Prostate Health
Symptoms, Causes & Treatment
Everything you need to know about prostate conditions: benign prostate enlargement (BPH), prostatitis, and prostate cancer — what causes them, how they are diagnosed, and the treatment options available.
What Is the Prostate & What Can Go Wrong?
The prostate is a small, walnut-sized gland located just below the bladder in men, surrounding the upper part of the urethra. Its primary function is to produce seminal fluid, which nourishes and transports sperm. Despite its modest size, the prostate is the source of some of the most common and important health conditions affecting men, particularly as they age.
Three main prostate conditions are encountered in clinical practice:
Benign Prostatic Hyperplasia (BPH) – a non-cancerous enlargement of the prostate that is extremely common with increasing age. By age 60, over 50% of men have some degree of BPH; by age 85, this rises to over 90%. BPH causes lower urinary tract symptoms (LUTS) by compressing the urethra as the gland enlarges, but it does not increase the risk of prostate cancer.
Prostatitis – inflammation of the prostate, which may be acute (bacterial), chronic bacterial, or chronic non-bacterial (chronic pelvic pain syndrome, or CPPS). Prostatitis affects men of all ages and is the most common urological diagnosis in men under 50.
Prostate Cancer – the most common cancer in men in the UK, with over 55,000 new diagnoses per year. Prostate cancer develops from the glandular cells of the prostate and ranges from slow-growing, low-risk disease that may never require treatment to aggressive, life-threatening malignancy. Early detection through PSA testing and clinical assessment is critical.
What Are the Symptoms of Prostate Problems?
Prostate symptoms depend on the condition involved. BPH and prostatitis primarily cause urinary and pelvic symptoms, while early prostate cancer may produce no symptoms at all. Any new or worsening urinary symptoms in a man over 50 warrants clinical assessment.
Difficulty starting to urinate · Weak or interrupted urine flow · Frequent urination, especially at night (nocturia) · Urgent need to urinate · Feeling the bladder has not fully emptied · Dribbling at the end of urination · Straining to pass urine · Urinary tract infections
Blood in urine (haematuria) · Blood in semen · Bone pain, especially in the back, hips, or pelvis · Unexplained weight loss · Persistent pelvic or lower back pain · Complete inability to urinate (acute urinary retention) — seek emergency care immediately
Seek urgent medical attention if you experience blood in your urine or semen, cannot pass urine at all, develop severe pelvic pain with fever, or notice unexplained weight loss with bone pain. These symptoms require same-day or emergency assessment.
What Causes Prostate Problems?
Prostate conditions have distinct but sometimes overlapping causes. Age and hormonal changes are the primary drivers of BPH. Prostatitis is usually triggered by bacterial infection or an inflammatory process. Prostate cancer arises from genetic mutations influenced by age, family history, ethnicity, and lifestyle factors.
BPH is the most common prostate condition in older men. The prostate gland enlarges with age, compressing the urethra and causing lower urinary tract symptoms (LUTS). It is not cancer and does not increase cancer risk.
Inflammation of the prostate, often caused by bacterial infection. Acute bacterial prostatitis presents with fever, pelvic pain, and urinary symptoms. Chronic prostatitis may cause persistent pelvic discomfort with minimal systemic symptoms.
Prostate cancer arises from abnormal cell growth in the prostate. It is the most common cancer in UK men. Risk increases with age, family history, and Black African/Caribbean ethnicity. Many cases are slow-growing and may never cause symptoms.
Testosterone and dihydrotestosterone (DHT) drive prostate cell growth throughout life. Hormonal imbalances associated with ageing contribute to both BPH and prostate cancer risk.
A family history of prostate cancer significantly increases risk. BRCA2 gene mutations carry a particularly elevated risk. Men with affected first-degree relatives should consider earlier screening discussions with their GP.
Obesity, high red meat consumption, and low physical activity are associated with increased prostate cancer risk. A diet rich in vegetables, particularly lycopene-containing foods, may be modestly protective.
Key Risk Factors
How Are Prostate Conditions Diagnosed?
Diagnosis depends on the specific condition suspected. For BPH and prostate cancer, PSA testing and physical examination are the starting point. For prostatitis, urine culture and clinical assessment are key. A GP can initiate the appropriate investigations and refer to urology where needed.
How Are Prostate Conditions Treated?
Treatment varies significantly by condition. BPH is managed with medications, lifestyle changes, or surgery. Prostatitis is treated with antibiotics, physiotherapy, or pain management. Prostate cancer treatment ranges from active surveillance through to surgery, radiotherapy, and hormone therapy depending on risk and stage.
Supportive Measures
Lifestyle measures play an important role in managing all prostate conditions. For BPH, reducing caffeine and alcohol, timed voiding, and pelvic floor exercises can meaningfully reduce symptoms. For prostate cancer, maintaining a healthy weight, exercising regularly, and eating a plant-rich diet supports both prevention and recovery. For prostatitis, warm baths, avoiding prolonged sitting, and anti-inflammatory pain relief support recovery alongside medical treatment.
Recurrent or Persistent Prostate Problems
Chronic prostatitis and recurrent BPH symptoms are common. If symptoms persist or worsen despite treatment, a urology referral is appropriate. PSA monitoring continues long-term for men on active surveillance for prostate cancer, with clear escalation pathways if the cancer shows signs of progression. Men with a rising PSA after radical treatment should be assessed promptly for recurrent cancer.
When Should You Seek Medical Advice About Your Prostate?
You are completely unable to pass urine (acute urinary retention) · You have a high fever with severe pelvic pain suggesting acute bacterial prostatitis or sepsis · You have bone pain with neurological symptoms suggesting spinal cord compression from advanced cancer.
You notice blood in your urine or semen · You are over 50 and have new or worsening urinary symptoms · You have a family history of prostate cancer and have never had a PSA test · You are experiencing pelvic pain with fever · You are aware of a rising PSA result that has not been followed up.
How Can You Protect Your Prostate Health?
While prostate cancer and BPH cannot always be prevented, several evidence-based lifestyle measures reduce risk and support early detection. Knowing your risk and engaging with appropriate screening is the most important step.
Men aged 50 and over, or 45+ with a family history, or 45+ of Black African/Caribbean ethnicity, can request a PSA test from their GP. Early detection significantly improves treatment outcomes.
Maintaining a healthy weight reduces prostate cancer risk and the severity of BPH symptoms. Excess body fat is associated with hormonal changes that promote prostate cell growth.
A diet high in vegetables (particularly tomatoes, broccoli, and leafy greens) and low in red and processed meat is associated with reduced prostate cancer risk. Limiting dairy may also be beneficial.
Regular aerobic and resistance exercise reduces prostate cancer risk and improves urinary symptoms in BPH. Aim for at least 150 minutes of moderate exercise per week.
Men with a father or brother diagnosed with prostate cancer, or known BRCA2 mutations, should discuss earlier and more frequent PSA screening with their GP.
Limiting alcohol, avoiding smoking, and managing stress support overall hormonal and immune health, reducing inflammatory conditions that may contribute to chronic prostatitis.
Speak to a Clinician About Prostate Health
Discussing prostate symptoms online has never been easier. Through The GP Service, you can speak to a licensed clinician confidentially from home, get a PSA test referral, and receive guidance on next steps — without waiting weeks for a GP appointment.
Expert clinical advice, when you need it.
Prostate Health FAQs
The PSA (Prostate-Specific Antigen) test is a blood test that measures a protein produced by the prostate gland. A raised PSA level can indicate BPH, prostatitis, or prostate cancer — but a high PSA does not automatically mean cancer. In the UK, PSA testing is available to any man over 50 who requests it after a discussion with their GP about its benefits and limitations. Men aged 45 or over with a family history of prostate cancer, or Black African/Caribbean men aged 45+, should consider testing earlier.
Not necessarily. An elevated PSA can be caused by BPH (benign prostate enlargement), prostatitis, recent sexual activity, or vigorous exercise before the test. A raised PSA result will typically prompt a multiparametric MRI scan before any biopsy is considered. Many men with elevated PSA do not have cancer. The test is a starting point for further investigation, not a diagnosis in itself.
BPH (benign prostatic hyperplasia) is non-cancerous enlargement of the prostate that commonly affects men over 50. It causes urinary symptoms due to pressure on the urethra but does not increase the risk of developing prostate cancer. Prostate cancer is a separate condition that can occur alongside, before, or independently of BPH. It is important to investigate urinary symptoms even if BPH is suspected, as both conditions can coexist.
Many prostate cancers grow very slowly and may never cause symptoms or shorten life. For low-risk, localised prostate cancer, active surveillance — regular monitoring with PSA tests, MRI scans, and biopsies — is a clinically appropriate option that avoids the side effects of immediate treatment. The decision to treat or monitor depends on the Gleason grade, PSA level, age, and overall health. A urologist or oncologist will guide this decision.
Treatment for localised prostate cancer — particularly radical prostatectomy and radiotherapy — can cause side effects including erectile dysfunction and urinary incontinence. These vary significantly between individuals and treatment methods. Nerve-sparing surgical techniques and modern radiotherapy approaches have reduced but not eliminated these risks. Many men recover significant function with time and with support from physiotherapy, medication, and penile rehabilitation programmes. Discussing these risks fully with your specialist before treatment is essential.
Prostatitis is inflammation of the prostate gland. Acute bacterial prostatitis causes sudden fever, pelvic pain, and urinary symptoms and requires prompt antibiotic treatment. Chronic bacterial prostatitis involves recurrent urinary tract infections linked to persistent prostate infection. Chronic pelvic pain syndrome (CPPS), also known as non-bacterial prostatitis, is the most common form and causes persistent pelvic pain without evidence of infection. CPPS is challenging to treat and may require a combination of physiotherapy, alpha-blockers, anti-inflammatories, and psychological support.
The relationship between testosterone and prostate cancer has been misrepresented for decades. The fear — based on early case reports — that testosterone causes prostate cancer is not supported by current evidence. The ‘saturation model’ suggests that at physiological testosterone levels, prostate cancer growth is driven by androgen receptor saturation, not absolute testosterone concentration. Current evidence does not show TRT increases the risk of developing prostate cancer. However, TRT is contraindicated in men with active or recently treated prostate cancer, and PSA should be monitored during TRT. Men with a history of prostate cancer require specialist endocrinology review before any TRT is considered.
Gleason grading is the pathological classification system for prostate cancer, based on the appearance of cancer cells under a microscope. The Gleason score ranges from 6 (least aggressive) to 10 (most aggressive). More recently, Grade Groups 1–5 have been introduced to simplify communication. A Gleason 6/Grade Group 1 cancer is low-risk and often managed with active surveillance. A Gleason 8–10/Grade Group 4–5 cancer is high-risk and typically requires treatment. Understanding the Gleason score helps patients and clinicians make informed decisions about whether to treat immediately or monitor.