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As men age, their likelihood of having benign prostatic hyperplasia (BPH) (an enlarged prostate) increases. Nearly half of all men over the age of 50 have enlarged prostates. That number jumps to almost 80% of men above age 80.

Your prostate is a walnut-sized gland that sits between your bladder and rectum. It surrounds part of your urethra, the tube that carries urine and semen out of the penis.

BPH is a noncancerous condition that is believed to be caused by normal hormonal changes and cell growth.

Common symptoms of BPH include:

• Difficulty stopping or starting urination.
• Dribbling pee after urinating.
• Feeling like you cannot empty your bladder completely.
• Frequent urination, especially at night.
• Needing to urinate urgently.
• Taking longer than usual to empty your bladder completely.
• Weak urine flow.

If your prostate swells in size, it may affect your ability to pass urine or semen through the urethra. This can cause more complicated medical conditions if left untreated.

While BPH isn’t curable, certain lifestyle changes can be made to minimize symptoms and avoid surgical intervention. Here’s what to keep in mind.

Do Pelvic Floor Exercises Help an Enlarged Prostate?

An enlarged prostate can impact your urethra’s function. Pelvic floor exercises can stimulate the muscles needed to strengthen the bladder.

Kegel exercises

A Kegel is performed by squeezing the same muscles you would engage if you were trying to stop urination. Hold this contraction for a few seconds before relaxing and releasing tension. You can practice Kegels in sets of 10 three times a day.

How Does Toilet and Bladder Training Help with an Enlarged Prostate?

Toilet and bladder training methods include:

• Delayed voiding.
• Double voiding.
• Urethral milking and massage.

What is double voiding?

Double voiding is one of the most common approaches for ensuring the bladder is fully emptied. This method works best if you are sitting on the toilet to urinate.

• Sit comfortably and lean forward on the toilet slightly.
• Rest your hands on your thighs or knees.
• Urinate normally, completely emptying the bladder as much as you can.
• Lean back but stay on the toilet for 30 seconds.
• Lean forward again and try to urinate completely again.

You can try different variations of the double voiding method, including standing up and walking around for a few moments before returning to the toilet to urinate again. It is important not to strain when pushing out urine to avoid damaging pelvic floor muscles.

What is urethral milking and massage?

This technique helps urine move into the urethra, emptying the bladder by using intentional pressure under the scrotum.

• After urinating, wait a moment to allow the bladder and urethra to empty completely.
• Place three fingertips behind the scrotum, gently massaging in a forward and upward direction, outward toward the base of the penis.
• Repeat this process up to two times to ensure an empty bladder and urethra.

This technique moves urine into the urethra, where you can shake or squeeze the penis to ensure the last drops are released.

It can help to perform a Kegel exercise by holding for up to 10 seconds and then releasing after urethral milking.

What is incremental delayed voiding?

This technique is used to improve bladder function by gradually increasing the time between bathroom visits. It can help people who feel the urge to urinate suddenly and with intense urgency.

Does Stress Affect Enlarged Prostate Symptoms?

Stress can worsen BPH by releasing adrenaline into the body. This causes the muscles of the bladder and prostate to contract more. This contraction can cause the urethra to shrink and make urinating harder or more painful.

There are several ways to manage the effects of stress on BPH:

• Developing a mindfulness practice — Mindfulness practices can help reduce stress, increase presence, and improve your overall health. A short meditation in the morning or evening, attending a yoga or mindfulness class, or simply walking around the neighborhood without any distractions can prove beneficial for your stress levels and bodily function.
• Spending time with loved ones and doing activities you enjoy — This can also reduce your stress and improve your mood. Exercising, playing an instrument, making art, cooking, or reading can be relaxing activities that boost morale and reduce stress.
• Talking to someone — If you feel like you are experiencing worsening mental health, talk with a trusted family member or friend or seek help from a therapist.

Can Exercise Reduce Prostate Enlargement?

Managing a healthy weight with a regular exercise routine can improve prostate health by relaxing tightened muscles. This reduces the risk of further medical complications.

Try to exercise for at least 30 minutes several times a week with a movement you enjoy. Examples include walking, running, swimming, strength training, or playing a sport like pickleball or soccer. Breaking a sweat is a good indicator that you are exercising adequately.

How Does Diet Affect Your Prostate?

Your diet has a significant impact on your overall health, including your prostate health. You are in control of what enters your body. You can make intentional, informed decisions that have lasting effects.

What foods should I avoid with an enlarged prostate?

Certain foods and beverages can worsen BPH symptoms or increase your risk. Avoid (in high quantities):

• Alcohol.
• Caffeine, such as coffee, some teas, and sodas.
• Dairy.
• High-dose vitamin C or zinc supplements.
• Overconsumption of carbohydrates.
• Processed foods.
• Red meat.
• Saturated fats.
• Sodium.

Which foods are best for prostate health?

To eat foods that can improve BPH symptoms or decrease your risk, follow the Mediterranean diet. This diet involves eating a variety of fruits, vegetables, whole grains, and lean proteins. Consider focusing on these foods when preparing meals:

• Berries.
• Beta carotene-rich foods, such as butternut squash, carrots, mangoes, spinach, and sweet potatoes.
• Citrus.
• Greens, such as arugula, Brussels sprouts, collard greens, and kale.
• Healthy fats like avocado, olive, or vegetable oils.
• Legumes.
• Foods high in fiber to avoid constipation.
• Nuts, especially walnuts, which are sources of protein, omega-3 fatty acids, and vitamins.
• Oily fish, such as sardines, mackerel, or salmon.
• Seeds, especially sesame seeds for their zinc, and pumpkin seeds.
• Sulforaphane-rich foods, such as broccoli, bok choy, cabbage, and cauliflower.
• Tomatoes for their antioxidant properties.
• Turmeric.

Talk with your PCP or a nutritionist to receive specialized dietary recommendations for your prostate health.

How does hydration affect BPH symptoms?

While it’s important to stay hydrated throughout the day, avoiding liquids after dinnertime can improve sleep and decrease the likelihood of waking up in the middle of the night to urinate. It’s even more important to avoid caffeine and alcohol in the evenings, as these will stimulate nighttime urination.

When Do I See a Doctor About My Prostate?

When you meet with your PCP for a yearly exam, they will discuss your prostate health. Most men get regular prostate checkups around the age of 50. If you have a family history of prostate cancer or other risks, it could benefit you to begin these checkups even earlier. You may also be referred to a urologist.

Your doctor may ask you questions about your prostate, examine your prostate, or perform certain tests to determine if you have BPH or another prostate condition.

If left untreated, an enlarged prostate can lead to more serious urinary complications. These include a urinary tract infection (UTI), bladder stones, or kidney damage.

It is important to take your yearly checkups seriously. Don’t delay or allow long periods of time between checkups. Delaying care can allow symptoms to worsen until they become medical emergencies or conditions that take a lot longer to heal or are no longer treatable.

Know these symptoms and find the nearest emergency department if you are experiencing:

• Blood in your urine (it may look pink, red, or brown).
• Pain when urinating.
• The inability to urinate at all.

These symptoms could indicate a more serious health problem and need to be addressed right away.

The UPMC Department of Urology provides expert care for conditions of the male and female urinary tract and the male reproductive organs, including BPH. For more information, visit our website.