FAQs

Whilst these responses aim to answer your general enquiries, they are no substitute for visiting a healthcare professional. These responses are based only on the information provided and not on a man's medical history or following a physical examination. Only a healthcare professional can diagnose and treat a condition, so it's essential that you seek advice from a healthcare professional. if you are worried about any aspect of your health.

What is a prostate?

The prostate gland (or, simply, prostate) is a walnut-shaped organ found just underneath the bladder in men. It's normally about 4cm wide and 3cm thick.³ It produces a milky fluid, which, together with sperm and other secretions, makes up semen. The urethra is the tube that carries urine from the bladder out through the penis, and runs through the middle of the prostate.

Do women have a prostate?

No, women don't have a prostate.

What can go wrong with the prostate gland?

The three main things that can go wrong are:⁹

• BPH - benign prostatic hyperplasia, a simple enlargement of the prostate
• Prostatitis - inflammation or infection of the prostate
• Prostate cancer

What is BPH?

BPH stands for benign prostatic hyperplasia. It is an overgrowth of the cells in the prostate gland. As the prostate gets bigger, it starts to obstruct the urethra because it is near to the bladder. This is what causes the symptoms of BPH, such as needing to go to the toilet often or taking a while to get started. These urinary symptoms can have an extremely negative impact on a man's quality of life.¹⁶

How do I know if I've got BPH?

You will probably have what doctors call lower urinary tract symptoms or LUTS. The symptoms: ⁴

• Poor stream - The flow of urine is weaker, and it takes longer to empty your bladder
• Hesitancy - You may have to wait at the toilet for a while before urine starts to flow
• Dribbling - Towards the end of passing urine, the flow becomes a slow dribble
• Poor emptying - You may have a feeling of not quite emptying your bladder
• Frequency (passing urine more often than normal). This can be most irritating if it happens at night. Getting up several times a night is a common symptom and is called 'nocturia'.
• Urgency. This means you have to get to the toilet quickly when you 'need to go'.

Can these symptoms be caused by anything else?

Although BPH is the most common cause of these symptoms in men over the age of 40, a number of conditions can also cause similar symptoms. The only way to be sure that you have BPH and not another condition is to get advice from a healthcare professional.

How common is BPH?

The prostate gets larger in most men as they get older and, overall, one in four (25%) of men over the age of 40 can expect to suffer from the symptoms of BPH.¹ Your chance of having BPH also increases with age. By 60, around six out of 10 men are affected. This rises to nine out of 10 in 85-year-olds.⁹

Does it have any other names?

Yes, you might also hear it being called benign prostatic hypertrophy, benign prostatic obstruction or just enlarged prostate (EP). It can also be referred to by the symptoms it causes - LUTS or lower urinary tract symptoms.

What can I do to make the symptoms better?

The symptoms may be improved by taking your recommended prescription medications regularly. Also, pelvic floor exercises, altering fluid intake and changes to your diet may also help. ²⁷

Can BPH be treated?

Yes, in most cases BPH can easily be treated - it is not a condition you have to put up with. There are over the counter and prescription medicines you can take that can relieve the symptoms or slow the enlargement of the prostate. If these don't work, there are other options that you can discuss with your healthcare professional.

What should I take with me when I visit my pharmacist?

If you have kept an online diary it may help the pharmacist if you print it off and take it with you to help them assess the severity of your symptoms.

In addition, providing the following information will help your pharmacist assess your condition more accurately and thoroughly. As an aide memoir, try to remember MAPS:

• Medications: have a complete list of all medications you take. That should include prescription items, over-the-counter products, alternative therapies and herbal remedies.
• Allergies: provide a full list of everything you’re allergic to.
• Personal: don‘t be embarrassed to disclose personal information. BPH is very common and its symptoms will come as no surprise to your pharmacist but you can ask to talk to him/her in a private area of the pharmacy if required.
• Share: be prepared to discuss your family medical history.

What should I take with me when I visit my doctor?

It may help your doctor if you took a urine sample with you when you visit him or her. If you have kept an online diary you might also want to print this off and take it with you to help your doctor assess the severity of your symptoms.

Why does BPH happen?

Doctors don't know why some men get BPH symptoms and others don't. It is related to ageing, with older men more likely to have it, but even some younger men over about 40 years have urinary symptoms due to BPH. BPH may also be linked to the amount of testosterone you have in your body.⁹ Some doctors think that as you get older, prostate cells become more sensitive to a hormone called dihydrotestosterone, which is related to testosterone. There may also be genetic, environmental and dietary links.^28,29

Can I prevent it?

There is no evidence to suggest that BPH can be prevented, but eating a balanced diet, low in saturated fats, and taking regular physical activity will increase your chances of staying generally healthy. Some doctors believe that high levels of physical activity could help to prevent BPH.³⁰ However, it is important to remember that BPH itself is not a life-threatening condition and occurs in most men as they get older.

Can it affect sex?

It might. Some men with BPH may also have problems with sex.⁹ You may not be able to get or keep an erection, or you may experience pain or notice a reduced amount of semen when you ejaculate.¹⁰ These symptoms may well improve by treating the BPH. However, some medicines can cause a reduction in the amount of semen when ejaculation occurs. This is caused by the bladder neck relaxing, causing the semen to go up into the bladder.³¹ This will not cause you any harm and, in fact, can be a sign that the medicine is working.

If the prostate is located just under my bladder, why is it examined via the rectum?

The prostate is in close proximity to the rectum (back passage). A doctor can feel it by putting pressure on the inside wall of the rectum with a gloved finger due to its close proximity to the rectum.

Can I live without a prostate gland?

Yes, although it's not common to have your prostate gland completely removed due to BPH that has not responded to medicines. The more common operation is to remove part of the prostate gland.

What happens if I do nothing?

It is essential that you speak to a healthcare professional if you think you might be suffering from BPH. Although in some men nothing will happen if they do not treat the condition, many find that their symptoms get worse and affect quality of life more and more. ¹⁶

I've heard I can get treatment from my pharmacy – is this true?

Yes – you can now visit your pharmacist who will be happy to offer friendly advice and discuss your treatment options treatments. Your pharmacist will ask you to complete a Symptom-check Questionnaire. This will help them to identify any symptoms of a more serious nature. If they identify any alarming symptoms they will immediately refer you to your doctor. If they deem you suitable for treatment, they can supply you with some OTC treatment or they might recommend lifestyle advice to you. If you are given an OTC treatment you will still be advised to see you doctor to exclude any serious underlying conditions but you will be able to purchase the OTC treatment for up to six weeks. Once you have visited your doctor, you will then be able to continue purchasing OTC treatment as long as you do not experience any significant changes or new symptoms. Your doctor will also probably want to see you annually for a prostate health check.

The opportunity to speak with your pharmacist will help to increase awareness and understanding of BPH. In addition, the pharmacy is an ideal place to discuss your symptoms as it is more informal than a doctor’s surgery and many pharmacists have a private consultation room and are experienced in dealing with sensitive issues like this.

I don't know how to talk about it with my partner

Whilst it can be embarrassing talking about BPH and its symptoms, it may help to confide in your partner so that you both understand what's happening with your body. Remember, your BPH can often have an effect on your partner's life as well as your own. It could be that they can't sleep at night because of your trips to the toilet, or is as frustrated as you are when you need to keep disappearing to the loo at social gatherings.

You can direct your partner to the What is BPH? of this website where they can read more about BPH. Of course, if you‘re going to see a healthcare professional you may want to consider taking your partner with you for support and to ensure they receive reassurance too.