What causes bhp

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Last updated: April 4, 2026

Quick Answer: BHP, or Benign Prostatic Hyperplasia, is a non-cancerous enlargement of the prostate gland. It is primarily caused by aging and hormonal changes, specifically a decrease in testosterone and a relative increase in estrogen, which can stimulate prostate cell growth.

Key Facts

BHP affects more than 50% of men over 60 years old.
It is a common condition, not a form of cancer.
Hormonal changes associated with aging are the primary drivers.
BHP can lead to symptoms like frequent urination and difficulty emptying the bladder.
While not fully understood, genetics and lifestyle factors may also play a role.

What is Benign Prostatic Hyperplasia (BHP)?

Benign Prostatic Hyperplasia, commonly known as BHP, is a very common non-cancerous condition characterized by the enlargement of the prostate gland. The prostate is a small gland in men, located just below the bladder, that surrounds the urethra (the tube that carries urine from the bladder out of the body). As men age, the prostate naturally tends to grow larger. This enlargement, when it causes bothersome symptoms, is referred to as BHP.

It's crucial to understand that BHP is not cancer and does not increase a man's risk of developing prostate cancer. However, the symptoms of BHP can sometimes be confused with those of prostate cancer, making regular medical check-ups important for accurate diagnosis.

What Causes BHP?

The exact cause of BHP is not fully understood, but it is strongly linked to the aging process and hormonal changes that occur in men over time. The primary factors believed to contribute to BHP include:

1. Aging:

Age is the most significant risk factor for developing BHP. While the prostate gland begins to grow in about 20% of men in their 30s, symptoms typically don't appear until after age 50. The prevalence of BHP increases with age; by the time men reach their 60s, more than half have some degree of prostate enlargement, and by their 80s, up to 90% of men are affected. This suggests a natural, age-related process rather than a disease in the traditional sense.

2. Hormonal Changes:

Hormones play a critical role in the development and growth of the prostate. During puberty, androgens, primarily testosterone, stimulate the prostate to grow. As men age, testosterone levels gradually decline. However, another hormone, dihydrotestosterone (DHT), which is derived from testosterone, remains at higher levels in the prostate and is thought to be a key factor in the continued growth of prostate tissue in older men. It's believed that a decrease in testosterone, coupled with a relative increase in estrogen (which men also produce), may lead to an imbalance that promotes prostate cell proliferation and enlargement.

3. Other Potential Factors:

While aging and hormonal changes are the leading causes, other factors may contribute to or influence the development of BHP:

Genetics: A family history of BHP may increase a man's risk. Certain genetic predispositions could make the prostate more susceptible to age-related hormonal influences.
Lifestyle: Some studies suggest that lifestyle factors might play a role, although the evidence is not conclusive. These could include diet, obesity, lack of physical activity, and metabolic syndrome. For instance, men with metabolic syndrome (a cluster of conditions including high blood pressure, high blood sugar, unhealthy cholesterol levels, and excess abdominal fat) may have a higher risk of developing BHP.
Ethnicity: BHP appears to be less common in men of Asian descent and more common in men of European and African ancestry, suggesting potential genetic or environmental influences.

BHP Symptoms and Diagnosis

The enlargement of the prostate gland in BHP can press on the urethra, obstructing the flow of urine. This can lead to a variety of lower urinary tract symptoms (LUTS), which can be categorized as:

Voiding symptoms: Difficulty starting urination, a weak or interrupted urine stream, straining to urinate, and a feeling of incomplete bladder emptying.
Storage symptoms: Increased frequency of urination (especially at night, known as nocturia), a sudden urge to urinate (urgency), and sometimes incontinence.

Diagnosis typically involves a medical history, a physical examination (including a digital rectal exam to feel the prostate), urine tests, blood tests (to check kidney function and prostate-specific antigen levels, PSA), and sometimes imaging tests like ultrasound.

Treatment for BHP

Treatment for BHP depends on the severity of symptoms and their impact on a man's quality of life. Options range from watchful waiting for mild symptoms to medications that relax the prostate muscles or shrink the gland, and in more severe cases, surgical procedures to remove excess prostate tissue.

Understanding the causes of BHP, primarily aging and hormonal shifts, is key to managing expectations and seeking appropriate medical advice if symptoms arise. It's a natural part of aging for many men, but its symptoms can significantly affect daily life and should be discussed with a healthcare provider.