Written by Dr.Albana Greca Sejdini, Md, MMedSc

The control able and uncontrol able causes of enlarged prostate

You might know that causes of enlarged prostate are multifactorial. 
From the clinical point of view, there are many risk factors which are believed to enhance the chances for enlarged prostate onset.
The role of action of these risk factors is mostly unknown.

causes of enlarged prostate

Increase in age

This is the primary cause of enlarged prostate. Though males younger than forty years rarely have BPH, nearly more than 50% of elderly males (at age >60 years old) suffer symptoms of enlarged prostate. And this you cannot control from happening.

Heredity as cause of enlarged prostate

Usually, you are more susceptible of having enlarged prostate if your father or one of your family had experienced it.

In fact, a positive family history is a very strong predisposing factor for BPH that you cannot control.

Whether you are married or not

This is one of the unexplained, controllable causes of enlarged prostate; but it is found that married men most commonly develop enlarged prostates.

Your nationality

If you are American or European man, then you are at high risk of having BPH. Asian men are less frequently affected. This uncontrollable factor is true and not yet explained.

Metabolic syndrome and some metabolic disorders

Many metabolic disorders, like abdominal obesity, increased fasting blood glucose level, diabetes type 2 and elevated blood pressure are usually accompanied with high risk for enlarged prostate.

If you prevent this conditions from setting, you may control enlarged prostate onset too.

Alcohol drinking and smoking

Health Professionals Follow-up Study suggests that reasonable alcohol drinking and quitting smoking can limit the enlarged prostate onset.

Your lifestyle (diet and physical activity)

It is proved that a diet containing more calories can directly influence the chemical structure of androgens. This can definitely influence the prostatic growth. It is also found that physical activity enhances the chances to develop BPH.

That's why if you can take good control of your diet and try to be physically active, you may prevent BPH onset.

Furthermore, scientists have hypothesized myriad theories to what causes of enlarged prostate are:

  • It is found that men who had experienced the removal of their testes before reaching puberty didn’t suffer from enlarged prostates. It is thought that enlargement of the prostates might be evoked by factors correlated to testes aging.

  • Normally within the body of a completely healthy man, a male sex hormone called testosterone as well as a female sex hormone called estrogen (in small amounts) is produced.
  • By aging, naturally testosterone become less produced, this will change the normal balance between 2 hormones. Some animal clinical researches have proved that the increased amounts of estrogen can trigger the development of enlarged prostate.

  • Androgens (male sex hormones) are very important for the growth of your prostate, especially testosterone.
  • Naturally, testosterone is transformed to a more potent form called dihydrotestosterone (DHT), which increases the growth of tissues lining your prostate (the glandular epithelium).

    Really, DHT is responsible for the fast growth of prostate in the period of puberty (as one of the causes of enlarged prostate in young men).

    Studies suggest that older men produce large amounts of DHT. Therefore, DHT is the major suspect of causing enlarged prostate in elderly.

  • Theoretically, many scientists think that specific prostatic cells are programmed to be reawakened for late activation of cell growth. Meaning that these cells will be multiplying and growing actively, triggering the normal cells of your prostate to replicate further.
  • Occurrence of faulty cell apoptosis (programmed cellular suicide); this theory suggests that abnormal prostatic cellular proliferation occur due to defect in cell natural self-destruction.

  • Finally, researchers theorize that aging causing the prostatic blood vessels to become more weakened, which results in decreased in blood flow as well as loss of oxygen to prostatic tissues.
  • These can aggravate growth of prostatic cells. What really supports this theory is the presence of many cardiovascular problems in elderly men suffering from enlarged prostate.

When should I seek for medical support?

In conclusion, the enlarged prostate is normal with aging, you must contact your doctor immediately if you have one or all of below signs:

  • Less urination than you normally do.
  • Malaise or chills.
  • Unusual pain in the side, abdomen or back of your body.
  • When your urine becomes red in color or smells bad.
  • You still feel that your bladder is full even after complete urination.
  • If you are taking drugs that might cause some kidney troubles, such as hypertensive medications, drugs for allergy, or analgesics, you must not by any way stop or reduce your dose without consulting your doctor.

  • What exams should I perform to find the cause of my prostate enlargement?

      In order to determine what causes enlarged prostate, your doctor will ask you to tell him/her your complete medical history, and to describe exactly what your symptoms are. 

      A digital rectal examination will be done gently by your doctor to evaluate the enlargement of your prostate. Some other tests will be done too, including:

    • Post-void residual urine test: to measure the amount of residual urine after you urinate.
    • Pressure flow studies: to determine the pressure exerted on your urinary bladder while urination.
    • Urinalysis test: to estimate presence of blood or pus.
    • Urine culture: to determine the type of micro-organisms causing the infection.
    • Prostate-specific antigen (PSA) blood test: to discover cancer if present.

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