We don’t really understand the cause of BPH, but what we do know is that as a man becomes older, prostate cells become more sensitive to the testosterone known as DHT (dihydro-testosterone) circulating in the body.
Prostatic cells react and respond by dividing and multiplying (the hyperplasia mentioned above) and this causes the prostate to enlarge. However, the enlargement in itself does not always explain why BPH symptoms occur:
- Mildly enlarged prostate glands can lead to severe symptoms, including obstructive symptoms making it difficult or nearly impossible for a man to urinate comfortably
- Very large prostate glands on the other hand, have been found in men who complain of no or few symptoms.
It is suggested that apart from responding to DHT by growing more cells, inflammation is present in prostatic tissue. This leads to an irritation or disturbance of nerve function in the bladder as well as at the junction of the bladder and the prostate (known as bladder neck) which controls the flow of urine.