Benign Prostatic Hyperplasia (BPH): An Enlarged Prostate
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Benign prostatic hyperplasia (BPH)

Also called BPH, enlarged prostate, benign prostatic hypertrophy · Reviewed

Definition: Benign prostatic hyperplasia (BPH) is a condition in which the prostate grows larger than normal, but not because of cancer, NIDDK says. As it grows it can press on the bladder and urethra and slow urine flow. The NCI dictionary notes that BPH does not raise the risk of prostate cancer.

Common symptoms

The NCI dictionary lists needing to urinate often or urgently, waking many times at night to urinate, trouble starting, leaking, and pain during urination. Left untreated, BPH can lead to urine retention, bladder stones, infections and bladder or kidney damage. It is most common in older men.

Labels that mention it

  • Approved for it: Proscar (finasteride 5 mg) and Avodart (dutasteride) improve symptoms and lower the risk of acute urine retention and surgery. Cialis is approved for BPH symptoms and for ED with BPH.
  • Warned about: the AndroGel label says men with BPH may see symptoms get worse on testosterone, and that androgens may raise prostate cancer risk.
  • Affects lab work: finasteride and dutasteride cut PSA by about half, so results are read against a new baseline.

Why it matters for your log

NIDDK says the prostate has two growth phases: it doubles in size early in puberty, then grows slowly again from around age 25 for the rest of life. BPH usually develops late in that second phase, which is why it is so common in older men.

Urinary changes come on slowly. A short note when night-time trips or a weak stream first show up, next to testosterone dose changes and PSA results, gives the prescriber a timeline instead of a guess.

Read more on Dose Track: Can TRT make urinary symptoms worse? · Proscar side effects · Avodart side effects · Cialis side effects

General education drawn from labels and published studies, not personal medical advice. Your prescriber, pharmacist and the label that came with your product are the final word.
Prostate-specific antigen (PSA)Prostate-specific antigen (PSA) is a protein made by the prostate gland and found in the blood. The NCI… PDE5 inhibitorA PDE5 inhibitor is a class of drugs that includes sildenafil (Viagra) and tadalafil (Cialis). The Viagra… Testosterone esterA testosterone ester is testosterone with a fatty acid chain attached, such as cypionate or enanthate. The… Free testosteroneFree testosterone is the part of testosterone in your blood that is not attached to a protein. Most… Off-label useOff-label use is using an FDA-approved drug in a way its label does not cover: for a different condition,…

Frequently asked questions

Does BPH turn into prostate cancer?+
No. The NCI dictionary says BPH does not increase the risk of prostate cancer, though both can raise PSA.
Can testosterone make BPH worse?+
The AndroGel label says men with BPH may see their symptoms worsen, and that men are checked for prostate cancer before and during treatment.

Sources

  1. NIDDK (NIH): Enlarged prostate (benign prostatic hyperplasia)
  2. NCI Dictionary of Cancer Terms: benign prostatic hyperplasia
  3. Proscar (finasteride 5 mg) US prescribing information, DailyMed
  4. Avodart (dutasteride) US prescribing information, DailyMed
  5. Cialis (tadalafil) US prescribing information, DailyMed
  6. AndroGel 1.62% (testosterone gel) US prescribing information, DailyMed

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