You are here
Home > Health > Men's Health > Help- I Get Up 3 Times at Night to Pee! Do I Have an Enlarged Prostate?

Help- I Get Up 3 Times at Night to Pee! Do I Have an Enlarged Prostate?

enlarged prostate symptoms and treatment
50PlusToday sometimes uses affiliate links, and also earns from qualifying purchases as an Amazon Associate. These efforts don't cost you anything, but help offset the costs related to publishing this free resource for you. All opinions remain our own. Thank you for your support.

by Ronald Kline, M.D.

Dear Dr. K, I’m getting up two to three times a night to pee and the loss of sleep is killing me. What can I do? signed I.P. Nightly


You’re not alone

First of all, you’re not alone. Most men know what it feels like to be comfortable and cozy in bed, and then feel that pressure sensation in our bladder. We get out of bed to urinate often more than once during the night. This condition is common in men and happens more frequently with age. Nighttime urination is problematic when it disturbs your sleep patterns and productivity the next day. It’s important to seek medical attention to determine if there is an underlying reason for your nocturia.

Do I have an enlarged prostate?

For men, nightly trips to the bathroom are a symptom of an enlarged prostate or Benign Prostatic Hyperplasia (BPH). Other symptoms include:

  • Frequent or urgent need to urinate
  • Nocturia, or a need to get up at night to urinate
  • Urinary hesitancy, when you need to stand there for a while before things start to flow
  • Weak stream
  • Dribbling after urination
  • Incomplete emptying of the bladder and feeling like you need to go again

More severe symptoms of BPH include urinary tract infections, bleeding, and urinary blockage.

What is the prostate and what does it do?

The prostate is a walnut-sized gland that sits right below your urinary bladder. The urethra, the tube that urine and semen pass through, runs through the middle of the prostate. The urine flow can shut down if the prostate enlarges.

Your prostate continues to grow throughout your life, and can lead to diminished urine flow, or possibly a total blockage that requires urgent attention. We don’t know the reasons for prostate enlargement, but it’s possibly related to a hormone imbalance. One theory is that there is a reversal of the ratio of testosterone and estrogen. (Yes, believe it or not, a man does produce estrogen.) It’s interesting that the size of your prostate does not necessarily determine if you will experience symptoms. Some men with extremely large prostates have no symptoms, while others with minimal enlargement might have multiple issues.

enlarged prostate symptoms and treatment

What are the risk factors for Benign Prostatic Hyerplasia (BPH)?

The obvious primary risk factor is aging. Other risk factors include (but are not limited to):

  • Family history of BPH in close male relatives
  • Diabetes
  • Heart Disease
  • Obesity
  • Low testosterone levels

How do I know if I have a prostate problem?

Talk with your doctor about your symptoms. A digital rectal exam assesses the size of your prostate and checks for tenderness or lumps. Your doctor will also rule out other issues that can mimic BPH with blood or urine tests, and evaluate your urine flow and bladder functioning. Additional tests are sometimes required depending on your situation.

OK, so I have BHP. What’s next? 

Treatment is based on the severity of your symptoms. The first step usually involves medications. Some of the more common remedies are natural factors derived from plants, such as saw palmetto, but there are numerous compounds you may see advertised on TV, on the internet, and in magazines.  

Your doctor may recommend one of two types of prescription medications: alpha blockers and 5-alpha reductase blockers. Alpha blockers relax the muscles in your bladder neck and prostate, making urination easier. 5-alpha reductase blockers inhibit the conversion of testosterone to DHT which can cause the cells of your prostate to enlarge. Some use another medication, Cialis, which is generally used to treat erectile dysfunction, to treat BPH symptoms.

In some advanced cases, surgery is indicated to provide relief. Typically, the surgery involves enlarging the passage through your prostate.  Doctors may use one of several different modalities, from conventional resection through a scope placed in the penis to resection using laser, infrared freezing methods. A newer procedure uses a technique to compress your prostate by placing special tags through the prostate walls.

If you prefer a non-invasive treatment, Low intensity Shock Wave Therapy (LiSWT) can reduce or eliminate the symptoms of Benign Prosthetic Hyperplasia, which has the added benefit of treating ED symptoms as well.

Here’s what worked for me

On a personal note, I experienced symptoms of BPH in 2017. My urologist treated me with all the usual remedies, but my symptoms did not resolve. Eventually, I had a laser resection of my enlarged prostate tissue, but still my symptoms returned. About four months ago I started LiSWT treatment. I noticed a decrease in the frequency of my urination within the first month. Now, I sleep all night and urinate less often in the day. 

The bottom line

Frequently getting up at night to pee is common, particularly among men as they age. It might simply be an inconvenience, but it could be something more serious. See your doctor to determine what is going on.


dr ron klineDr. Ronald Kline graduated with his M.D. from the University of Texas Medical Branch, then completed both his general surgery residency and a colon and rectal surgery fellowship at Baylor University Medical Center in Dallas. He is certified by the American Board of Colon and Rectal Surgery.  Additionally, he is a Fellow of both the American College of Surgeons and the American Society of Colon and Rectal Surgeons.

Dr. Kline received his certification in age management medicine from the Cenegenics Institute. This training led him to incorporate hormone replacement therapy into his practice. He saw the effects hormone replacement provided in all aspects of the patient’s life, especially sexual health. From there, he looked for additional methods to improve and enhance sexual performance, which in turn brought him to Renewal Medical Centers and the innovative therapy for improving men’s sexual health.

renewal medical centers of north dallas

Disclaimer: This article is not intended as a substitution for medical advice.

originally posted 3/17/2021
updated 1/12/2022

We'd love to hear from you!

This site uses Akismet to reduce spam. Learn how your comment data is processed.