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 urologist Max White, M.D. They are:
- Enlarged prostate gland
- Prostate cancer
- 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,” Dr. White says.
Enlarged prostate gland
As men age, most will develop an enlarged prostate gland. About 25-30% 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,” Dr. White says. 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 replacement hormones can worsen prostate cancer and other prostate conditions, so men should first undergo a PSA test or rectal exam to rule out potential complications prior to treatment. Dr. White says that Communication is key in men’s health.
“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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