For men under age 50, the most common problem of the prostate is prostatitis, and for men over age 50, the most common prostate problem is prostate enlargement. This condition is also called benign prostatic hyperplasia (BPH). The prostate, which surrounds the urethra in men, is typically the size of a walnut, but with age, it can increase to the size of a lemon. When this occurs, pressure is put on the urethra, which can make urinating difficult.

The reason the prostate starts to enlarge is not specifically known, but it is thought to be related to the effect of male hormones, including testosterone, on the aging gland. Family history of prostate enlargement can also increase the odds of developing BPH. BPH is very common - affecting over 10 million American men. That includes half of all men over the age of 50 and nearly 80% of men over the age of 70. Older men are also at risk for prostate cancer, but prostate cancer is much less common than BPH.

BPH is not linked to cancer and does not raise your chances of getting prostate cancer - yet the symptoms for BPH and prostate cancer can be similar and include:

- Hesitancy (difficulty urinating)
- Frequency (urinating more frequently than usual)
- Nocturia (frequent urination at night)
- Feeling that the bladder has not fully emptied
- Urgency (a strong urge to pass urine)
- Stasis (decreased urinary flow)
- Stopping and starting again several times while passing urine
- Urinary tract infections

While there is no cure for BPH, medications or surgery can often relieve the symptoms. BPH symptoms do not always grow worse. In general, there are four ways to manage BPH:

1. Watchful waiting (regular check-ups with your doctor)
Men with mild symptoms of BPH who do not find them bothersome often choose this approach. Watchful waiting means getting annual checkups.

2. Drug Therapy
Millions of American men with mild-to-moderate BPH symptoms have chosen prescription drugs over surgery since the early 1990s. There are two main types of drugs used. One type, which is alpha-blockers, relaxes muscles near the prostate, while the other type-5 alpha-reductase inhibitors, such as finasteride - shrinks the prostate gland.

3. Natural Health Remedies
Some specific natural supplements have been proven to promote prostate health. The following are examples of herbs and nutrients that are used to support prostate health:

- Saw palmetto, a natural herb, has been clinically shown to decrease the urinary symptoms associated with BPH.
- Ginger root has powerful anti-inflammatory effects.
- Both nettle root extract, which increases urinary output, and pumpkin seed have been approved by Germany\'s Commission E for relieving urinary disorders associated with BPH.
- Pygeum bark extract decreases frequency of nighttime urination, permits more complete emptying of the bladder, and increases peak urine flow by about 23%.
- Maca root decreases symptoms of BPH and may have a great side effect of improving sexual function.
- L-Arginine is an essential amino acid, which may play a role in improving sexual function, as well as in enhancing the immune system.
- Green tea leaf contains an active ingredient that is a powerful antioxidant polyphenol compound, which may reduce symptoms of BPH and may play a role in cancer prevention.
- Vitamin E protects the prostate from oxidative damage by unstable molecules known as free radicals.
- Zinc is an antioxidant mineral, which protects the prostate from oxidative damage.
- Selenium, another antioxidant mineral, protects the prostate from oxidative damage.

There are many herbal supplements that contain some of these ingredients, but look for the supplements that include all of these ingredients for maximum effectiveness.

4. Surgery
Surgery is used when symptoms are severe or drug therapy has not worked well. Types of surgeries include:

- TURP (transurethral resection of the prostate) is the most common surgery for BPH, accounting for 90% of all BPH surgeries. The surgery takes about 90 minutes. The doctor passes an instrument through the urethra and trims away extra prostate tissue, which is sent to a laboratory to check for cancer.
- TUIP (transurethral incision of the prostate) is similar to TURP.
- TUNA (transurethral needle ablation) removes excess prostate tissue using radio waves.
- TUMT (transurethral microwave thermotherapy) uses microwaves sent through a catheter to destroy excess prostate tissue.
- TUVP (transurethral electroevaporation of the prostate) uses electrical current to vaporize prostate tissue.
- Open prostatectomy means the surgeon removes the prostate through a cut in the lower abdomen. This surgery carries a higher risk of complications (incontinence, impotence) than other options.

Be sure to discuss options with your doctor and ask about the potential short and long-term benefits and risks of each procedure.