH. A biopsy is usually ordered to take care of this stage of the testing.


DHT, BPH and MPB – Oh My!

There’s also an interesting connection between BPH and male pattern baldness. Both of these conditions result from the same process, which is the formation of DHT. In the case of BPH, the DHT is traveling to the prostate gland and spurring growth. In the case of male pattern baldness, the DHT travels to the hair follicle and attaches itself to it, which prevents nutrients from reaching the hair. The hair strand eventually falls out of the follicle, which shrinks and dies.

Studies have now shown a definite connection between both MPB and BPH. Men with early signs of MPB were shown in the study to have a much higher incidence rate of BPH than those who weren’t displaying early signs of MPB. The men with MPB also had a weaker urine stream, suggesting their prostates had already begun to expand and pinch off the urethra pathway.

So if you want to know your chances of developing BPH, your hair may be a great early indicator of the likelihood of that happening, as it could be a definite sign that your body is converting more testosterone into DHT than may be needed.


Potential Complications

If not treated BPH symptoms may continue to worsen, and this could lead to further complications and more serious health issues, though this is uncommon. Only 10% of men out of the 50% that end up getting BPH end up needing a medical or surgical procedure done.

The most notable of these complications is acute urinary retention, which signals the complete blockage of the urethra and an inability to urinate. Surgery is needed to correct this issue, either by expanding the urethra pathway, or by shrinking the size of the prostate gland.

Potential complications from BPH treatments can also arise. Using alpha blockers can lead to headaches and fatigue. Using 5-alpha reductase inhibitors to treat the condition could lead to decreased libido and the resultant loss of interest in sex, as well as problems while ejaculating. It could even lead to sexual dysfunctions such as erectile dysfunction.


Surgical treatment options can also lead to numerous complications and side effects, such as blood in the urine, infertility, erectile dysfunction, and incontinence (loss of urinary control). These side effects will often clear up after several weeks have passed, but they may persist indefinitely in some men.




  • BPH Symptoms • BPH Treatments
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