Understanding Age-Related Prostate Growth
For most men, the prostate begins a second growth phase after age 25, which continues throughout life. This gradual, age-related enlargement is called benign prostatic hyperplasia (BPH) and is extremely common. While a healthy young man's prostate is roughly the size of a walnut and weighs about 30 grams (or 30 ml in volume), by age 70, it is often the size of a lemon or larger.
Average Prostate Volume by Age
- 40s: Approximately 28 ml
- 50s: Approximately 30-35 ml
- 60-70s: Approximately 35-40 ml or more
It is important to remember that these are just averages, and individual prostate size can vary widely. What is considered "normal" is a broad spectrum, and the presence or absence of bothersome symptoms is often a more important indicator of health than size alone.
Benign Prostatic Hyperplasia (BPH) vs. Cancer
While a naturally larger prostate at age 70 is expected, it is important to distinguish between benign enlargement (BPH) and prostate cancer. BPH is a non-cancerous condition where an overgrowth of cells in the prostate squeezes the urethra, causing urinary symptoms. Prostate cancer, on the other hand, is the most common cancer in men after skin cancer, though it is not a direct result of BPH. Some of the symptoms of BPH and prostate cancer can overlap, which is why regular screenings are crucial.
How an Enlarged Prostate Affects the Body
The prostate is located just below the bladder, with the urethra running through it. As the prostate enlarges, it can put pressure on the urethra, leading to a variety of lower urinary tract symptoms (LUTS). These can include:
- Frequent or urgent need to urinate
- Peeing more often at night (nocturia)
- Difficulty starting urination (urinary hesitancy)
- A weak or slow urine stream
- A stream that starts and stops (intermittency)
- The feeling of incomplete bladder emptying
- Dribbling at the end of urination
Diagnosis and Measurement of Prostate Size
Doctors use a variety of methods to diagnose and measure prostate size. A complete evaluation is necessary to determine the cause of any urinary symptoms and to rule out more serious conditions like prostate cancer.
Common Diagnostic Tools
- Digital Rectal Exam (DRE): A quick and simple exam where a doctor inserts a gloved, lubricated finger into the rectum to feel the size, shape, and texture of the prostate. This can help detect any abnormalities.
- Transrectal Ultrasound (TRUS): This uses sound waves to create an image of the prostate and is the most accurate method for measuring its volume. A small probe is inserted into the rectum.
- Symptom Score Sheets: Questionnaires like the International Prostate Symptom Score (IPSS) help measure the severity and disruptiveness of BPH symptoms.
- PSA Blood Test: A blood test that measures prostate-specific antigen. Elevated PSA levels can indicate a problem with the prostate but do not necessarily mean cancer is present.
Comparison of Prostate Health Factors
| Feature | Healthy Young Prostate (approx. 20s) | Prostate in a 70-Year-Old (can vary) | Enlarged Prostate (BPH) Symptoms |
|---|---|---|---|
| Size/Volume | Walnut-sized, ~30 ml | Lemon-sized or larger, typically 35-40+ ml | Variable, but causing urinary obstruction |
| Symptom Profile | Generally no urinary symptoms | Often asymptomatic, or mild to moderate LUTS | Moderate to severe LUTS impacting quality of life |
| Risk Factor for BPH | Low | High (approx. 70-80% prevalence) | Considered a key risk factor due to age |
| Cancer Risk | Very Low | Higher risk, requires regular screening discussions | Symptoms can mimic cancer; necessitates full evaluation |
Managing Prostate Health in Later Years
Fortunately, there are many ways to manage prostate health, with treatment options ranging from lifestyle adjustments to medication and surgery. The best approach depends on the severity of symptoms and individual health factors.
- Watchful Waiting and Lifestyle Changes: For mild symptoms, a "wait and see" approach combined with lifestyle modifications can be effective. This includes reducing fluid intake before bed, moderating caffeine and alcohol, and exercising regularly.
- Medications: Several types of medications can help relieve BPH symptoms by relaxing bladder muscles or shrinking the prostate. Your doctor will determine the best course of action.
- Surgical Intervention: If symptoms are severe and do not respond to medication, various surgical options are available to remove excess prostate tissue that is blocking the urethra.
Conclusion
The normal prostate size for a 70-year-old man is larger than in his younger years, with most men experiencing some degree of age-related growth. While this is a natural part of aging, it is important to be aware of urinary symptoms that could signal BPH or, less commonly, prostate cancer. By maintaining a healthy lifestyle and discussing any concerns with a doctor, senior men can proactively manage their prostate health. For more detailed information on prostate health, the National Institute on Aging offers comprehensive resources. A conversation with a healthcare provider is the best way to determine what is normal for your body and when further evaluation is needed.
Maintaining a Healthy Prostate
- Eat a balanced diet: Focus on fruits, vegetables, and healthy fats while limiting red meat and saturated fats.
- Stay active: Regular exercise can help reduce the risk of prostate problems.
- Manage stress: Stress can worsen urinary symptoms.
- Avoid certain medications: Over-the-counter cold and sinus medicines with decongestants or antihistamines can worsen symptoms.
- Stay sexually active: Some studies suggest frequent ejaculation may be beneficial.
