Men's health & hormones
Enlarged prostate (BPH)
We assess and treat an enlarged prostate, which is what usually causes urinary symptoms in men over 50 — a weak stream, going more often, getting up at night. It is very common, it is not cancer, and there is a lot that can be done about it if it is affecting your life.
Come in if you have
- Getting up at night to urinate, more than once
- A weak or interrupted stream, or straining to start
- Feeling you have not fully emptied
- Sudden urges, or going much more often
- You are over 50 and have never discussed prostate health
What happens at your visit
- We ask how much this actually bothers you, which matters more than any measurement.
- We test your urine to rule out infection, and check kidney function.
- We discuss PSA testing and what it does and does not tell you, before deciding whether to do it.
- We treat according to how much it affects you — from watchful waiting to medication to referral.
Extremely common, and treatable
Prostate enlargement affects the majority of men as they age. It is not cancer, it does not become cancer, and it is not something to feel awkward raising.
What it does do is disrupt sleep — getting up two or three times a night wears people down considerably, and many men simply adapt to it for years without mentioning it.
Treatment follows how much it bothers you
This is the key principle. The size of the prostate correlates poorly with how much trouble it causes, so the decision is based on your symptoms and your tolerance of them.
- Mild, not bothersome — monitoring is perfectly reasonable, with some practical adjustments to fluid timing and caffeine
- Moderate, affecting sleep or daily life — medication usually helps substantially
- Severe, or complications — referral to a urologist, where procedures are available and effective
First we rule other things out
Urinary symptoms in men are usually BPH, but not always. We check a urine sample for infection, look at kidney function, and consider diabetes, medications and bladder problems — all of which can produce a similar picture and need different treatment.
On PSA
We will not simply order it without discussion. PSA testing genuinely finds some cancers early. It also finds slow-growing ones that would never have caused problems, and the resulting biopsies and treatments carry real risks of their own.
Reasonable, well-informed men decide differently on this. Our job is to give you the actual trade-off rather than a default.
Get seen urgently if
You cannot pass urine at all — that is an emergency and needs immediate attention. Also come in promptly for blood in the urine, fever with urinary symptoms, or sudden significant worsening.
Common questions
- Does an enlarged prostate mean cancer?
- No. Benign prostatic hyperplasia is a normal enlargement that happens to most men with age, and it is not cancer and does not turn into it. That said, some symptoms overlap, which is why we assess rather than assume.
- Should I have a PSA test?
- It is a decision to make together, not automatic. PSA can detect cancer early, but it also picks up things that would never have caused harm, leading to biopsies and treatment that carry their own consequences. Your age, family history and ethnicity all affect the balance. We will explain both sides.
- Do I have to take medication?
- Not necessarily. If symptoms are mild and not bothering you much, monitoring is a legitimate choice. Treatment is driven by how much it affects your life, not by the size of the prostate.
- Will treatment affect me sexually?
- Some prostate medications can, and you should know that before starting rather than discovering it afterwards. Different drug classes have different profiles. We will be upfront about the trade-offs so you can choose.
This page explains how we care for this condition at our office. It is general information, not medical advice for your specific situation — please talk to us about your own care.
Ready to get this looked at?
Call us or send a request and we will get you in — often the same or next day.