For such a small nub of flesh, the prostate can cause more than its fair share of problems and concerns for men. Some are relatively minor, but there are also prostate difficulties that can affect your quality of life, or even be deadly. It's essential that you be aware of your prostate: get it checked regularly, know and watch for symptoms, and above all, take a proactive approach to prostate problems - particularly an enlarged prostate, properly known as benign prostatic hyperplasia, or BPH, one of the most common conditions associated with the gland. It's also sometimes called enign prostatic hypertrophy.

It's estimated that eight percent of men between the ages of 30 and 40 have BPH. The problem becomes worse with age, with as many as 80 percent of all men affected when they are 80 years of age or older.

The prostate is about the size of a walnut, and sits just below the bladder, surrounding the urethra. Normally, it undergoes two growth spurts: one at puberty, the other around the age of 30. Unfortunately, for many men, it doesn't stop growing, and eventually becomes large enough that it squeezes the urethra, causing problems with urination and ejaculation. This usually happens very gradually, and so many men aren't aware their prostates are getting larger until they find themselves faced with some of the symptoms: getting up several times throughout the night to use the toilet, a long time for the urine flow to start, a thin stream without much force, painful or difficult urination, dribbling, or blood in the urine. The problem can range from simply being annoying, to a worst-case scenario where the urine flow is blocked entirely.

While the symptoms of BPH (enlarged prostate) are well-documented, researchers don't have all the answers on why the gland gets bigger. Its growth spurt at puberty is understandable, given its essential role in sexual maturity. But why it "starts up" again around the age of 30, and continues to grow into an enlarged state in most men, isn't entirely understood, especially since the initial puberty-related growth stops when the gland reaches its normal size.

There are a lot of theories, though, beginning with genetics: if your father or older brothers had BPH, you will probably experience it also. However, this could simply be a case of playing the odds: since almost all men have some degree of prostate enlargement in their lifetime, it's not surprising that it "runs in families."

Many men with enlarged prostates also suffer with heart or circulatory system disease, suggesting that poor blood flow may be to blame. Given that cardiovascular problems are a known cause of erectile dysfunction, it is possible and perhaps probable that it would also affect other components of the reproductive system.

What is known is that BPH does not occur in men who have had their testicles removed, and that it regresses in those who lose their testicles after the prostate enlarges. Testosterone is believed to play a major role in prostate growth, especially dihydrotestosterone, or DHT, a powerful male hormone created by the body from testosterone. The female hormone estrogen also comes under suspicion. All men have some estrogen in their bodies, the proportion of which increases as they get older, which could possibly play a role in prostate size. No matter what the cause, though, it is clear that advancing age is the common factor in men with BPH.

Treatment for BPH is usually dependent on the severity of the problem. Even before any symptoms are noticed, doctors usually recommend regular testing for BPH and cancer. These include a rectal exam, where the doctor feels the size and condition of the prostate with a gloved finger, and a PSA blood test, which looks for prostate-specific antigen, which may indicate cancer if the levels are high.

If the symptoms are very mild, some men will simply live with them. The doctor may suggest cutting back on bladder irritants, such as caffeine or alcohol. Some over-the-counter medications may also increase the severity of the symptoms, including certain decongestants and antihistamines.

More aggressive symptoms require more aggressive treatment. Prescription medicines for BPH include alpha blockers and alpha-reductase inhibitors, which most men will need to continue taking for the rest of their lives. The two types of drugs work differently: alpha blockers are used to relax the prostate, allowing urine to flow more easily through it, while alpha-reductase inhibitors stop the prostate from becoming any larger, and may shrink it. Depending on the patient, some doctors recommend both.

Many men use herbal supplements, primarily saw palmetto, which was initially used primarily in Europe and is now widely used across the United States. It inhibits the body's conversion of testosterone into dihydrotestosterone, or DHT, a hormone believed to be instrumental in triggering prostate growth.

In cases where the prostate seriously reduces or blocks the flow of urine, surgical procedures may be required. These include catheterization, widening of the urethra, or destruction or removal of excess prostate tissue.