Enlarged prostate/BPH Causes
December 5, 2009 by Prostate Dr.
Risk factors for the dtraevelopment of BPH are poorly understood. Some studies have suggested racial differences while others have noted genetic predisposition. Approximately 50% of men under the age of 60 who undergo surgery for BPH may have a heritable form of the disease. This form is most likely a dominant trait, and first-degree male relatives of such patients carry an increased relative risk of approximately 4 times.
There are no clear statistics concerning the causes of BPH/Enlarged prostate. It is not clear whether certain groups face a greater risk of getting it. Studies done over the years suggest that benign prostatic hyperplasia occurs more often among married men than single men and is more common in the United States and Europe than in other parts of the world. However, these findings have been debated, and no definite information on risk factors exists.
Most specialists say that the age is the main cause behind and enlarged prostate gland. Others say hormonal levels are causing bph symptoms. While some blame it on the lifestyle.
The truth, as always, lies somewhere in between. All the aforementioned "causes" only allow to build up the terrain for the future prostatic disorder. The fact is... noone can say for sure what causes prostate enlargement.
For the prostate gland to vary in size during the lifetime is quite normal, and it has some precise limits within which it does so.
At the beginning of puberty, there is prostate growth because of the increase of testosterone levels. After puberty, when reaching an adult age, the prostate gland ceases to grow and it normally stagnates up until aroud the age of 45, when it starts to grow again, and keeps growing for the rest of the normal man's life. In an article in Urology, Oct. 1994, page 487, it says that some glands that were removed weighed as much as 230 grams. One ounce is 28.3 grams, so this prostate weighed over a half pound. Dr. A. Roumani says that he removed one that weighed 600 grams, or about 1.25 pounds.
If during puberty, testosterone quantities trigger prostate enlargement, after age 45 there is normally a reduction in testosterone levels. Thus the conclusion that there has to be something else producing an enlarged prostate other than merely testosterone levels.
One thing is certain: a functioning testicle is necessary for development of benign prostatic hyperplasia (as evidenced by the absence in males who were castrated before puberty).
Although the prostate gland continues to grow during most of a man's life, the enlargement only causes problems late in life. BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.
The etiology of BPH/Enlarged prostate is not completely understood, but the causes seem to be multiple and and endocrine controlled. The prostate is composed of both stromal and epithelial elements, and each, either alone or in combination, can give rise to hyperplastic nodules and the symptoms associated with benign prostatic hypertrophy. Each element may be targeted in medical management schemes.
Observations and clinical studies in men have demonstrated clearly that BPH is under endocrine control. Castration results in the regression of established BPH and improvement in urinary symptoms, but we would'n never advise it since it is a dehumanizing experience.
Additional investigations have shown a positive correlation between levels of free testosterone and estrogen and an prostate enlargement. The latter (estrogen correlation) may suggest that the association between aging and BPH/Enlarged prostate might result from the increased estrogen levels of aging causing induction of the androgen receptor, which thereby sensitizes the prostate gland to free testosterone. However, no studies to date have been able to demonstrate elevated estrogen receptor levels in human BPH.
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