Benign prostatic hyperplasia
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of BPH.
Alternative Names
Enlarged prostate
Causes of Benign Prostatic Hyperplasia
The causes of benign prostatic hyperplasia are not fully known. Several theories have been proposed to explain benign cell growth in older men.
Hormonal Changes
Male Hormones.
Androgens (male hormones) most likely play a role in prostate growth. The most important androgen is
testosterone
, which is produced throughout a man's lifetime. The prostate converts testosterone to a more powerful androgen,
dihydrotestosterone
(
DHT
). DHT stimulates cell growth in the tissue that lines the prostate gland (the glandular epithelium) and is the major cause of the rapid prostate enlargement that occurs between puberty and young adulthood. DHT is a prime suspect in prostate enlargement in later adulthood.
Estrogen.
Some authorities believe that the female hormone estrogen may also play a role in BPH. (Some estrogen is always present in men.) As men age, testosterone levels drop, and the proportion of estrogen increases, possibly triggering prostate growth.
Late Activation of Cell Growth
Another theory focuses on cells in a certain section of the gland that may become active late in life, signaling other prostate cells to replicate or causing them to be sensitive to growth-stimulating hormones.
Defective Cell Death
This theory suggests that a process known as apoptosis, in which cells naturally self-destruct, goes awry and results in cell proliferation.
Blood Vessel Injury
Some experts theorize that the blood vessels in the prostate gland may deteriorate as men age, causing abnormal blood flow and oxygen loss, which would stimulate cell growth. Such a theory is supported by the presence of heart and circulatory problems in many men with BPH.
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Review Date: 6/26/2006
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Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital
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