Causes of benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) refers to a benign enlargement of the prostate gland. The prostate may eventually increase to a size that is large enough to press against the urethra and bladder and cause urinary symptoms.

The exact cause of BPH is not clear but nearly 60% of men aged over 60 suffer from the condition. The symptoms of BPH range from mild to severely bothersome, depending on the degree of enlargement and obstruction caused.

Risk factors

  • Perspectives on how to communicate to older adults about stopping cancer screening
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  • Some of the risk factors for BPH include:


    Research has shown that the risk for BPH increases as a man ages. Symptoms usually start to manifest around the age of 50 and by the age of 60, most men have some degree of prostate enlargement. However, in some individuals, the condition is asymptomatic and may go undetected.

    Hormonal changes

    Research suggests that hormonal changes that occur as a man ages play an important role in the development of an enlarged prostate.

    Studies have shown that the level of the male hormone dihydrotestosterone, which stimulates the growth of prostate cells, increases with age. Others have shown that the balance between testosterone and estrogen concentrations alters with increasing age. In younger men, levels of testosterone are very high relative to estrogen levels, while in older men, this gap is narrowed by a decreasing testosterone level. This means older men have a greater proportion of estrogen in their bodies and this relative increase in estrogen has been suggested to stimulate prostate growth.

    Obesity and diabetes

    Obese men with diabetes and/or high blood pressure for long durations are at an increased risk of prostatic enlargement.

    Genetic predisposition

    Genetics are also thought to play a role in BPH. Men with a first-degree relative such as a father or brother who has been affected by BPH are more likely to develop the condition than men who do not have a first-degree relative who has been affected.


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