When you’re in your 40s, suddenly the health reminders start rolling in. Schedule a colonoscopy. Keep an eye on your cholesterol. Maybe start stretching before you work out.
But there’s one thing most men don’t think about until it starts causing problems: their prostate.
As you get older, your prostate naturally starts to grow. It’s common and usually harmless, but it can also lead to frustrating symptoms, like getting up to pee three times a night or feeling like you never fully emptied your bladder.
“It’s important to know the symptoms and when it’s time to speak up or get treatment,” says Michael Siev, MD, a urologist at the Tallwood Urology & Kidney Institute at Hartford Hospital.
Here’s what every man over 40 should know about their prostate.
1. Benign prostatic hyperplasia (BPH) is common
Almost all men will develop prostate enlargement at some point thanks to hormone shifts, cell growth and aging.
The prostate is a small gland that wraps around the urethra, the tube that carries urine out of the body and helps produce semen.
“Benign prostatic hyperplasia, or BPH, is when the prostate grows larger,” explains Dr. Siev. “It often starts in your 40s, but it can kick in earlier – even in your 30s – or much later, like your 80s.”
> Related: 5 Signs That Your Prostate Is Enlarged
2. BPH can lead to urinary symptoms – but not always
Some people with an enlarged prostate have symptoms. Others don’t.
“It depends on how the prostate grows – both in size and shape – and how those changes play out over time,” says Dr. Siev.
When symptoms do show up, they can include:
- Waking up multiple times at night to pee.
- Feeling like you have to push or strain to get started.
- Peeing more often during the day.
- Getting sudden urges that feel hard to hold.
- Feeling like your bladder never fully empties.
Blood in the urine isn’t a typical sign of an enlarged prostate, though. Get medical care right away if you see this.
> Related: Is Your Testosterone Low? Here’s How You Can Tell
3. If you need treatment for BPH, it’s available
Not everyone with BPH needs treatment. Sometimes, lifestyle changes can get the ball rolling.
“There’s a lot you can do to support your prostate health,” adds Dr. Siev. “Keep active, eat right, maintain a healthy weight, limit alcohol, avoid tobacco and get your regular check-ups.”
But when symptoms are starting to interfere with your life, it may be time for your doctor to step in.
“Treatment depends on what’s causing the blockage,” says Dr. Siev. “We use testing to understand the size, shape and function of the prostate to help you choose the option that’s most likely to help.”
Treatment options may include:
- Lifestyle changes, like limiting how much you drink before bed.
- Medications that relax the muscles around the prostate to improve your flow.
- Minimally invasive procedures like Rezūm™ (steam therapy) or UroLift® (tiny implants that open the urethra).
- Surgery, in more advanced cases, to remove extra prostate tissue.
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4. Not all prostate changes are harmless
And while most prostate changes after 40 are harmless, there’s another reason to stay informed: prostate cancer.
Screening usually involves a PSA (prostate-specific antigen) blood test and sometimes a physical exam. But not everyone needs screening at the same time – or at all.
“Men between ages 55 and 69 should talk with their doctor about the pros and cons of prostate cancer screening,” says Dr. Siev. “It’s especially important if you have a higher health risk, like a family history of prostate cancer or if you’re Black. Your doctor can help you decide what makes sense for you.”
> Related: Do I Need a PSA Test for Prostate Cancer?
Talk to your doctor about any changes
Even if they seem minor, don’t brush off changes in urination, new discomfort or even mild symptoms.
“Don’t wait too long before bringing it up,” says Dr. Siev. “We have more options when we check you out sooner. There’s power in getting answers early.”
