Enlarged Prostate

Enlarged Prostate: Overview

By the age of fifty, about 30% of men will start to experience difficulties with urination related to enlargement of the prostate gland, also known as benign prostatic hypertrophy (BPH).  These symptoms often lead to an increased sense of frustration and embarrassment, as well as the disruption of normal activities.

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Causes and Development

Enlargement of the prostate is usually caused by an abnormal overgrowth and/or swelling of the tissue of the prostate, which then blocks the urethra or opening from the bladder.

Throughout their lives, men produce both testosterone (an important male hormone) and small amounts of estrogen – a female hormone.  As men age, the amount of active testosterone in the blood decreases, leaving a higher proportion of estrogen.  Studies done with animals have suggested that BPH may occur because the higher amount of estrogen within the gland increases the activity of substances that promote cell growth.

Another theory focuses on dihydrotestosterone (DHT), a substance derived from testosterone in the prostate, which more actively stimulates prostate growth.  Most animals lose their ability to produce DHT as they age.  However, some research has indicated that even with a drop in the blood's testosterone level, older men continue to produce and accumulate high levels of DHT in the prostate.  Scientists have also noted that men who do not produce DHT do not develop BPH.  5-alpha reductase is the enzyme which converts testosterone to dihydrotestosterone (DHT) which, besides stimulating prostate growth is the hormone that triggers androgenetic alopecia in individuals who are genetically susceptible.

Some researchers suggest that BPH may develop as a result of "instructions" given to cells early in life.  According to this theory, BPH occurs because cells in one section of the gland follow these instructions and "reawaken" later in life.  These "reawakened" cells then deliver signals to other cells in the gland, instructing them to grow or making them more sensitive to hormones that influence growth.

Diagnosis and Tests

There appears to be little or no connection between BPH and prostate cancer development.  PSA, a lab test for detecting prostate cancer can occasionally be elevated in BPH also.

Treatment and Prevention

Several natural treatments have been found to be very useful in preventing and treating BPH.  Some products contain combinations of beneficial agents and as such may be more effective.

Signs, symptoms & indicators of Enlarged Prostate:

Symptoms - Urinary

(Very) weak urine stream

A reduction in the force and caliber of urination is characteristic of prostatic enlargement.

Counter-indicators
Strong/normal urine stream

A reduction in the force and caliber of urination is characteristic of prostatic enlargement.

Conditions that suggest Enlarged Prostate:

Symptoms - Reproductive - General

Counter-indicators

Uro-Genital

Increased Urinary Frequency

Increases in the number of times a man has to visit the bathroom along with a frequent sensation of having to urinate – especially at night – are among some of the early signs.  In addition, a reduction in the force and caliber of urination is also characteristic of prostatic enlargement.

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Risk factors for Enlarged Prostate:

Digestion

Constipation

Chronic constipation has been implicated as a contributing factor to prostatic discomfort when there is an already enlarged gland.  A correction of the constipation will bring some relief of symptoms since the rectum puts pressure on the prostate gland when it is enlarged.  In addition, there is a buildup of waste products in the circulation with chronic constipation.  This will indirectly have an effect on the function of the prostate.

Hormones

Medical Procedures

Counter-indicators

Nutrients

Enlarged Prostate suggests the following may be present:

Digestion

Constipation

Chronic constipation has been implicated as a contributing factor to prostatic discomfort when there is an already enlarged gland.  A correction of the constipation will bring some relief of symptoms since the rectum puts pressure on the prostate gland when it is enlarged.  In addition, there is a buildup of waste products in the circulation with chronic constipation.  This will indirectly have an effect on the function of the prostate.

Recommendations for Enlarged Prostate:

Botanical

Saw Palmetto

One of the most well-known and time-honored herbs for prostate problems is saw palmetto.  Saw palmetto has been tested in clinical trials and results show that the berries improve signs and symptoms of an enlarged prostate.  During the trials, benefits were recorded for symptoms such as difficulty in urination, frequent urination at night, urine flow and size of enlarged prostate.

In all cases, the treatment was free of side effects.  Scientists believe the main benefits may be due to the ability of some constituents in saw palmetto to inhibit the enzyme 5-reductase in the body.  This enzyme converts the hormone testosterone to DHT.  DHT is five times more potent than testosterone in stimulating the enlargement of the prostate.

Stinging Nettle

Radix urticae is another plant investigated for its beneficial properties in treating benign prostate hyperplasia.  Much less information is available on radix urticae compared to saw palmetto and what little there is comes from Eastern Europe, but there are a few reports that suggest radix urticae extracts may help improve symptoms.  [Romics 1987]

Diet

Pumpkin Seeds

Pumpkin seeds have long been used by naturopathic physicians in treating prostate disorders.  Pumpkin seed oil has become popular today as a treatment, and it was approved for this use in 1985 by Germany's Commission E.  The efficacy of pumpkin seeds is thought to be due to their high content of essential fatty acids, zinc and plant sterols.

Pumpkin seed relieves the urinary difficulties that develop when an enlarged prostate or prostate cancer obstructs the exit from the bladder.  Although pumpkin seed promotes normal urination, it does not correct the underlying problem, so it is important to pursue other treatments for the condition.

Note, however, that there is no meaningful evidence that pumpkin seed is helpful for this condition.  Only double-blind, placebo-controlled studies can prove a treatment effective, and none have been reported for pumpkin seed oil alone.

Hormone

Natural Progesterone

Males also produce progesterone, although only about half as much as females do.  Progesterone prevents the body from converting testosterone to dihydrotestosterone by inhibiting the enzyme 5-alpha reductase.  Progesterone inhibits 5-alpha reductase more effectively than Proscar and saw palmetto which are the more standard agents employed in traditional and natural treatments for BPH.  The dose of natural progesterone for men is 10-12mg per day (5-6mg bid) applied topically.  Men do NOT need to cycle like premenopausal women and can safely take the progesterone daily.

Mineral

Zinc

Zinc supplementation has a clearly documented usefulness in shrinking an enlarged prostate.  Research has shown that zinc and essential fatty acids are important to help prevent prostate problems that affect men as they grow older.  Many studies confirm that a lack of these two nutrients in the diet could be associated with prostate enlargement.

Zinc has been found to inhibit the activity of 5-alpha reductase, the enzyme that irreversibly converts testosterone to dihydrotestosterone, a form which binds more avidly to the prostrate and stimulates greater growth.  It also decreases prolactin secretion by the pituitary gland, thus decreasing its binding to the prostate, both of which prevent prostatic enlargement.

Nutrient

Essential Fatty Acids

The administration of an essential fatty acid (EFA) complex containing linoleic, linolenic and arachidonic acids has resulted in significant improvement for many patients.  All 19 subjects in an uncontrolled study showed diminution of residual urine, with 12 of the 19 having no residual urine by the end of several weeks of treatment.  These effects appear to be due to the correction of an underlying EFA deficiency, since these patients' prostatic and seminal lipid levels and ratios are often abnormal.  Gamma-linolenic acid (GLA), which is derived from evening primrose oil and borage oil, appears to be a powerful 5-alpha reductase inhibitor.

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