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Can stress cause an enlarged prostate?

Although the exact relationship between stress and BPH is unclear, it's possible that stress may cause levels of certain hormones to shift, which in turn results in prostate enlargement. All of which makes it imperative to manage stress levels as you age, particularly when you have BPH.

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If you have benign prostatic hyperplasia (BPH) — also called enlarged prostate — it may or may not affect your ability to urinate. Although most men will develop BPH over time, symptoms generally start after the age of 50, according to the National Institute of Health. The most common symptom of BPH is the frequent need to urinate, especially at night, the American Urological Association (AUA) says. Men may need to urinate as often as every one to two hours, depending on the severity of their BPH. Other symptoms can include a feeling of incomplete emptying of the bladder, leaking, and feeling like you need to urinate urgently or frequently. This latter symptom in particular can cause increased levels of stress in many men, as the frequent need to use the bathroom may interrupt their days and impact their work and social lives. Perhaps not surprisingly then, a study published in July 2020 in the Journal of Endourology found that men experienced higher levels of anxiety as their BPH symptoms worsened. “It's not necessarily that stress makes the prostate enlarge more, but there may be certain behaviors that somebody who's more stressed might exhibit that might affect the way they urinate,” explains Petar Bajic, MD, a urologist at the Center for Men’s Health at the Glickman Urological and Kidney Institute at Cleveland Clinic in Ohio. “Men in general are not great about talking about things that might be stressing them out or causing anxiety or even depression, but it's really important to take these issues seriously and to have a very deliberate approach to stress relief and managing difficult emotions,” he adds. In addition, it turns out that stress may also worsen the symptoms of BPH, according to Harvard Medical School. Although the exact relationship between stress and BPH is unclear, it’s possible that stress may cause levels of certain hormones to shift, which in turn results in prostate enlargement. All of which makes it imperative to manage stress levels as you age, particularly when you have BPH.

Stress Management Techniques for BPH

There are several things you can do to help make managing BPH less stressful, as well as practices that can help reduce your overall stress levels. Stress management for BPH starts with some behavioral changes that can help ease your symptoms, according to Dr. Bajic: Proactively treat your bladder health. While BPH symptoms don’t require treatment for everyone, it’s still important to check in with your doctor to stay as healthy as you can. “If a man is worried that he may have prostate enlargement, it's important that he goes to see a doctor who is experienced in this condition,” Bajic says. This can be a primary care doctor or a urologist. Once your symptoms are under control, you’ll probably have annual checkups, he adds. Follow some healthy habits. For men with BPH, there are several practices that can help ease symptoms throughout the day. These can include avoiding drinking fluids within a few hours of bedtime, avoiding caffeine, and not holding your urine for too long, according to Bajic. In addition, these techniques can help lower your overall stress levels, he says:

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Lean on your support system. You don’t need to go it alone. “Talk about your stress with people in your support group, whether that's your partner or friends or family, or even a licensed therapist,” suggests Bajic. Get moving. Exercise is a proven stress-buster. According to the Anxiety & Depression Association of America, regular aerobic exercise can help decrease tension, improve sleep, and elevate your mood. And it doesn't have to be for long — even five minutes of exercise can help lower anxiety. Explore mindfulness. Practices like meditation and yoga have also been shown to alleviate stress. According to a June 2019 article published in the American Journal of Pharmaceutical Education, college students who completed a six-week program of yoga and guided meditation before final exams experienced a significant reduction in anxiety and stress. Get a good night’s sleep. Get at least six hours of sleep per night and try to stick to a regular sleep schedule. In addition, avoid the blue light of device screens just before bedtime, as it can disrupt sleep.

Don’t Stress About Stress

If these practices aren’t enough to lessen your symptoms, don’t worry. Every case of BPH is different, and there are several effective treatment options if lifestyle changes aren’t enough, including medication and surgical procedures, some of which are minimally invasive, according to Bajic. “Talk to a urologist who is experienced with treating BPH to make sure that you're really getting an understanding of what all of the different treatment options are that are available,” he suggests. “And that way you can make an informed decision about what might be the best approach.”

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