When the prostate makes urination difficult
Benign prostatic hyperplasia (BPH) , or benign enlargement of the prostate gland, affects more than half of all men over 50. With increasing age, the prostate gland slowly grows, which can lead to urinary problems and other unpleasant symptoms. Even though it is a non-cancerous condition , it can significantly impair quality of life.
However, if detected early, BPH can be treated effectively, for example through lifestyle changes, herbal preparations or medically supervised therapies.
What is benign prostatic hyperplasia?
The prostate gland lies below the bladder and surrounds the urethra. With age, certain cells in the so-called periurethral zone (around the urethra) begin to multiply. As a result, the organ enlarges, which can mechanically obstruct the flow of urine.
Important: BPH is not a precursor to prostate cancer , but both can cause similar symptoms. Therefore, a medical evaluation is crucial.
Who is particularly affected?
- Men aged 45 and over
- With family history
- With an unfavorable hormone profile (e.g., elevated DHT, estradiol)
- In cases of obesity and chronic silent inflammation
- Declining testosterone levels can increase the risk of BPH.
What symptoms occur with BPH?
Not all men with an enlarged prostate have symptoms, but many notice typical changes when urinating:
- weakened urine stream
- Post-dribbling
- Frequent urination, including at night (nocturia)
- Feeling of incomplete bladder emptying
- Difficulty starting to urinate
- Occasional urge to urinate without success ("urge without stream")
- Rare: bladder infections or urinary retention
These symptoms arise because the urethra is increasingly constricted from the outside .
How is BPH diagnosed?
An experienced urologist can determine whether BPH is present and how severe it is with just a few targeted examinations.
Typical diagnostic procedures:
- Medical history and IPSS questionnaire (standardized)
- Digital rectal examination (DRE): Palpation of the prostate
- Ultrasound of the prostate (residual urine, volume determination)
- PSA level in the blood
- If necessary, hormone levels: testosterone, DHT, estradiol
👉 View the PSA test at Adon Health here
What role do hormones play in BPH?
An imbalance in the male hormonal system can promote the growth of the prostate:
- Dihydrotestosterone (DHT): Formed from testosterone, it stimulates prostate growth.
- Estrogens (especially estradiol): Promote cell proliferation in the prostate.
- Declining testosterone (with age) changes the balance; the relative influence of DHT and estradiol increases.
A hormone analysis can help identify causes, especially in cases of simultaneous loss of libido, erectile dysfunction, or lack of motivation.
What treatment options are available?
The therapy depends on the severity of the symptoms, lifestyle and personal preference.
Conservative measures:
- Watchful waiting in cases of mild severity
- Adjust your lifestyle (e.g., weight loss, less alcohol/caffeine)
- Reduce fluid intake in the evening
- Targeted pelvic floor training
- Anti-inflammatory diet
Herbal therapies (for mild/moderate symptoms):
- Saw palmetto (Serenoa repens)
- Nettle root
- pumpkin seed extract
- Pygeum africanum
These preparations can alleviate symptoms and improve quality of life, but they are not sufficient for everyone.
Medications:
- Alpha blockers: Relax the muscles of the urinary tract.
- 5-alpha reductase inhibitors (e.g., finasteride): Inhibit DHT production
- A combination of both approaches is also possible.
Surgical procedures:
- TURP (transurethral resection of the prostate)
- Laser therapy, microwave or steam ablation , minimally invasive procedures
These are usually necessary in cases of severe BPH or complications.
What can men do themselves?
- Check your PSA level regularly (detect changes early)
- Reduce excess weight: Lowers aromatase activity and hormonal pressure
- Relieving the liver: For better hormone breakdown
- Exercise and moderate strength training: have a regulating effect on hormones.
- Visit a urologist 1-2 times a year (especially from age 45)
Conclusion
Benign prostatic hyperplasia (BPH) is not uncommon; it is an age-related, hormonally driven development observed in many men. It is important not to ignore symptoms and to take early action.
With a conscious lifestyle, early diagnosis (e.g. via PSA test from Adon Health ) and, if necessary, therapeutic support, you can maintain your quality of life and avoid more serious complications.
