There are two things you should know about benign prostatic hyperplasia (BPH) and stress. The first is that having BPH symptoms causes stress. The second is that having stress makes BPH symptoms worse. BPH is the enlargement of your prostate gland, which that happens as men age. Most men in their 60s have BPH symptoms, and after age 70 up to 90% of men have BPH symptoms. Your prostate gland sits at the opening of your bladder. As it gets larger, it starts to cause symptoms like urgency and frequency because it is harder to empty your bladder completely. The Links Between Stress and BPH It's easy to understand how BPH symptoms can cause stress. Having an urgent need to find a bathroom while at work, while traveling, or when you are out on the golf course is stressful. Having to get up four or five times during the night can lead to poor sleep, which also adds to your stress. To understand how stress makes BPH worse, you need to understand the evolutionary "fight or flight" response. When your body is preparing for fight or flight, you can't stop to find a bathroom. Stress causes your body to release adrenaline, and adrenaline causes your bladder to shut down. That makes it even tougher for a man with BPH to empty his bladder. A study of 83 men with BPH enrolled in the Medical Therapy of Prostatic Symptoms (MTOPS) study found that men who had experienced recent stress had more difficulty emptying their bladders than men who did not have stress. Men who had the most stress had the most severe BPH symptoms. Tips to Reduce Stress and BPH Symptoms Limiting the amount of fluid and caffeine you drink before bed or before leaving the house and taking every opportunity you can to use a bathroom are simple ways to reduce the stress caused by BPH. Here are some tips for reducing the stress that can make BPH worse: Avoid the urge to smoke as a way to relieve stress. Smoking increases BPH symptoms. Studies show that men who smoke heavily are almost 50% more likely than nonsmokers to develop BPH and that smokers are 39% more likely than nonsmokers to have BPH symptoms. Lose some weight. Obesity is stressful and studies show that men with waistlines of at least 43 inches are more than twice as likely to have BPH as men with waistlines at or below 35 inches. Exercise regularly. Exercise will help you lose weight and reduce your stress. Walking about 20 minutes every day can reduce your risk of BPH by about 25%. When you exercise, you burn off the hormones released during stress. Exercises that combine physical activity and relaxation, like yoga, tai chi, or qigong, can be particularly helpful for stress reduction. Learn to focus your breathing. Concentrating on slowing your breathing for several minutes is a form of meditation that can reduce stress quickly. Find a quiet place; take slow, deep breaths through your nose; and let your belly expand as you inhale. While doing your breathing, think relaxing thoughts or repeat a calming phrase in your mind. Body scanning is another type of stress-reducing meditation. While focusing on your breathing, start at your head or feet and work your way up or down. As you come to each part of your body, let all the tension flow out and imagine a peaceful warmth flowing in. Give yourself time to relax. Studies show that relaxation releases a chemical called nitric oxide in your body. Nitric oxide opens up your blood vessels, which is the opposite of the stress response. Nurture yourself with meditation, a good book, or your favorite music. Nitric oxide is also good for reversing erectile dysfunction, and good sex is another way to reduce your stress. Key Takeaways BPH symptoms are stressful, and stress makes BPH worse. Avoid stressful BPH symptoms by limiting your caffeine and fluid intake, especially before going to bed or being away from home. Make healthy lifestyle choices by exercising, maintaining a healthy weight, and not smoking. Avoid stress that can add to BPH by learning how to use stress reduction techniques like focused breathing, meditation, and self-nurturing relaxation.