The prostate is an important component of the male urinary system, which is responsible for making most of the fluid that makes up semen. Regularly checking prostate health is essential as there is an increased risk of urinary complications as the prostate continues to grow with age. 

This normal enlargement of the prostate is caused when the prostate gland cells multiply, and the increased number of cells can cause expansion, thus increasing pressure on the urethra. As a result, unpleasant symptoms can develop for many men, and urination and ejaculation can be affected. 

A regular screening routine and proper doctor evaluation are essential to maintain prostate health and quality of life, even with a growing prostate. Understanding prostate health is an important component of this process, and the eight questions below are a good place to start.

1. What causes the prostate gland to enlarge?

The prostate develops throughout childhood and also begins to grow again around age 40. As the gland grows larger, it can increase pressure on the urinary tract. The exact cause for this additional growth is not completely understood, but increased levels of certain male hormones are believed to play a role. 

The factors believed to influence symptoms of an enlarged prostate can include:

Aging:  Enlargement rarely causes symptoms in men younger than age 40. However, close to one-third of men experience moderate to severe symptoms by age 60, and about half do so by age 80.

Family history: Having a first-degree relative, such as a father or a brother, with previous or current prostate problems can increase your risk of having problems.

Other medical conditions: Studies show that certain conditions affecting blood glucose and circulation as well as the medications taken for these conditions, might increase the likelihood of urinary symptoms and associated complications 

Lifestyle: Being overweight increases the risk of complications from an enlarged prostate. Exercise can lower your risk.

2. What are the symptoms of an enlarged prostate?

Symptoms may not always be present, and those reporting symptoms can experience varying degrees of severity. The most common symptoms to look for  include:

♦ Frequent or urgent need to urinate
♦ Increased frequency of urination at night
♦ Difficulty starting urination
♦ Weak urine stream or a stream that stops and starts
♦ Dribbling at the end of urination
♦ Inability to completely empty the bladder

It is important to speak with your doctor right away if you experience these because other conditions can lead to symptoms similar to prostate enlargement. Timely intervention will likely prevent the progression of the symptoms and further complications.

3. What are the complications of an enlarged prostate?

Left untreated, complications of an enlarged prostate can include:

Urinary retention: This sudden inability to urinate can result in the need for a tube (catheter) to be inserted into your bladder to drain the urine. In some cases, men with an enlarged prostate may need surgery to relieve urinary retention.

Infections: The inability to fully empty the bladder can increase the risk of bacterial infection along your urinary tract. Should this happen frequently, surgery may be required to remove part of the prostate to reduce the obstruction.

♦ Bladder stones: An inability to completely empty the bladder can contribute to the formation of bladder stones, which can cause bladder irritation, blood in the urine, and obstruction of urine flow.

Bladder damage: A bladder that hasn't emptied completely can stretch, and over time can weaken significantly. When the bladder wall muscles can no longer contract properly, it becomes more difficult to empty your bladder. 

Kidney problems: Increased pressure in the bladder from urinary retention can directly damage the kidneys or allow bacteria to reach the kidneys, causing infection.

4. What will a visit to a urologist be like?

Before any testing or screening is done, your initial doctor visit will be a discussion. To properly identify which testing will be beneficial, your doctor will likely ask about the following factors:

♦ When the problem began 
♦ What symptoms are present
♦ Urinary tract medical history
♦ Medications and supplements you take, both prescription and over the counter.
♦ How much fluid you typically drink each day
♦ Consumption of caffeine and alcohol, quantity and frequency
♦ General medical history, including any major illnesses or surgeries
♦ Family history of prostate problems

5. What tests are there to check prostate health?

Based on your initial visit, your doctor will perform specific tests to identify any potential issues and to evaluate any enlargement that occurs naturally with age. Early identification of these issues is important because prostate enlargement can increase the risk of serious problems in some men. 

The following tests are most commonly done to evaluate the health of the prostate. 

Digital rectal exam (DRE): This simple test checks the prostate by inserting a gloved, lubricated finger into the rectum. The prostate is situated directly in front of the rectum allowing the doctor to evaluate its size and position. They will be able to determine if the gland is the expected size for your age. The prostate should feel smooth, so identification of a hard or bumpy surface can indicate potential problems. 

Urine test: Bacteria can be identified with urine testing and often identifies if there is a need for further testing to be done in the urinary tract.  

Prostate-specific antigen (PSA) test: This is a blood test to evaluate levels of PSA, a protein that both normal and abnormal prostate cells produce. Generally, higher levels of PSA can indicate possible prostate issues. Abnormal DRE and PSA test results may lead to additional testing, such as a multiparametric MRI of the prostate and/or a prostate biopsy.

Urinary flow test: This test looks at the speed of urine flow over time to identify any issues with the bladder, such as those that may be caused by an enlarged prostate. 

Postvoid residual volume test: This measures how much urine stays in the bladder after urination and can prompt more complex testing. 

If your condition is more complex, your doctor may recommend:

Cystoscopy: This allows your doctor to examine your bladder and urethra. Since your urethra passes through the prostate, any narrowing can indicate that the prostate is enlarged. 

Transrectal ultrasound: This imaging test allows your doctor to check for any abnormalities that may be causing symptoms and evaluate the size of the prostate.

Urodynamics: This test will help assess the functionality of your bladder and coordination between its muscles and your urinary sphincter. It will also evaluate the degree of obstruction if such a present.

6. What are medical treatment options for an enlarged prostate?

Depending on the condition of your liver, the amount of enlargement, and the severity of symptoms, medications, or surgical procedures may be available


Alpha-Blockers can help relax prostate muscles to the point of less tension in the urethra, allowing both urine and semen to flow more easily.

5-Alpha Reductase Inhibitors interfere with the hormones that influence prostate growth, thus decreasing the prostate's actual size and/or growth rate.

Phosphodiesterase-5 (PDE-5) Inhibitors work by way of inhibiting an enzyme's actions that control blood flow so that muscles can relax and urine can flow more easily.

Surgical therapy:

Transurethral resection of the prostate (TURP): Parts of the prostate that are blocking the urethra are removed through the penis.

Prostatic Urethral Lift (Urolift): Tiny stainless-steel implants are inserted to lift or hold the enlarged prostate tissue out of the way so that it no longer blocks the urethra.

Transurethral incision of the prostate (TUIP): Small incisions are made in the area where the prostate and the bladder are connected to open the urinary channel to promote urine flow.

Rezum Water Vapor therapy: Steam is injected into the prostate, killing prostate cells and reducing gland volume, which decreases compression of the urethra.

Aqua-ablation therapy: High-velocity water pistons melt prostate tissue and open the urethral channel. 

Many medications used to treat prostate health can produce unpleasant side effects and typically only address the symptoms. To avoid the risks of surgery and the side effects of medications, promoting prostate health and function naturally is often a preferred path to take. 

7. What can I do to improve prostate health?

The prostate may enlarge naturally with age, but there are things you can do to slow growth and reduce the risk of symptoms. Without medications and surgery, you can make lifestyle changes that support prostate health. 

Healthy eating: Adopt a healthful, low-fat diet with plenty of fiber. Fiber promotes healthy bowel movements that reduce pressure on the prostate. Focus on getting plenty of fruits and vegetables, limiting red meat, and avoiding high-sugar and processed foods. Reduce the amount of alcohol, caffeine, and spicy foods you consume. 

Routine: Limit the amount of liquid you consume before sleep and long journeys. Be sure to empty your bladder frequently, and avoid holding your urine for long periods of time. Some patients with an overactive bladder may benefit from supervised bladder training, thus increasing their bladder capacities and lowering urination frequency.

Exercise: Stay active and exercise regularly. This will help promote weight loss and promote healthy circulation to the prostate. You can also learn exercises that work to strengthen the pelvic floor muscles. 

8.  Are there natural treatments that boost prostate health?

In some cases medical treatments may be necessary, but there are also natural ingredients that can be used to support prostate health and reduce symptoms. ProstateMD®️ is a physician-formulated and clinically effective combination of bioavailable plant sterols, essential antioxidants, and vital minerals that have been shown to improve prostate, bladder, and urinary tract health. 

Saw palmetto: Saw palmetto extract has been studied for its effectiveness in reducing the rate of prostate cell growth. We use USPlus®️ saw palmetto, which is the highest quality saw palmetto oil available on the market. Containing ten times the amount of lutein and thirty times the zeaxanthin of typical saw palmetto extracts, your prostate gets antioxidant protection and the best natural support for prostate enlargement. 

Pygeum: This herbal extract from the bark of the African cherry tree supports healthy prostate cell function and helps reduce symptoms such as painful urination and urination frequency. 

Pumpkin seed oil: Pumpkin seeds and pumpkin seed oil interfere with enzyme activity to promote healthy prostate cell growth. Pumpkin seeds are also rich in zinc, which is an essential mineral for prostate health. 

Stinging nettle: Stinging nettle leaves contain many antioxidant compounds that protect the prostate and urinary tract. These leaves also support urinary tract health through increased production of nitric oxide, which is needed for urination muscles to relax. 

Pine bark extract: Full of potent antioxidants, pine bark promotes healthy growth of prostate cells and reduces the proliferation of potentially harmful cells, to support overall prostate and urinary tract health. 

Final Thoughts

The prostate plays an important role in male reproduction and urinary tract health. However, its anatomical location predisposes men to develop urinary problems when natural prostate growth occurs with age. While several medications are available for the treatment, there is a risk for adverse side effects. 

When you promote prostate health with more natural and clinically effective ingredients, you can slow prostate enlargement and avoid these side effects. ProstateMD®️ is the best available prostate supplement, using the only certified saw palmetto extract, USPlus®️. This approach, combined with the supporting cast of natural ingredients to complement the activity of USPlus®️, creates a potent combination that ensures optimal prostate health and function for all men.

Dr. Daniel Brison

Dr. Daniel Brison is a board certified urologist who completed medical school at the State University of New York, and residency at the prestigious Endourology fellowship program at UCLA.