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Prostate issues

Three age-related prostate issues men should know about

Aging is inevitable and so are certain changes in the body. As men grow older, there are three prostate-related issues they may face, says Max White, M.D., a urologist at Piedmont Atlanta Hospital:

  1. Enlarged prostate gland
  2. Prostate cancer
  3. Low testosterone levels

“As men get older, there are various things that happen to their bodies, some they expect and some they don’t expect,” says Dr. White.

Enlarged prostate gland

As men age, most will develop an enlarged prostate gland. About 25 to 30 percent of men with an enlarged prostate experience symptoms, such as:

  • Difficulty urinating
  • Weak urine stream
  • Frequent need to urinate, especially at night
  • Urinary tract infection
  • Stones in the bladder
  • Decreased kidney function

Treatment options include lifestyle modifications, medication and/or surgery, depending on the severity of the symptoms.

Prostate cancer

“Part of an evaluation for an enlarged prostate is the attempt to rule out prostate cancer,” says Dr. White. In the United States, prostate cancer is the most common cancer in men, after skin cancer. Prostate cancer has many of the same symptoms as an enlarged prostate, as well as:

  • Pain or burning during urination
  • Blood in the urine or semen
  • Nagging pain in the back, hips, or pelvis
  • Painful ejaculation

Dr. White recommends men begin yearly prostate cancer screenings at age 50. Screening methods include a prostate-specific antigen (PSA) blood test and a rectal exam.

Low testosterone levels

Decreased levels of testosterone, the male sex hormone, are another common problem that comes with age. “There is a normal physiologic drop off in testosterone and it occurs in some men earlier than others,” he says. “It’s very important to recognize the symptoms of a drop off in testosterone." Symptoms include:

  • Decrease energy levels
  • Reduced sex drive
  • Depression

A blood test can determine if testosterone levels are too low. Replacement hormones can be appropriate if the cause of low testosterone is determined, whether it is a pituitary gland or testicular issue. Men should learn the advantages and disadvantages of replacement testosterone before beginning treatment.

Dr. White says prostate cancer and other prostate conditions can be worsened by replacement hormones, so men should first undergo a PSA test or rectal exam to rule out potential complications prior to treatment. Communication is key when it comes to men’s health, says Dr. White.

“Men should not feel that this is just part of getting older – there are a variety of therapies for low testosterone,” he says. “Patients should feel comfortable in reporting these symptoms, just like other symptoms that may or may not be normal aging processes. There are remedies.”

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