Benign Prostatic Hyperplasia (BPH): Signs, Causes, Treatment

Benign Prostatic Hyperplasia (BPH) occurs when the prostate expands to twice or even three times its regular size.

The growing prostate gland gradually presses against the urethra and restricts urinary flow.

This results in more frequent urination, and as the urethra becomes increasingly narrowed, the urine remains in the bladder, accounting for urinary problems.

As the word benign suggests, BPH does not indicate severe diseases like cancer or other malignancies. However, it can cause some discomfort, as we will explain below.

benign prostatic hyperplasia
Figure 1: Enlarged prostate.

What are the symptoms of BPH?

Enlarged prostate symptoms can be subtle and as a result, remain undetected.

Moreover, many men will dismiss their symptoms as ‘old age.’ However, by knowing what BPH feels like, you will more closely be able to determine if you are experiencing it.

The symptoms usually manifest as problems during and after urination.

This is due to the enlarged prostate pressing down on the urinary tract and inhibiting the urine flow.

LUTS (lower urinary tract symptoms) is a collective term that describes a range of urinary symptoms. This includes urinary urgency, urinary frequency, urinary incontinence, and weak urinary stream.

Lower urinary tract symptoms from BPH can fall into two categories; obstructive or irritative.

Irritative Symptoms of Prostate Enlargement

Irritative symptoms include urgent or frequent urination during the day and night.

Frequent Urination

A need to pass to urinate more frequently and urgently. This is because the enlarged prostate gland puts increased pressure on the urethra and bladder, which therefore makes it increasingly difficult to hold in urine.  


A need to get up to urinate during the night. This is called “nocturia” and is defined as a need to urinate three or more times at night.  

Urinary Retention

Urinary retention is a feeling that you cannot empty your bladder properly.

Obstructive Symptoms of Prostate Enlargement

Obstructive symptoms can cause a delay or straining when starting to urinate and result in a dribbling flow of urine.

How common is BPH (by age)?

An enlarged prostate is one of the most common health problems for men over the age of 50.

Though the actual cause is unknown, it links to aging and changes in the cells of the testicles.

As you age, you are more likely to develop an enlarged prostate. More than 90% of men over age 80 have this condition.

Often, this condition is not a cause for concern. Not all men with enlarged prostate experience bothersome symptoms.

Causes and Risk Factors of BPH

So, what causes BPH? And what increases your risk?


There is no concrete evidence for one cause of BPH. However, medical sources agree the condition is most likely linked to aging and the impact the production of testosterone has on older men.


As men age, their production of testosterone (male hormones) naturally diminishes, and their production of estrogen (female hormones) increases.

The change in the hormonal balance is often noticeable as men start to get middle-age spread and lose some of their assertiveness.

Some studies indicate that the body’s system for working off testosterone slows in middle age.

As a result, the body reacts by using this extra testosterone for the production of Dihydrotestosterone (DHT). High levels of DHT can cause enlarged prostate tissue growth.


Certain foods can encourage your body to produce these hormones, ultimately causing damage to your prostate’s health.

Daily consumption of red meat increases the chances of developing an enlarged prostate by 38%.

Replace red and processed meats with other forms of protein like fish, chicken, and turkey. You can also get protein from non-meat sources like beans and nuts.

Dairy is another offender. Cow’s milk is full of female hormones. Therefore, dairy products can further raise estrogen levels, upsetting your hormonal balance and increasing your production of DHT.

Family history and ethnicity

Family history and ethnicity should also be considered. Men of European ancestry are at a slightly increased risk of developing the condition, particularly those from southern Europe.

Still, other studies show a connection between BPH and lifestyle factors such as high cholesterol, excessive weight, poor diet, and immoderate alcohol consumption.

Those with conditions such as diabetes, a lowered immune system, high blood pressure, metabolic syndrome, and atherosclerosis should also practice caution and remain vigilant for the development of BPH symptoms.

Lifestyle and BPH

The prevalence of metabolic syndrome is due to the western lifestyle (which includes higher intakes of processed food, animal fat, refined carbohydrates, excess calories, and physical inactivity).

These health conditions substantially increase the risk of BPH and advanced prostate cancer.

One example is the Baltimore Longitudinal Study of Aging. The male participants underwent a number of prostate examinations (MRI, PSA, and DRE) and anthropometric measurements (weight, BMI, waist and hip circumference) between 1992 and 2002.

The study found that for each 1 kg/m-2 increase in BMI, there was a 0.41 cc increase in prostate volume. Elevated fasting blood sugar levels and diagnosed diabetes were also linked with prostate enlargement.

Low HDL cholesterol and insulin resistance have both been suggested as possible reasons explaining the link between metabolic syndrome and BPH.

If you are looking to treat an enlarged prostate, make natural changes to your lifestyle.


Find out more information on how diet impacts on an enlarged prostate here.

How is BPH diagnosed and evaluated?

If you start to experience BPH symptoms, your doctor will perform a thorough physical examination.

They will also consult your medical and familial history. The patient’s lifestyle will also be taken into account with issues like mobility and diet being given particular precedence.

DRE (Digital Rectal Exam)

The physical exam will most likely include a digital rectal examination (DRE).

This is one of the simplest and most effective procedures for detecting abnormalities like BPH in the prostate, as well as in the early detection of prostate cancer.

A doctor will insert a gloved finger up the rectum of the patient and will feel the prostate. If they detect any lumps on it, or irregularities, this could be a warning sign of cancer.

PSA Test

Prostate-specific antigen (PSA), is a protein produced exclusively by the male prostate gland. It is a normal secretion of the cells of a healthy gland.

The PSA test measures the level of this antigen in a blood sample.

Doctors will often order a Prostate Specific Antigen (PSA) test to ascertain the level of antigens in the bloodstream.

Recent studies show that the PSA test is not an accurate indicator of prostate cancer. There are cases in which some men who don’t have prostate cancer are diagnosed with it.

As a result, they undergo unnecessary and dangerous invasive treatments with many long-term side effects.

Post-void residual

Postvoid residual tests the amount of urine left in your bladder after urination.

It can be completed either by inserting a catheter through your urethra and into your bladder or by using an ultrasound to show images of your bladder so that your Doctor or urologist can access how much urine is there.


A cystoscopy is a visual inspection of the prostate through a thin, lighted tube inserted into the urethra of the penis. This test is also used, though it is less common.

This is passed into the bladder to allow a doctor to see inside. In some cases, small surgical instruments can be passed down the cystoscope to treat bladder problems.

Prostate Biopsy

A prostate biopsy is a procedure used to detect prostate cancer. Small samples of the prostate are removed and then observed under the microscope.

Doctors usually recommend a biopsy of your prostate gland based on individual findings.

One is when your prostate-specific antigen (PSA) blood test results are higher than normal for your age.

Another is when your Doctor detects some signs of a prostate problem during your digital rectal exam (DRE).

However, a biopsy can have a number of risks and life-changing side effects, including chronic infection, chronic pain, and bleeding of the urinary tract.

Therefore, you may wish to consider some less invasive alternatives to a prostate biopsy.

RELATED: Alternatives To A Prostate Biopsy.

What PSA level indicates BPH?

High PSA levels do not always mean that you have prostate cancer or any other prostate problem.

Many factors can affect your PSA levels. Therefore, your doctor won’t consider your PSA level on its own.

There is no specific normal or abnormal level of PSA because factors such as age and ethnicity make it hard for researchers to establish a normal range.

However, most doctors consider PSA levels of 4.0 ng/ml as high and would often recommend a prostate biopsy.

One study shows that men with this level of PSA often have prostate cancer.

Low PSA levels also don’t always mean that you don’t have prostate cancer. Studies show that some men with a PSA below 4.0 ng/ml do have prostate cancer.

prostate health support group

What are the complications of BPH?

Despite its prevalence, many cases of an enlarged prostate are left undiagnosed.

If left untreated, an enlarged prostate may lead to problems.

Here are some of the complications of BPH:

Acute Urine Retention

Acute urinary retention is a condition where a person is unable to urinate. It needs urgent treatment, as the bladder can possibly tear if it stretches beyond its capacity.

The increased pressure in the bladder can also prevent urine from passing through the lower urinary tract. Thus, urine gets back up into the bladder and kidneys, causing tissue damage and kidney failure.

Chronic Urine Retention

Chronic urine retention occurs when the bladder is unable to empty itself of urine over a long period of time.

In this case, the bladder may show a massive increase. This condition may require some type of surgical procedure.

Bladder Stones

Bladder stones, like UTIs, can occur if you are unable to empty your bladder. They are crystallized minerals in the bladder that form when urine becomes concentrated.

These stones can cause bladder irritation, blood in the urine, severe infections, and blockage of urine flow.

Blood in the Urine

Blood in the urine, or hematuria, occurs when the veins on the surface of an enlarged prostate gland dilate.

Gross hematuria occurs when blood in the urine is visible to the naked eye.

Urinary Tract Infection

Urinary retention can cause urine to concentrate. If the bladder can’t empty itself, bacteria will soon grow in it. In this case, urine turns darker and with a strange smell.

Bladder and kidney damage

Over time, the bladder may stretch and weaken if it cannot empty.

The muscular wall of the bladder will be unable to contract normally, making it more difficult to empty itself.

Frequently Asked Questions

Can BPH cause testicular pain?

BPH doesn’t usually cause testicular pain.

If you have testicular pain, this could be because you have inflammation of the prostate, called prostatitis.

It’s possible for men to have either BPH or prostatitis, but also possible to have both conditions at the same time.

One of the common symptoms of prostatitis is discomfort, pain, or aching in your testicles or the area between your testicles and back passage

Can BPH cause hydronephrosis?

Yes, prostate enlargement is one of the most common causes of hydronephrosis.

Hydronephrosis is a condition that occurs when a kidney swells as a result of urine failing to drain from the kidney to the bladder.

If there is an obstruction in the urinary tract, pressure can build up and eventually cause the kidneys to enlarge.

In severe cases that are left untreated, you can suffer kidney damage, which could lead to loss of kidney function.

Hydronephrosis is not a primary disease. It is an underlying condition of other health issues. There are many causes of hydronephrosis, with one of the most common being an enlarged prostate.

Benign prostatic hyperplasia (BPH) can compress and obstruct the urethra, resulting in difficulty passing urine.

Can BPH cause impotence?

There is some evidence for a link between erectile dysfunction (ED) and BPH, although the consensus among medical professionals in this area is far from united on the topic.

However, some of the medical treatments for BPH can lead to impotence.

Once you are diagnosed with BPH, doctors usually recommend medication. Therefore, it is crucial you know that some of the drugs to treat BPH have known side-effects.

Some of these include ED and a diminished sex drive. Other sexual health problems, in some cases, include retrograde ejaculation, lower sperm count, and low libido.

Men who take alpha-blockers (Flomax, Tamsulosin) and alpha-reductase (Finasteride, Dutasteride) are prone to develop erectile dysfunction.

Studies show that approximately 3% of men who took Dutasteride and 6.4% of men who took Finasteride experienced a loss of libido.

The active component of the prostate plays a crucial role in generating libido and sustaining erectile rigidity.

Therefore, it is not uncommon for men to experience flagging sexual desire and compromised erectile after initiation of treatment.

One example is Finasteride (Proscar), a drug that treats BPH symptoms by blocking testosterone. Studies reveal that 3.7% of men who use it experience erectile dysfunction, and 3.3% experienced decreased libido.

Can BPH cause hypertension?

When you look at the numbers, it appears that there’s a connection between BPH and hypertension. 25 to 30% of all men over the age of 60 years old have both of them.

Doctors say this makes sense because of the influence of stress on the body.

You may already know that the nervous system composes of two primary parts – the sympathetic nervous system and the parasympathetic nervous system.

The sympathetic part is related to you reacting properly when you are facing a tiger or a lion-like stressor in your life. It helps you respond so you can survive.

The parasympathetic nervous system tries to help you regain composure after the lion or tiger response.

The higher the number of minutes your body spends in the parasympathetic nervous system, the better you will feel. This is the neurological state where you feel peace and contentment.

BPH can be the result of sympathetic nervous system activity and may be related to the development of high blood pressure.

What’s one of your best strategies to deal with stress?

It’s to relax, to reset your stress reflex mechanism via your brain, and don’t give up until you stop reacting to little stresses as if they were major ones. In this way, you can impact not only BPH symptoms but also hypertension.

Can BPH cause prostate cancer?

In many cases, these two conditions coexist. BPH and prostate cancer are conditions that increase in prevalence as men age.

Researchers have looked into the link between the two conditions to try and establish a direct relationship. In addition, a meta-analysis of observational research found BPH does link with an increased risk of prostate cancer.

The risk was particularly high in Asian BPH patients. The analysis included 16 case-control studies and 10 cohort studies, with 1.6 million participants.

Having BPH increased the risk of developing prostate cancer by 2.9 times. However, the study did not provide the absolute number of patients that had both prostate cancer and BPH.

Other research shows contradictory findings. For example, one study found men with smaller prostate sizes were less likely to develop prostate cancer and were less likely to develop aggressive prostate cancer.

Prostate cancer tends to develop in the peripheral zone of the prostate, while BPH usually occurs in the transition zone. Thus some scientists argue that there cannot be a direct link between the two conditions.

Men with BPH are more likely to make regular visits to a urologist and undergo prostate cancer screenings.

This may explain the link between BPH and prostate cancer. Family history is another strong risk factor that must be accounted for in research studies.


Find out more information on prostate cancer here.

What are the treatment options for BPH?

There are many treatments for an enlarged prostate.

The usefulness of each BPH treatment depends on the severity of symptoms and whether you have other medical problems.

Treatment is also based on your age and overall health condition.


Drugs are the conventional treatment for an enlarged prostate.

Different Types of BPH drugs include:

These medications can be useful in treating BPH. However, they can come with many negative side effects and cause long-term dependency.

medications to avoid with swollen enlarged prostate

Find out more information on prostate medication here.

Surgery for BPH

Along with drugs, surgical procedures can also treat prostate enlargement.

The problem with almost all of these invasive procedures is that they damage the prostate tissue and, therefore, cause short or even long-term consequences.

The only difference between them is that they use different technologies. But it doesn’t matter how you damage the prostate, it is damaged either way.

Before undergoing surgery, carry out extensive research and consult your doctor on the after-effects and impact on your quality of life.


Find out more information on prostate surgery here.

How can you reduce your prostate naturally?


Diet can be a contributing factor to an enlarged prostate.

Certain foods can affect your hormonal balance, resulting in higher levels of DHT.

However, while some risk factors, such as family history, may be out of your hands, the good news is that you can modify your diet to reduce your prostate.

The phrase ‘you are what you eat’ remains distinctly true, and some studies identify foods that help or hinder your prostate health.

Therefore, all men should consider consuming a prostate-friendly diet, including fruit and vegetables, legumes, nuts and seeds, healthy sources of fat.

best foods for prostate

Find out 10 Best Foods For Prostate Health.

Research shows that plant-based diets may reduce the risk of prostate diseases.

Fruits and vegetables contain antioxidants, polyphenols, vitamins, minerals, and fibers that reduce may help reduce inflammation in BPH and improve urinary symptoms.

A prostate-friendly diet includes plant foods such as rice bran, wheat germ, peanuts, corn oil, and soybeans containing beta-sitosterol, which may protect prostate health.

A study by John Hopkins researchers evaluated the intake of fruit, vegetables, and antioxidants among men with BPH.

The results found that vegetable consumption, especially vegetables rich in beta-carotene, lutein, and vitamin C, was associated with a reduced risk of BPH.  

Find out more about the relation between diet and an enlarged prostate here.

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According to the American Cancer Society, not being active is a key factor that can increase a person’s risk of cancer.

Countless studies show that exercise can prevent prostate enlargement and help to manage BPH symptoms.

A meta-analysis involving 43,083 men looks at the relationship between physical activity and benign prostatic hyperplasia (BPH).

The results suggest that men undertaking moderate or vigorous physical activity were less likely to develop BPH compared with prolonged sedentary time.


Find out more information on the benefits of exercise on prostate health here.

Pelvic Floor Training

Many studies show pelvic floor training, or Kegel exercises, can help strengthen your pelvic muscles. These muscles make sure that the bladder, rectum, as well as small intestines, are all in place.

When these muscles are weak due to prostate cancer surgery, for example, incontinence from urine and feces may increase.

This is also a non-invasive treatment for health problems in men with impotence or erectile dysfunction.


It is well known that stress has a significant effect on your overall health and wellbeing. However, people tend to underestimate the effects of stress on your prostate health.

High levels of stress and anxiety impair the body’s immune system, leaving you vulnerable and hindering your ability to fight off diseases and illness. When you receive a diagnosis like prostate disease, your stress levels rise.

It is natural to feel anxious and worried when faced with the unknown.

This can result in a vicious cycle, whereby stressing about your prostate health can actually worsen it.

A research team at Ohio State University found a link between stress and the spread of cancer cells.

Their research showed that stress triggers a ‘master switch’ gene known as ATF3. This gene is expressed in all types of cells as a response to stressful situations.

stress and prostate

Find out more about the effects of stress on your prostate health.

Do supplements help with BPH?

The world is over-medicated, and people spend billions of dollars on prescription drugs each year.

However, several studies establish that the effectiveness of drugs is questionable. Many drugs often only mask the symptoms without fixing the root cause of the disease.

The truth is that prevention is way better than cure, and supplements are a better option. They are natural therapies that are much safer and more effective.

Ryegrass pollen

Multiple clinical studies support the effectiveness of Rye Grass Pollen in the treatment of an enlarged prostate.

One 2017 meta-analysis consisting of 10 clinical studies revealed an 83% positive response rate from patients, with no side effects reported.


Beta-sitosterol is a sterol, similar to cholesterol, that we can find in plant foods. It has been shown to help reduce the symptoms of BPH, including improving urination flow and prostatitis.

Many studies have reviewed the effectiveness of beta-sitosterol as a natural treatment for an enlarged prostate.

French researchers say this well-known herb is a suitable replacement for Flomax, plus it decreases 65% of biomarkers for chronic prostate inflammation. That’s a good amount since Flomax only decreased the biomarkers by 46%.


In recent years, there have been many studies that demonstrate that boron can kill prostate cancer cells while leaving healthy cells unharmed selectively.

In addition, boron has been found to lower PSA—which was previously believed to be only a marker for prostate cancer.

More recent research shows that elevated PSA is a causal factor in prostate cancer progression.

Pygeum Africanum

Pygeum Africanum is a cherry tree found in Africa.

It contains a wide variety of active components, including the phytosterols beta-sitosterol.

Phytosterols in plants produce an anti-inflammatory effect, helping to relieve the uncomfortable symptoms of BPH.

One study reviewing the benefits of pygeum africanum found that men using the herb were more than twice as likely to report an improvement in overall symptoms.

Turmeric (Curcumin)

The active ingredient in turmeric, curcumin, is a powerful weapon against inflammation, even matching the effectiveness of some anti-inflammatory drugs such as ibuprofen, aspirin, tamoxifen, sulindac, and naproxen, but without adverse side effects.

Ellagic Acid

Ellagic acid is an antioxidant naturally found in 46 different types of fruit. Studies by The Hollings Cancer Institute found that ellagic acid can cause apoptosis (death of cancer cells) for prostate cancer cells within 72 hours.

Japanese Sophora (Flower Buds) Quercetin

Quercetin is a flavonol, derived from plants. Many studies show it can be an effective anti-inflammatory, helping to reduce prostate-related pain and swelling.

Quercetin has been labeled a Tier 1 Supplement. That, therefore, means that quercetin has many successful clinical studies and research that support its effectiveness.


Find out more information on prostate supplements here.

Ben’s Natural Remedies For An Enlarged Prostate

At Ben’s Natural Health, our prostate supplements are a great natural remedy for an enlarged prostate.

Total Health

total health

Our natural supplement, Ben’s Total Health contains ingredients clinically proven to reduce prostate size, manage BPH symptoms and help you restore optimal prostate health.

Clinical trials and meta-studies show the active ingredients in Total Health have a positive impact on prostate volume, improve lower urinary tract symptoms, and decrease the risk of acute urinary retention.

Find out more about Total Health.

Prostate Healer

prostate healer

We formulated Prostate Healer to effectively combat BPH and prostatitis and provide symptomatic relief from urgency, frequency, and nocturia.

It works on the prostate, kidney, and bladder simultaneously, coaxing cells gently to resume normal function.

So, by this action, you’re fighting against prostatitis and BPH. If you’re like many customers that use the formula, you’ll see a reduction in the number of times you get up to go to the bathroom to urinate.

Plus, you’ll see an improvement in the flow of your urine.

Find out more about Prostate Healer.

Prostate Power

prostate power supplement

Our dietary supplement, Prostate Power, contains ingredients clinically proven to shrink an enlarged prostate and slow the progress of BPH and prostate disease.

The key active ingredients in Prostate Power have been shown in numerous clinical trials and meta-studies to shrink prostate volume, improve urine flow and decrease the risk of acute urinary retention.

Find out more about Prostate Power.

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At Ben’s Natural Health, our motto is to combine holistic healing with modern science.

Ben’s Natural Health is the world’s first high-quality, all-natural, scientifically proven clinical supplement company. Our supplements are effective, natural and 100% side effect free.

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So, BPH occurs when the prostate, expands to twice or even three times its regular size.

50% of men over 50 will suffer from the condition, while 90% of men over 80 will develop benign prostatic hyperplasia.

There are many treatments for an enlarged prostate. However, the usefulness of each treatment for BPH depends on the severity of symptoms and whether you have other medical problems.

Making lifestyle changes such as improving your diet and doing regular exercise are great and effective ways to shrink your prostate and naturally reduce your risk for prostate diseases such as BPH.

Explore More

how to prevent enlarged prostate

How to Prevent BPH: 5 Strategies to Reduce Your Risk.


BPH –  Causes, Diagnosis, Symptoms

  1. Wein AJ, et al., eds. Benign prostatic hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016.
  2. Management of benign prostatic hyperplasia (BPH). American Urological Association. Accessed April. 15, 2019.

BPH Complications

  1. Riyach O, Ahsaini M, Kharbach Y, et al. Bilateral ureteral obstruction revealing a benign prostatic hypertrophy: a case report and review of the literature. J Med Case Rep. 2014;8:42. Published 2014 Feb 11. doi:10.1186/1752-1947-8-42
  2. Kopp, W. (2018). Diet-Induced Hyperinsulinemia as a Key Factor in the Etiology of Both Benign Prostatic Hyperplasia and Essential Hypertension? Nutrition and Metabolic Insights.
  3. White, William B. and Moon, Timothy. Treatment of benign prostatic hyperplasia in hypertensive men. Journal of Clinical Hypertension, April 2005, 7;(4):212-217.

Can BPH cause prostate cancer?

  1. Chang RT, Kirby R, Challacombe BJ. (2012). Is there a link between BPH and prostate cancer?. Practitioner. 2 (1750), p13-6.
  2. Dai, X., et al. Benign prostatic hyperplasia and the risk of prostate cancer and bladder cancer: A meta-analysis of observational studies. Medicine (Baltimore). 2016 May;95(18):e3493.
  3. Liu ZM, Wong CK, Chan D, Tse LA, Yip B, Wong SY. Fruit and vegetable intake in relation to lower urinary tract symptoms and erectile dysfunction among Southern Chinese elderly men: a 4-year prospective study of Mr OS Hong Kong. Medicine. 2016 Jan;95(4).
  4. Schwarz S, Obermuller-Jevic UC, Hellmis E, Koch W, Jacobi G, Biesalski HK. Lycopene inhibits disease progression in patients with benign prostate hyperplasia. The Journal of nutrition. 2008 Jan 1;138(1):49-53.
  5. Khalil S, de Riese W. Association of benign prostatic hyperplasia (BPH) volume and prostate cancer: consecutive data from an academic institution in respect to the current scientific view. World journal of urology. 2017 Oct 1;35(10):1633-4.
  6. van Breemen RB, Sharifi R, Viana M, Pajkovic N, Zhu D, Yuan L, Yang Y, Bowen PE, Stacewicz-Sapuntzakis M. Antioxidant effects of lycopene in African American men with prostate cancer or benign prostate hyperplasia: a randomized, controlled trial. Cancer prevention research. 2011 May 1;4(5):711-8
  7. Chen L, Stacewicz-Sapuntzakis M, Duncan C, Sharifi R, Ghosh L, Breemen RV, Ashton D, Bowen PE. Oxidative DNA damage in prostate cancer patients consuming tomato sauce-based entrees as a whole-food intervention. Journal of the National Cancer Institute. 2001 Dec 19;93(24):1872-9.
  8. Paur I, Lilleby W, Bøhn SK, Hulander E, Klein W, Vlatkovic L, Axcrona K, Bolstad N, Bjøro T, Laake P, Taskén KA. Tomato-based randomized controlled trial in prostate cancer patients: effect on PSA. Clinical nutrition. 2017 Jun 1;36(3):672-9
  9. Barnard RJ, Kobayashi N, Aronson WJ. Effect of diet and exercise intervention on the growth of prostate epithelial cells. Prostate Cancer and Prostatic Diseases. 2008 Dec;11(4):362.

Lifestyle and metabolic

  1.       Barnard RJ, Kobayashi N, Aronson WJ. Effect of diet and exercise intervention on the growth of prostate epithelial cells. Prostate Cancer and Prostatic Diseases. 2008 Dec;11(4):362.
  2.       Yong L, Jin-Lian L, Yan-Lin W, Shu-Guang P, Su H, et al. (2012) The Effect of Weight Losing to Benign Prostate Hyperplasia Patients with Metabolic Syndrome. J Obes Wt Loss Ther 2:151.
  3.       Muller RL, Gerber L, Moreira DM, Andriole G, Hamilton RJ, Fleshner N, Parsons JK, Freedland SJ. Obesity is associated with increased prostate growth and attenuated prostate volume reduction by dutasteride. European urology. 2013 Jun 1;63(6):1115-21.
  4.       Barter PJ. The causes and consequences of low levels of high density lipoproteins in patients with diabetes. Diabetes & metabolism journal. 2011 Apr 1;35(2):101-6.
  5.       Parsons JK, Kashefi C. Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. european urology. 2008 Jun 1;53(6):1228-35.
  6.       Raheem OA, Parsons JK. Associations of obesity, physical activity and diet with benign prostatic hyperplasia and lower urinary tract symptoms. Current opinion in urology. 2014 Jan 1;24(1):10-4.
  7.       Liu ZM, Wong CK, Chan D, Tse LA, Yip B, Wong SY. Fruit and vegetable intake in relation to lower urinary tract symptoms and erectile dysfunction among Southern Chinese elderly men: a 4-year prospective study of Mr OS Hong Kong. Medicine. 2016 Jan;95(4).
  8.       Schwarz S, Obermuller-Jevic UC, Hellmis E, Koch W, Jacobi G, Biesalski HK. Lycopene inhibits disease progression in patients with benign prostate hyperplasia. The Journal of nutrition. 2008 Jan 1;138(1):49-53.
  9.       van Breemen RB, Sharifi R, Viana M, Pajkovic N, Zhu D, Yuan L, Yang Y, Bowen PE, Stacewicz-Sapuntzakis M. Antioxidant effects of lycopene in African American men with prostate cancer or benign prostate hyperplasia: a randomized, controlled trial. Cancer prevention research. 2011 May 1;4(5):711-8.
  10.   Chen L, Stacewicz-Sapuntzakis M, Duncan C, Sharifi R, Ghosh L, Breemen RV, Ashton D, Bowen PE. Oxidative DNA damage in prostate cancer patients consuming tomato sauce-based entrees as a whole-food intervention. Journal of the National Cancer Institute. 2001 Dec 19;93(24):1872-9.
  11.   Paur I, Lilleby W, Bøhn SK, Hulander E, Klein W, Vlatkovic L, Axcrona K, Bolstad N, Bjøro T, Laake P, Taskén KA. Tomato-based randomized controlled trial in prostate cancer patients: effect on PSA. Clinical nutrition. 2017 Jun 1;36(3):672-9.
  12.   Barnard RJ, Kobayashi N, Aronson WJ. Effect of diet and exercise intervention on the growth of prostate epithelial cells. Prostate Cancer and Prostatic Diseases. 2008 Dec;11(4):362.

What are the treatment options for BPH?

  1. Bird ST, Delaney JA, Brophy JM, Etminan M, Skeldon SC, Hartzema AG. Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology. BMJ. 2013 Nov 5. 347:6320.
  2. Brigantia, A, Fossatia, N, Cattob, J, Cornfordc, P, Montorsia, F. (2018). Active Surveillance for Low-risk Prostate Cancer: The European Association of Urology Position in 2018. European Urology . 74 (3), p357–368.
  3. Christidis, C, McGrath, S, Perera, m. ( 2). Minimally invasive surgical therapies for benign prostatic hypertrophy: The rise in minimally invasive surgical therapies. Prostate International. 5 (2017), p41-46
  4. Elzayat EA, Habib EI, Elhilali MM. Holmium laser enucleation of the prostate: a size-independent new “gold standard”. Urology. 2005 Nov. 66(5 Suppl):108-13.
  5. Foster HE, Barry MJ, Dahm P, Gandhi MC, Kaplan SA, Kohler TS, et al. Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline. J Urol. 2018 Jun 11.
  6. Gupta N, Rogers T, Holland B, Helo S, Dynda D, McVary KT. Three-Year Treatment Outcomes of Water Vapor Thermal Therapy Compared to Doxazosin, Finasteride and Combination Drug Therapy in Men with Benign Prostatic Hyperplasia: Cohort Data from the MTOPS Trial. J Urol. 2018 Aug. 200 (2):405-413.
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Do Natural Treatments Work For BPH?

  1. Azimi, H., et al. A review of animal and human studies for management of benign prostatic hyperplasia with natural products: perspective of new pharmacological agents. Inflamm Allergy Drug Targets 2012 Jun;11(3):207-21.
  2. Barlet, A, Albrecht , J, et al. (1990). [Efficacy of Pygeum africanum extract in the medical therapy of urination disorders due to benign prostatic hyperplasia: evaluation of objective and subjective parameters. A placebo-controlled double-. S National Library of Medicine National Institutes of Health. 102 (22), p667-673.
  3. Cai, T, Verze, P, et al. (2017). The role of flower pollen extract in managing patients affected by chronic prostatitis/chronic pelvic pain syndrome: a comprehensive analysis of all published clinical trials.. BMC Urology. 17 (1), p120-130.
  4. Cui, Y, Winton, M, et al. (2011). Dietary boron intake and prostate cancer risk.. Oncology Reports. 4 (1), p887-892.
  5. Chen Y, Yu W, Zhou L, et alRelationship among diet habit and lower urinary tract symptoms and sexual function in outpatient-based males with LUTS/BPH: a multiregional and cross-sectional study in ChinaBMJ Open 2016;6:e010863. doi:10.1136/bmjopen-2015-010863
  6. Dal Maso L, Zucchetto A, Tavani A, et al. Lifetime Occupational and Recreational Physical Activity and Risk of Benign Prostatic Hyperplasia. International Journal of Cancer2006;118:2632–35. PMID: 16380994
  7. Demaagd GA, Davenport TC. (2012). Management of Urinary Incontinence. Pharmacy and Therapeutics. 37 (6), p345-361.
  8. Espinosa, G. (2013). Nutrition and benign prostatic hyperplasia.. Current Opinion in Urology. 23 (1), p 38–41.
  9. Favilla V1, Cimino S, Salamone C, Fragalà E, Madonia M,et al. (2013). Risk factors of sexual dysfunction after transurethral resection of the prostate (TURP): a 12 months follow-up.. Journal of Endocrinological Investigation. 36 (11), p1094-8.
  10. Garcia, C, Chin,P, Woo, H. (2015). Prostatic urethral lift: A minimally invasive treatment for benign prostatic hyperplasia. Prostate International . 3 (1), p1-5.
  11. Gonzalez A, Peters U, Lampe JW, White E. Boron intake and prostate cancer risk. Cancer Causes Control. 2007;18(10):1131–1140.
  12. Gallardo-Williams MT1, Chapin RE, King PE, Moser GJ, Goldsworthy TL, Morrison JP, Maronpot RR.. (2004). Boron supplementation inhibits the growth and local expression of IGF-1 in human prostate adenocarcinoma (LNCaP) tumors in nude mice.. Toxicologic Pathology. 32 (1), p73-78.
  13. Harrison S, Lennon R, Holly J, et al. Does milk intake promote prostate cancer initiation or progression via effects on insulin-like growth factors (IGFs)? A systematic review and meta-analysis. Cancer Causes Control. 2017;28(6):497–528. doi:10.1007/s10552-017-0883-1
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  15. Lee HW, Kim SA, Nam JW, Kim MK, Choi BY, Moon HS. The study about physical activity for subjects with prevention of benign prostate hyperplasia. Int Neurourol J. 2014;18(3):155–162. doi:10.5213/inj.2014.18.3.155
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  18. Michel, M, et al. (2004). Association of Hypertension with Symptoms of Benign Prostatic Hyperplasia . The Journal of Urology . 172 (1), p1390 –1393.
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  20. Rohrmann S et al. Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men. American Journal of Clinical Nutrition2007 Feb; 85(2): 523-29
  21. Taktak,S, Jones, P, Haq, A, et al. (2018). Aquablation: a novel and minimally invasive surgery for benign prostate enlargement. Sage Journal. 10 (1), p183-188.
  22. Wilt, T., et al. Pygeum africanum for benign prostatic hyperplasia. Cochrane Database Syst Rev 2002;(1):CD001044.

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