Last reviewed: May 12, 2026 Last updated: May 12, 2026

Written by: Jay Hastings , CEO of PlexusDx

Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations. He has more than 20 years of experience across healthcare innovation, genomics, laboratory operations, healthcare investing, and strategic finance. His work has included scaling healthcare startups, leading CLIA lab integrations, and helping expand consumer access to precision health tools.

Medically reviewed by: Jayden Lee, PharmD, EMBA

Jayden Lee, PharmD, EMBA, is the PlexusDx Medical Science Liaison with a PharmD and MBA specializing in pharmacogenomics and clinical product development, with a proven ability to bridge the gap between genomic research and practical patient outcomes. Dr. Lee has more than 10 years of professional experience in clinical pharmacy, academia, and research.

This article is part of the PlexusDx Education Hub — your resource for evidence-based guidance on hormones & fertility. Browse all Hormones & Fertility education

For many men, aging brings a familiar set of changes: waking at night to urinate, a weaker or start-stop stream, urgency, or a feeling that the bladder never fully empties. The usual cause is benign prostatic hyperplasia (BPH) — a non-cancerous enlargement of the prostate that squeezes the urethra. BPH is common, it is not prostate cancer, and it does not raise cancer risk. But it is influenced by hormones, aging, lifestyle, and genetics, and understanding those factors can help you and your provider stay ahead of the symptoms.

What BPH Is

The prostate is a walnut-sized gland that sits below the bladder and surrounds the urethra. In BPH, the gland grows larger with age, and because it wraps the urethra, that growth can obstruct urine flow. Typical symptoms include frequent nighttime urination, urgency, difficulty starting, a fluctuating stream, dribbling, incomplete emptying, and a higher chance of urinary tract infections. Left unaddressed, these can meaningfully disrupt sleep and daily life. Importantly, BPH is distinct from prostate cancer and carries no added cancer risk — though only a clinician can distinguish the two.

The Hormonal Driver: DHT and 5-Alpha Reductase

Prostate growth is closely tied to dihydrotestosterone (DHT), a potent androgen the body makes from testosterone. The enzyme that performs this conversion is 5-alpha reductase, encoded largely by the SRD5A2 gene. Variants in SRD5A2 can influence how much DHT the prostate is exposed to over a lifetime, which helps explain why hormonal biology sits at the center of BPH. This androgen pathway is also why several medical approaches to BPH focus on modulating DHT — a decision that belongs entirely with a physician.

Genetic Factors in BPH

Genetics accounts for roughly 40% of the variation in BPH risk between men, and a family history of prostate issues raises the odds. Beyond SRD5A2, the AR (androgen receptor) gene matters: the length of a repeating CAG segment within AR affects how strongly cells respond to androgens, and this has been studied in relation to prostate growth. Genes involved in estrogen balance, such as CYP19A1 (aromatase), have also been examined, since the ratio of androgens to estrogens shifts with age. No single gene causes BPH; it emerges from several hormonal-pathway genes interacting with aging.

Non-Genetic Risk Factors

Age is the strongest driver — BPH becomes far more common after 50. Other contributors include obesity, metabolic conditions like diabetes and heart disease, and certain medications. Ethnicity plays a role too, with reported differences in risk across populations. Regular physical activity is associated with lower risk, which underscores that lifestyle interacts with inherited biology. These factors are levers you can discuss and, in some cases, influence — unlike your genotype, which is fixed.

Evaluation and Management With a Provider

BPH should be evaluated by a clinician, who may use a symptom questionnaire, a physical exam, and appropriate tests to assess the prostate and rule out other causes. From there, the options a provider might discuss range from watchful waiting and lifestyle adjustments to medications that relax the bladder neck or reduce DHT, up to procedures for more advanced cases. The right approach is individual. Genetic and lifestyle context can inform that conversation, but the evaluation and any treatment plan belong with a qualified healthcare provider.

What Genetic Insight Adds

Understanding that variants in SRD5A2, AR, or CYP19A1 shape your androgen biology does not diagnose, treat, or prevent BPH — it adds context about the hormonal pathways involved and can encourage earlier, more informed monitoring. The Precision Peptide Genetic Test analyzes your DNA across 14 pathways, 49 peptides, 150+ genetic insights, mapping hormone and metabolic pathways rather than delivering a diagnosis. PlexusDx tells you about your biology; it does not tell you what to put in your body. Use the insight to prompt the right conversation, then let your provider guide the plan.

Frequently Asked Questions

Is an enlarged prostate genetic?

Genetics accounts for roughly 40% of the variation in BPH risk, and a family history of prostate issues raises the odds. Genes in the androgen pathway, especially SRD5A2 (which produces 5-alpha reductase) and the androgen receptor gene AR, are studied contributors. Age and lifestyle interact with this inherited biology.

What role does SRD5A2 play in BPH?

SRD5A2 encodes 5-alpha reductase, the enzyme that converts testosterone into DHT, the androgen most linked to prostate growth. Variants in SRD5A2 can influence lifetime DHT exposure in the prostate. This is why the androgen pathway is central to BPH biology and to how physicians think about managing it.

Is BPH the same as prostate cancer?

No. BPH is a benign, non-cancerous enlargement of the prostate and does not raise prostate cancer risk. However, both can cause urinary symptoms, so only a clinician can distinguish them through proper evaluation. If you have urinary changes, see a provider rather than assuming the cause.

Can a genetic test manage my prostate health?

No. A genetic test does not diagnose, treat, or manage BPH. It provides pathway-level context about androgen genes such as SRD5A2 and AR that you can bring to a provider. Evaluation and any management plan are determined by a qualified healthcare professional, not a DNA report.

Curious how your own biology fits the picture? Take the Precision Peptide Genetic Test to see pathway-level context drawn from your DNA — then bring those insights to a conversation with your provider. Test before you invest.

This article is part of the PlexusDx Education Hub. Browse all Hormones & Fertility education

The Precision Peptide Genetic Test analyzes how your genes influence peptide-related biological pathways. It does not recommend, prescribe, or determine which peptides you should use, and it does not diagnose, treat, cure, or prevent any condition. Consult a qualified healthcare provider before beginning any peptide protocol or making changes to your care.

Medical and Editorial Standards

Medical review process: This article was reviewed for medical accuracy, scientific clarity, evidence alignment, and appropriate discussion of genetics, medications, supplements, biomarkers, and health-related claims.

Sources and evidence: PlexusDx educational content is developed using peer-reviewed research, clinical literature, reputable medical references, and, where applicable, public health or regulatory guidance. References are included at the end of the article when scientific, medical, or health-related claims are discussed.

Commercial transparency: PlexusDx offers genetic testing, blood biomarker testing, personalized supplement recommendations, and related precision wellness services. Product mentions are intended to help readers understand available options and should not be interpreted as medical advice.

Important disclaimer: PlexusDx educational content is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about medications, supplements, genetic testing, lab testing, or health-related care.