Does stress worsen benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH) induces symptoms which affects patients physically (including difficult to urinary urgency, frequent urination and nocturia). Such symptoms create mental distress which can affect sleep quality of patients. If the symptoms of BPH can create stress, is the vice versa possible?

A clinical study of prostatic symptoms was conducted at the University of lowa to investigate the relationship between stress and the prostate.^{1, 2} 83 men with an average age of 68 and diagnosed with BPH were evaluated. In order to assess the severity of BPH, each man underwent a complete urologic evaluation, which included ultrasound measurements of the prostate and the amount of urine that remained in bladder after normal urination. In addition, all subjects completed questionnaires to measure total lifetime stress, recent stress and hostility.¹

n general, the larger the prostate and the volume of urinary retention, the higher the severity of BPH. The study showed that men who reported high levels of recent stress had more difficulty emptying their bladders even with smaller prostate, which proved the relationship between stress and urination.¹ Scientists believed that the study describes two possibilities: one is the body’s testosterone and hormone dihydrotestosterone, which can encourage prostate growth; the other possibility is stress triggers the release of adrenaline, which leads to the muscle cells contract. With tense muscle cells, they narrow the urethra, slowing the flow of urine and preventing the bladder from emptying completely.

This study proved that stress may aggravate the symptoms of BPH, and meanwhile having BPH can be plenty stressful on its own, which results in a vicious circle. Patients who are having the symptoms of BPH are advised to seek immediate medical attention to relieve symptoms, and to exercise more or to connect with friends to reduce stress in daily life.

References

1. Ullrich PM, et al. Psychosom Med 2005; 67: 476-82.
2. Ullrich PM, et al. Urology 2007; 70: 487-91; discussion 491-2.