Prostate Enlargement. Causes, symptoms and how to treat it.

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The prostate is part of the male reproductive system. It’s a walnut size gland that sits underneath the bladder and surrounds the urethra, which is the tube that carries urine (wee) out of the body. The prostate's main job is to help make semen – the fluid that carries sperm. You can learn more in our guide to prostate health.

What is prostate enlargement?

An enlarged prostate is very common and associated with getting older. More than 1 in 3 of all men over 50 will have some symptoms of prostate enlargement and many more may have an enlarged prostate but show no symptoms. It's not known why the prostate gets bigger as you get older, but it is not caused by cancer and does not increase your risk of developing prostate cancer. Some studies show that men with diabetes are more likely to have an enlarged prostate.

An enlarged prostate is usually not serious and for many men it can be easy to manage. But it can put pressure on the urethra, which can affect how you urinate.

Prostate enlargement symptoms

Signs of an enlarged prostate might include:

  • Difficulty starting or stopping urinating
  • A weak flow of urine
  • Straining when weeing
  • Feeling like you're not able to fully empty your bladder
  • Prolonged dribbling after you've finished weeing
  • Needing to wee more frequently or more suddenly
  • Waking up frequently during the night to wee
🩺 It is not possible to distinguish between cancerous and non-cancerous (benign) enlargement of the prostate by symptoms alone. So, you need to see your GP if you notice any of the above symptoms related to prostate enlargement, changes to, your usual pattern of weeing or if you see any blood in your urine or semen.

Going to your GP

If you do notice changes in your usual weeing patterns it is worth talking to your GP, particularly if you are over 50. They will ask you questions about your symptoms, and they may carry out a physical examination. Sometimes medications you’re taking might be contributing to the symptoms so your GP should check those. They may also ask you to keep a diary of how often you urinate and answer a questionnaire called IPSS which explores urinary symptoms in more detail. They may decide to carry out blood tests to find out more.or decide to carry out blood tests to find out more.

These investigations will help them determine what treatment, if any, is needed and offer you advice about what to do. This might be as simple as recommending some changes to your lifestyle but in some cases and after further investigation, medication or even surgery might be advised.

Managing and treating symptoms of prostate enlargement

Having an enlarged prostate affects men in many different ways. For many, symptoms are mild and can be easily managed. For others it means always staying near a toilet and may result in undergoing medical treatment.

Lifestyle changes

There are things you can try yourself to manage the symptoms of an enlarged prostate:

  • Fluid management. Most symptoms of an enlarged prostate effect how you urinate. So it makes sense to consider how much and what you drink.
  • Avoid caffeine. Caffeine is a diuretic - it makes you wee more. So best to avoid it if you can or at least before bed.
  • Drink less in the evening. Try to drink less in the late afternoon and evening, so you’re less likely to get up in the night. But make sure you drink enough during the day – 1.5 to 2 litres (3 to 4 pints) a day.
  • Double voiding. This is a technique to make sure you empty your bladder properly so you don’t have to keep using the loo. After you wee, wait a few minutes and then try to go again. Do take care not to strain or push.
  • Eat more fibre. Fibre, found in fruit, vegetables and wholegrains help keep you regular. So if you don’t include enough of it, you may experience constipation which in turn puts pressure on the bladder and can make urinary symptoms worse. Our article on good gut health might help.
  • Keep a healthy weight - Being obese can increase your risk of having an enlarged prostate and if  you’re overweight, this can make your symptoms worse. Our 7 tips for weight loss article might help.
  • Exercise regularly - Studies have shown that regular exercise help reduce symptoms and men with more sedentary lifestyle are more likely to suffer from the effects of an enlarged prostate. If you’re not usually very active, speak to your doctor before starting any kind of exercise plan. They can talk with you about exercising safely. You might find out exercise to energise article useful too.
  • Absorbent pads. If you’re really struggling, there are absorbent pads available specifically to help men with untimely leaks. You can buy these online or talk to your doctor or pharmacist. If you have this symptom, you must get medical advice.

Home and herbal remedies for an enlarged prostate

There are also a number of herbal remedies that might help with urinary symptoms. These are generally available from health food shops.

  • Saw Palmetto. Made from the fruit of the Serenoa Repens tree, this is a supplement you can use to alleviate symptoms with no significant side effects. One study showed it made significant improvements to urinary flow and male sexual function.The effect was comparable to prescribed treatments.
  • Urtica Diolca. Taken from the humble stinging nettle, this herb has also shown improvement in symptoms with no change in actual prostate size, again with virtually no side-effects.
  • Beta sitosterol. Beta sitosterol is a member of the sterol family that is found in many plants, including pumpkin seeds and saw palmetto berries. It is available as a tablet supplement but is most often added to foods such as yogurt and margarine. It has been shown to improve urinary symptoms with no side-effects.
  • Camelia sinensis. This is the plant used to make green tea. High doses of green tea, tested in randomised controlled studies, showed a significant protective effect against Ca Prostate.

Prescribed treatments for prostate enlargement

If needed, your doctor may prescribe you a course of treatment for your enlarged prostate.

  • Medication can help reduce the size of your prostate and relax the muscles of your bladder.
  • Surgery When simple treatment such as lifestyle management or medication fail, surgery may be an option. There are a range of surgical options available which are all minimally invasive and the type of surgery offered will depend on individual circumstances and preferences. Surgery can have side effects but these will depend on the type of surgery carried out and should be discussed with your specialist before making any decisions. You can read more about the risks of surgery here.
  • Pelvic floor exercises. Often called Kegel exercises, these can help strengthen your pelvic floor muscles and may help reduce incontinence if used before and after prostate surgery. Your doctor can tell you more about this and there’s some useful information here.  

Remember, an enlarged prostate is often part of the natural ageing process and symptoms can often be easily managed. But you must talk to your GP if you have any concerns or changes to your usual pattern on weeing.

 The Prostate Check questionnaire within the Evergreen Life app can help you better understand your current prostate health and how best to protect it.

📲 Not got the app yet? Download the Evergreen Life app by tapping the button below and look out for a notification about your Prostate Health Check questionnaire*.

*Must be 18 or over and male to receive the Prostate Health Check. If you haven’t told us your age and sex, please first take the GP Check in your Records section.

References
Written by
Dr Brian Fisher MBBCh MBE MSc FRSA

Meet Dr Brian Fisher MBBCh MBE MSc FRSA, Strategy and Clinical Director at Evergreen Life, and a Medical Expert with more than 42 years' experience as a GP.

Article updated:
August 18, 2021
Reviewed by:
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