What Is the Main Cause of BPH?

One of the most common conditions men may encounter as they age is benign prostatic hyperplasia, or BPH. While the name sounds complex, it simply means an enlarged prostate. It is a natural part of aging for many men, and though it is not cancerous, it can impact your daily comfort and quality of life.

What is BPH?

Benign prostatic hyperplasia is the non-cancerous growth of the prostate gland. The prostate is a small gland located just below the bladder. As it enlarges, it can put pressure on the urethra, the tube that carries urine from the bladder. This can affect the urinary flow.

Key facts about BPH include:

• It is extremely common, especially in men over 50.
• It is not a dangerous condition on its own.
• It is not a sign of or leading to prostate cancer.

What is the difference between BPH and prostate cancer?

Many people worry that an enlarged prostate is a sign of cancer, but this is a common misconception. While BPH and prostate cancer can occur at the same time, one does not cause the other. BPH does not increase your risk for developing prostate cancer.

However, the symptoms can sometimes overlap. This is why you should always consult with your healthcare provider for a proper diagnosis. Your healthcare provider may request a prostate-specific antigen (PSA) test to monitor and distinguish benign changes from concerning trends.

What are the common symptoms of an enlarged prostate? 

When the prostate presses on the urethra, it can lead to a variety of urinary symptoms. You may experience:

• A weak or slow stream of urine
• Difficulty starting to urinate
• Dribbling or leaking after urination
• Waking up frequently at night to urinate (nocturia)
• A frequent or urgent need to urinate
• A feeling that your bladder is not completely empty

These symptoms can disrupt sleep, daily comfort and overall quality of life. The good news is that they are highly treatable.

How is BPH diagnosed?

To determine if you have BPH and rule out other conditions, our team takes a thorough and personalized approach. The diagnostic process often includes:

• A review of your medical history and symptoms
• A digital rectal exam (DRE) to feel the prostate
• A PSA blood test to help differentiate between prostate conditions
• A urinalysis to check for infection
• A bladder scan or ultrasound to see if you are emptying your bladder fully

In some situations, further testing like uroflow studies or a cystoscopy may be used to get a more detailed view.

What is the connection between BPH and PSA levels?

The PSA test often causes confusion, so let's clarify its role. PSA is a protein produced by the prostate gland. An elevated PSA level can be a sign of several different prostate issues, including BPH.

• An enlarged prostate from BPH can cause a mild and steady increase in PSA levels.
• A rising PSA does not automatically mean cancer; it often reflects the prostate's growth.

Monitoring your PSA trends over time helps your provider determine if the changes are consistent with BPH or if they require further evaluation. An elevated PSA with BPH is common, but it always deserves careful follow-up with your healthcare team or urology.

Can an enlarged prostate go back to normal?

An enlarged prostate is a progressive condition related to aging. While the prostate typically does not shrink back to its original size on its own, many men find meaningful relief from symptoms through lifestyle changes, medication or minimally invasive therapies. Medications can reduce the prostate size over time, and certain procedures can offer long-lasting results. With early evaluation and the right plan, you can achieve significant improvements in comfort and urinary function.

What are treatment options for BPH? 

Treatment for BPH is based on how severe your symptoms are and your personal preferences.

For mild symptoms, simple changes can make a big difference:

• Limiting fluids in the evening
• Reducing caffeine and alcohol intake
• Maintaining a healthy weight and staying active
• Practicing bladder training techniques

For moderate to severe symptoms, medication can be effective. Commonly prescribed medications include:

• Alpha-blockers: These work quickly to relax the muscles around the prostate and improve urine flow.
• 5-alpha reductase inhibitors: These medications work over several months to shrink the prostate gland itself.
• Combination therapy: Using both types of medication can be effective for more significant symptoms.

If medications are not providing enough relief, Ochsner offers advanced procedures such as:

• Minimally invasive therapies: Options like UroLift and Rezūm offer effective relief with less downtime.
• Surgical options: For severe enlargement, procedures like transurethral resection of the prostate (TURP) remain a gold standard, holmium laser enucleation of the prostate, also known as HoLEP or Aquablation therapy.

Does ejaculating help an enlarged prostate?

Ejaculation is a normal and healthy bodily function, but there is limited scientific evidence to suggest that it significantly impacts the size of the prostate or substantially eases BPH symptoms. Regular ejaculation may support overall prostate health, but it should not be considered a treatment for BPH. It is important to consult your healthcare provider about effective ways to manage symptoms and support your well-being.

Living with BPH does not have to mean living with discomfort. Our team is here to provide expert management and innovative solutions. Remember these key points:

• BPH is a very common and treatable part of aging.
• It does not increase your risk of prostate cancer.
• Early evaluation can prevent complications and improve your well-being.

If you are experiencing BPH symptoms, schedule an appointment with one of our urologists.