If you’re a man over 50, chances are you’ve heard of BPH, or benign prostatic hyperplasia—the medical term for prostate enlargement. It’s incredibly common, affecting millions of men worldwide. While not cancerous or life-threatening, BPH can seriously interfere with daily life, causing frustrating urinary symptoms and sleep disturbances.
But here’s something many men don’t realize: understanding the causes of prostate enlargement isn’t just helpful—it can be empowering. Knowing why it happens gives you a better shot at managing symptoms, slowing progression, and choosing the right treatment strategy before things get worse.
From hormonal changes to genetic and lifestyle factors, several key influences contribute to how and why the prostate grows with age. And while you can’t stop time, there are ways to reduce your risk or manage the condition effectively.
In this article, we’ll explore the science behind BPH—what triggers it, who’s most at risk, and how this knowledge can guide smarter choices for long-term prostate health.
What Is Benign Prostatic Hyperplasia (BPH)?
Benign prostatic hyperplasia (BPH) is the medical term for prostate enlargement. It’s not cancer. It doesn’t mean you have a tumor. But it can still cause problems—especially with urination.
The prostate is a small, walnut-sized gland located just below the bladder. Its job? To help produce semen. As men age, the prostate often grows. This growth is non-cancerous, but it can press against the urethra—the tube that carries urine out of the body.
That pressure can lead to annoying and sometimes serious symptoms. You might notice:
- Trouble starting urination
- A weak or slow urine stream
- Feeling like your bladder isn’t empty
- Frequent urination, especially at night
- Sudden, urgent urges to pee
BPH is very common, especially in men over 50. In fact, by age 60, more than half of men have some signs of it. By age 80, up to 90% do.
Even though BPH isn’t dangerous, it can lower your quality of life. That’s why it’s important to understand what it is—and what you can do about it.
Main Causes of Prostate Enlargement: What the Science Says
Benign prostatic hyperplasia (BPH) doesn’t happen overnight. It’s the result of complex interactions between hormones, age, genetics, and lifestyle. Understanding these underlying factors can help you better manage the condition—and possibly reduce your risk. Let’s explore what science tells us about the root causes.
Hormonal Changes: The Role of Testosterone and DHT
One of the most significant drivers of prostate growth is the hormone dihydrotestosterone (DHT). As men age, testosterone levels decline, but DHT remains active in the prostate. This hormone binds to androgen receptors in prostate cells, triggering them to grow and multiply. Over time, this leads to gland enlargement.
A 2023 review in Nature Reviews Urology confirms that elevated DHT levels correlate strongly with increased prostate volume and symptom severity.
There’s also a shift in the testosterone-to-estrogen ratio as men get older. Estrogen levels rise slightly, and some researchers believe this hormonal imbalance may stimulate further prostate cell proliferation, especially when DHT is also elevated.
Aging: The Most Consistent Risk Factor
Aging and BPH go hand-in-hand. Prostate enlargement is rare in men under 40 but increases rapidly with age. By 60, more than half of men show signs of BPH; by 80, nearly all do. Aging cells become more responsive to DHT and less efficient at regulating tissue growth, making age a key risk factor regardless of lifestyle.
Genetics: It May Run in the Family
Genetics also plays a role. If your father or brother had BPH, your chances are significantly higher. A 2022 study in The Prostate found that first-degree relatives of men with BPH were nearly twice as likely to develop the condition.
Genes may influence androgen sensitivity, inflammatory response, and cellular growth rates—making some men more prone to prostate enlargement than others.
Inflammation and Prostatitis
Chronic inflammation in the prostate—whether from infection or immune response—can stimulate cellular growth and tissue remodeling. Over time, this inflammation may contribute to prostate enlargement.
A study published in European Urology found that men with histological evidence of inflammation had larger prostate volumes and more severe symptoms than those without.
Lifestyle and Environmental Factors
Poor lifestyle habits don’t directly cause BPH, but they may speed up its development or worsen its symptoms.
- Obesity increases estrogen levels and systemic inflammation—both linked to prostate growth.
- A diet high in saturated fats and low in fiber and antioxidants may fuel inflammation and hormonal imbalance.
- Physical inactivity has been associated with increased BPH risk, while regular exercise can lower it.
- Excessive alcohol, smoking, and poor sleep have also been linked to worse prostate health outcomes.
Making healthy lifestyle choices won’t necessarily prevent BPH, but they can reduce symptom severity and improve treatment outcomes.
Prostate enlargement is a multifactorial condition, shaped by hormones like DHT, aging, genetics, and daily habits. While some risk factors are out of your control, others—like diet, weight, and activity—are well within reach.
Risk Factors for Enlarged Prostate: Are You at Risk?
Knowing the risk factors for an enlarged prostate can help you stay ahead of potential problems. While benign prostatic hyperplasia (BPH) can affect almost any man as he ages, certain factors increase the likelihood—and knowing them means you can take preventive steps sooner.
1. Age Over 50
Age is the biggest risk factor. Men over 50 are significantly more likely to develop BPH. By age 60, over half show signs of an enlarged prostate; by 80, up to 90% are affected.
2. Family History
If your father or brother had prostate problems, your risk is higher. Genetics may influence how your body processes hormones like testosterone and DHT—key players in prostate growth.
3. Sedentary Lifestyle
Physical inactivity is linked to increased BPH symptoms. A sedentary lifestyle can lead to weight gain, poor hormone regulation, and chronic inflammation—all of which contribute to prostate enlargement. Regular exercise may reduce your risk and improve overall prostate health.
4. Hormonal Imbalance
As testosterone levels drop with age and estrogen levels rise slightly, the balance shifts. This hormonal imbalance promotes prostate cell growth, especially in men who are more sensitive to DHT.
If you check more than one of these boxes, it’s a good idea to talk to your doctor about screening and lifestyle changes. Recognizing risk factors for enlarged prostate early gives you the power to take action before symptoms take hold.
BPH Questions: What Men Need to Know
Is prostate enlargement preventable?
Not entirely. Since BPH is closely tied to aging and hormonal changes, it can’t always be avoided. However, healthy habits—like regular exercise, a balanced diet, and maintaining a healthy weight—may lower your risk or slow the progression.
Does prostate enlargement mean cancer?
No. BPH is not prostate cancer. It’s a benign (non-cancerous) condition and doesn’t increase your risk of developing prostate cancer. That said, some symptoms of BPH and prostate cancer overlap, so it’s important to get checked if you notice changes.
Can lifestyle changes stop prostate growth?
Lifestyle changes probably won’t stop prostate growth entirely, but they can make a big difference. Exercise, weight loss, reducing alcohol and caffeine, and eating anti-inflammatory foods may ease symptoms and improve overall prostate health.
Is BPH dangerous if untreated?
In many cases, BPH is manageable—but if left untreated, it can lead to complications. These include bladder damage, urinary retention, frequent infections, or even kidney problems. If you’re having urinary symptoms, don’t ignore them—early treatment can prevent long-term issues.
Prostate Enlargement Summary: Take Charge of Your Health
Prostate enlargement, or BPH, is a common part of aging—but it doesn’t have to take over your life. Understanding what causes BPH—from hormonal changes and age to genetics and lifestyle—can help you take proactive steps to manage it.
While you may not be able to prevent prostate growth entirely, early detection, regular checkups, and healthy daily habits can reduce symptoms and slow progression. Staying active, eating well, and knowing your risk factors make a real difference.
If you’re over 50 or experiencing urinary changes, don’t wait. Talk to your doctor about screening options and treatment strategies. The sooner you act, the more control you’ll have over your prostate health.