Enlarged prostate is caused by hormonal processes within the tissue of the prostate gland. 95% of the testosterone in the body is produced in the testes. Testosterone is converted to dihydrotestosterone in the prostate gland. The prostate gland is much more sensitive to dihydrotestosterone than testosterone. An enzyme called 5-alpha reductase, which is only found in the prostate, mediates the conversion of testosterone to dihydrotestosterone. The accumulation of dihydrotestosterone leads to growth factors within the prostate. The result of this is an imbalance between cell growth and apostosis (programmed cell death). Over time the prostate will grow progressively larger. This is a natural process which will affect all men over time. However, not all men will develop symptoms of BPH. Complications will arise in accordance with the enlargement’s affect on the prostate or its interference with the workings of the bladder.