• Benign prostatic hyperplasia (BPH)

Explainer: Enlarged Prostate Symptoms and Treatments

An enlarged prostate — also called benign prostatic hyperplasia (BPH) — is a common condition that affects mostly older men, resulting in trouble urinating, discomfort while urinating, trouble emptying your bladder, and more painful symptoms.

As many as 50% of men between the ages of 50 and 60 will experience BPH, while men over the age of 70 are most at risk, with an 80% chance of developing an enlarged prostate.

Men with enlarged prostates can live relatively normal lives with minimal discomfort if their condition is properly managed with common medications. And while an enlarged prostate is not cancerous, it does share many of the same symptoms as prostate cancer. 

What is a Prostate?

Part of the male reproductive system, the prostate is a walnut-sized gland located below the bladder and in front of the rectum. The prostate surrounds the urethra, the tube through which urine and semen pass. 

The prostate produces the seminal fluid that carries sperm outside of the body during ejaculation. It’s an essential part of a healthy reproductive system and reproductive capabilities, but the prostate gland can be removed as one form of treatment for BPH. This is known as radical prostatectomy. 

Enlarged prostates can grow to the size of an orange, about 2X their normal size. As the gland expands, the urethra passing through its center is squeezed, causing the many symptoms of BPH.

What Are the Symptoms of an Enlarged Prostate?

Some men won’t notice any symptoms of an enlarged prostate. This is why regular screenings are important.

However, most men will experience one or more of the following symptoms:

• Frequent urination 

• The sensation of not being able to completely empty the bladder

• A weakened urine stream

• Dribbling toward the end of urination

• Trouble initiating urination

• Overflow incontinence (due to a blockage, the bladder fills with urine and overflows without warning)

• Difficulties with urination

• Frequent urinary tract infections (UTIs) which can present as painful urination, pelvic pain, and discharge that may be bloody. A UTI is a telling symptom as men rarely get UTIs compared to women.

If you experience any of these symptoms, contact your healthcare provider to discuss treatment options. Some of these symptoms may indicate conditions like bladder stones or urethral stricture (narrowing of the urethra). A doctor will be able to help you diagnose your condition.

How Do I Treat an Enlarged Prostate?

There are several ways you can minimize and even eliminate the symptoms of an enlarged prostate, including medication and surgical options. 

Medications will work for most people with an enlarged prostate, but surgical intervention may be required for those who don’t respond well to medication. 

Here are some treatments that you can discuss with your healthcare provider:

Oral Medications for BPH

Not everyone will respond well to the following medications — and your doctor will likely put you on a 6-month trial for some — with treatment evaluated after the trial period.

Some patients will feel relief sooner than others, but it’s important to monitor your symptoms and take the medication for as long as it’s been prescribed by your doctor. Some people can take time to respond.

Avodart® (dutasteride) and Proscar® (finasteride)

Dutasteride and finasteride belong to a class of medications known as 5-alpha-reductase inhibitors (5-ARIs). 

These drugs reduce the size of the prostate and may improve the strength of your urinary stream. 

Unlike other treatments that promise only symptomatic relief from an enlarged prostate, these medications actually help to shrink the size of the prostate or decrease its growth rate. And unlike alpha-blockers that are often used as antihypertensives (blood pressure medication) and may result in low blood pressure, Avodart does not affect blood pressure.

Men who are using 5-ARIs should not engage in unprotected sex or donate blood while they’re on treatment as these medications are absorbed into the bloodstream and semen and can be present in these fluids.

Alpha-blockers for BPH

These drugs help to relax the prostrate’s smooth muscles, reducing swelling and allowing urine to flow more easily. Some examples of alpha-blockers include Flomax® (tamsulosin) and Cardura® (doxazosin). 

Alpha-blockers may also be combined with 5-alpha-reductase inhibitors to reduce symptoms of an enlarged prostate with two mechanisms of action.

Surgery for BPH

Transurethral resection of the prostate — otherwise known as TURP — is a type of surgery that can provide symptomatic relief from an enlarged prostate. According to the Urology Care Foundation, around 150,000 men undergo TURP in the U.S. each year.

This procedure is quite effective. It involves inserting a resectoscope — a tube with lights, irrigation valves, and a wire loop into the urethra — and passing an electrical current through it. 

This electrified wire is then used to remove excess prostate tissue that’s blocking the urethra. The removed tissue is flushed into the bladder, from where it will be expelled from the body. 

Aftercare for this procedure involves using a catheter for one to two days.

In severe cases, a radical prostatectomy (the complete removal of the prostate) may be needed. While effective at eliminating symptoms of an enlarged prostate, this surgery does come with side effects. Men who undergo a radical prostatectomy may experience reduced sexual desire, inability to ejaculate, hormonal fluctuations, and other side effects. 

Prostatectomy is usually reserved for enlarged prostates that have been unresponsive to medications or when cancerous tissue is present in the prostate.

What Causes an Enlarged Prostate?

The precise cause of an enlarged prostate is not perfectly understood, but hormonal changes that occur during the aging process are a key contributing factor.

What are the Risk Factors for an Enlarged Prostate?

Lifestyle and genetic factors may increase the risk of developing an enlarged prostate, but the main risk factor is age. 

Regular prostate exams not only help detect an enlarged prostate, but they can also pick up on irregularities in the prostate that may be linked to cancer. 

A prostate exam typically consists of two parts: 

1. Digital rectal exam (DRE): During this process, the doctor inserts a gloved finger into the rectum and tries to detect abnormalities in the shape and size of the prostate. If the prostate is easily located, it may be enlarged.

2. PSA test: Your doctor may order a prostate-specific antigen test before or after the rectal exam if they discover irregularities that could indicate a cancerous growth. PSA is a protein secreted by the prostate. When cancer is present, PSA will be elevated in the bloodstream. Like an enlarged prostate, those with cancer may have additional symptoms, such as frequent urination — especially at night — and blood in the urine. 

Because the symptoms of an enlarged prostate and prostate cancer often overlap, regular screenings are vital. 

The American Cancer Society (ACS) recommends that men over the age of 40 start having discussions about cancer screenings with their healthcare providers annually, and a family history of prostate cancer may require earlier screenings.

These conversations can be daunting, but at LifeMD, you can talk to affiliated and board-certified doctors and nurse practitioners from the comfort of your home. This can make it easier to speak about sensitive health concerns. 

Can an Enlarged Prostate Go Back to Normal?

An enlarged prostate can be cured, but keep in mind that everyone responds differently to treatment.

Medication works well for many men with BPH while others require surgical procedures to decrease the size of the prostate and find relief from painful symptoms.

The prostate can also sometimes regenerate from a partial removal. Therefore, regular monitoring and checkups are recommended.

Where Can I Learn More about Enlarged Prostates?

If you’ve been having difficulty urinating or you’ve noticed blood in your urine, you may be experiencing the first signs of an enlarged prostate. Don’t wait until the pain and discomfort get worse. Schedule a virtual visit with LifeMD today.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

Connect with a doctor now!

Join Now

Text

Call