Every year, as our population ages, a larger and larger numbers of men visit their doctors complaining of problems urinating. They can't go, start and stop, have dribbles and weak flow, and in some cases pain. After describing these symptoms to their doctor and undergoing a rather uncomfortable exam they are told they have Benign Prostatic Hypertrophy (BHP) also known as an enlarged prostate.
It is also called Benign Prostatic Hyperplasia in the medical world. No matter its name it is a common problem in men over the age of 65. In fact fifty percent of all men over the age of sixty will suffer its effects while ninety percent of all men in their seventies and eighties will have to deal with BHP.
The big question for medical scientists is what causes benign prostatic hypertrophy? It seems to be a natural part of the aging process and seems to be a common condition for the vast majority of men.
The problem is there doesn't appear to be an easy answer to this question. Modern medicine doesn't have a specific cause but there is enough information to create a few viable theories.
If a mans father, brother, or other close relative has had BHP then chances are higher that he will also suffer it affects. This points to a genetic component that suggests it is passed down through the males in families.
Another theory suggests that cells of the prostate are given genetic instructions that controls its growth during puberty and for some unknown reason these instructions get sent again later in life causing the prostate cells to grow again or makes it more sensitive to growth promoting hormones.
Medical researchers have also discovered that men who have had their testes taken out early in life before puberty do not suffer from benign prostatic hyperplasia. It is thought that as the testes age they somehow contribute to its enlargement.
The role of the testes in all this is still not understood. What is known is that men produce testosterone and small amounts of the female hormone estrogen all through their life. As they age testosterone levels decrease but the levels of estrogen do not decrease at the same rate. It is theorized that as estrogen levels become proportionally higher it somehow promotes the activity of hormones that promote prostate cell growth.
The problem with this theory goes back to the link between men who had their testes removed not suffering from this condition. It would seem that the lack of testosterone in their bodies doesn't seem to have any negative effects on their prostate.
The most credible theory revolves around another hormone known as dihydrotestosterone (DHT). It is the hormone that is crucial for the development of the sex organs while still in the womb. It also starts the development of facial hair, the prostate, and deepens the voice during puberty.
Made from testosterone, DHT lives in the prostate and is thought to affect its growth. The interesting thing about DHT is that even as the production of testosterone drops as men age DHT production keeps humming along. It accumulates in the prostate promoting growth. Men who do lose the ability to produce DHT do not suffer from BHP.
Researchers continue to delve into identifying the causes of benign prostatic hypertrophy. Hormonal changes during the aging process are most certainly a primary cause, along with some men's genetic predisposition to BHP.
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