What are the symptoms of an enlarged prostate?
Problems peeing, mostly. Straining, a weak flow and getting up at night. It isn’t cancer, though cancer can cause the same signs. 7 questions score how bad yours are.
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What are the signs of an enlarged prostate?
Mostly problems peeing. Your prostate is a small gland below your bladder. As it grows, it can press on the tube that carries pee out, called the urethra.
Picture a foot on a garden hose. The water comes out weaker, takes longer, and some can be left behind.
| Sign | What you might notice |
|---|---|
| Hard to start | Having to push or strain to pee. |
| Weak flow | A weak, stop-start stream that takes longer than usual. |
| Not emptying | Feeling your bladder isn’t fully empty. |
| Dribbling | Drips of pee after you’ve finished. |
| Going more | Needing to go more often or urgently, including at night. |
Sources: NHS; Prostate Cancer UK
The signs usually develop slowly and may get worse as you get older. You may not get them all, and some men get none.
It’s common and not usually serious. About 1 in 3 men over 50 have peeing symptoms, and an enlarged prostate is the most common cause.
BPH is short for benign prostatic hyperplasia. Benign means not cancer. Hyperplasia means more cells, which is what makes the prostate bigger.
Notice these signs? For at least 3 days, write down how much you drink, and how often and how much you pee. Your GP will usually ask for this.
What causes an enlarged prostate?
No one knows for sure. The NHS says it’s thought to come from changes in your hormones as you get older.
Prostate Cancer UK explains that the balance of oestrogen and testosterone changes with age. This may make the prostate grow.
You may be more likely to get it if you’re over 50, or others in your family have it. Some studies show very overweight men and men with diabetes may be more likely to get it too.
You can’t change your age. You can work on your weight, and the NHS says being overweight can make symptoms worse.
Is an enlarged prostate a sign of cancer?
No. An enlarged prostate is not caused by prostate cancer, and it doesn’t raise your risk of it. The two usually begin in different parts of the prostate.
But you can have both at once. And the peeing signs can look the same.
| Enlarged prostate | Prostate cancer | |
|---|---|---|
| Is it cancer? | No | Yes |
| Peeing problems | The main symptoms | Often none at first. They can start once it has grown or spread. |
| Blood in pee | Rare, and usually caused by something else | Can be a symptom, as can blood in semen |
Sources: NHS; Prostate Cancer UK
The NHS lists other signs of prostate cancer: erection problems, lower back pain and weight loss without trying. The last two may be signs of advanced cancer.
So get peeing changes checked by a GP. If it is cancer, the NHS says finding it early may make it easier to treat.
Your GP may offer a PSA blood test. It can’t tell you if you have cancer, and a high result can come from an enlarged prostate. See our PSA blood test guide.
How bad are my symptoms?
An enlarged prostate doesn’t always need treatment. It depends on your symptoms and how they affect you.
NICE grades symptoms with a 7-question score. That score is your IPSS, short for International Prostate Symptom Score.
| How often did you... | Scores 0 | Scores 5 |
|---|---|---|
| Feel your bladder wasn’t empty after peeing? | Not at all | Almost always |
| Need to go again within 2 hours? | Not at all | Almost always |
| Stop and start several times? | Not at all | Almost always |
| Find it hard to put off peeing? | Not at all | Almost always |
| Have a weak stream? | Not at all | Almost always |
| Push or strain to start? | Not at all | Almost always |
| Get up to pee at night, on a typical night? | None | 5 times or more |
Source: NHS IPSS form
In between, score 1 for less than 1 time in 5, and 2 for less than half the time. Score 3 for about half, and 4 for more than half. For nights, score the number of times you get up.
- Below 8 points0 to 7: mild.
- 8 to just under 20 points8 to 19: moderate. Medicines may be offered.
- 20 points or above20 to 35: severe. Medicines or surgery may be offered.
Bother counts too. If your symptoms aren’t causing many problems, doctors usually suggest lifestyle changes first.
Some men find symptoms ease with time. For most, they stay the same or slowly get worse unless treated. Take your total to your GP, so you can track it over time.
How can I ease enlarged prostate symptoms?
Six NHS tips to ease symptoms
- Cut down on alcohol and caffeine, as they can make you pee more.
- Drink less before bed or going out, but drink enough the rest of the day.
- Eat enough fibre to avoid constipation, which can press on your bladder.
- Keep to a healthy weight, as being overweight can make symptoms worse.
- After you pee, wait a few moments, then try again.
- Ask a doctor or pharmacist if any of your medicines could be making symptoms worse.
Source: NHS
Don’t strain or push to pee. Try to relax. And don’t cut fluids too far, as that can cause problems such as urine infections.
For dribbling, the NHS suggests pressing gently with your fingertips, 3 finger widths behind your scrotum. Move forwards and up towards the base of your penis. Pelvic floor exercises strengthen the muscles that help control your bladder, and the NHS offers them as support.
Moderate or severe symptoms? You may be offered medicines that help you pee, such as tamsulosin. Others, such as finasteride, help stop the prostate growing if you’re at high risk of it getting worse.
If medicines haven’t helped or symptoms are severe, surgery may be offered. The most common removes part of the prostate through a thin tube passed up the penis. Never stop or change a prescribed medicine without your prescriber.
When to speak to a GP
Try not to be embarrassed. The NHS says GPs are used to talking about these symptoms. Book an appointment if:
- You find it hard to pee, or need to pee more often.
- Your symptoms change, get worse or don’t feel normal.
- You also have erection problems, blood in your semen, lower back pain or weight loss without trying.
- You keep getting urine infections, or start leaking pee at night. These can be signs you’re not emptying your bladder fully, which can harm your bladder and kidneys if not treated.
Ask for an urgent GP appointment or get help from NHS 111 if you have blood in your pee. It may look pink, red or brown. Do the same for pain when peeing, or if you cannot pee at all.
Suddenly can’t pee at all, and it hurts? Call your doctor or nurse, or go to A&E. It needs treating straight away.