A weak urine stream, urgency, hesitancy, incomplete emptying, and nighttime trips to the bathroom: These are the classic symptoms of benign prostatic hyperplasia (BPH). BPH is caused by age-related enlargement of the prostate. Half of men in their 60s and 85 percent over age 80 have prostates that are large enough to constrict the urethra and cause urinary problems.
Two types of drugs are prescribed for BPH. Alpha-blockers relax the smooth muscles in the prostate and neck of the bladder. They do improve urine flow but may also relax the arteries and can drive blood pressure too low, resulting in lightheadedness and dizziness.
Another class of drugs, 5-alpha reductase inhibitors, shrink the prostate by inhibiting the enzyme that converts testosterone to dihydrotestosterone (DHT), the hormone that stimulates prostate growth. These drugs are bad news. In addition to causing erectile dysfunction, low libido, and ejaculation problems, they are linked with increased risk of aggressive prostate cancer and birth defects in male babies whose mothers are exposed to the drugs during pregnancy.
For intractable symptoms such as urinary retention, invasive procedures may be required. Transurethral resection of the prostate (TURP) involves snaking a roto-rooter-like device up through the penis to cut away prostate tissue that blocks the urethra. Lasers, heat, freezing, microwaves, and radio waves are also used to remove excess tissue and, in very severe cases, prostatectomy (surgical removal of the prostate) is performed. All these procedures have serious side effects, including surgical, sexual, and urinary complications. And with the exception of prostatectomy, about 10 percent of patients require repeat treatment within five years.
Supplements for Prostate Support
Saw palmetto (Serenoa repens) inhibits 5-alpha-reductase and thus the conversion of testosterone to DHT and its stimulating effects on the prostate—without the drugs’ adverse effects. And it’s not just for prevention, as demonstrated in numerous clinical trials.
In a 2016 study, Spanish researchers followed 1,713 men with moderate to severe BPH who were being treated with alpha-blockers, 5-alpha-reduce inhibitors, or herbal supplements. When they were retested after six months, improvements in symptoms and quality of life were similar among all groups. The main difference? The men taking saw palmetto had fewer side effects.
Pygeum, stinging nettles, beta-sitosterol, and lycopene have been shown to have prostate benefits as well. Suggested doses of supplements for prostate health and BPH are: saw palmetto 320 mg, pygeum 100 mg, stinging nettles 200–300 mg, beta-sitosterol 130–180 mg, and lycopene 6–10 mg.
The Pain of Prostatitis
Prostatitis is an inflammatory condition marked by pain in the pelvis and a burning sensation while urinating. It’s a bear to treat. Doctors may prescribe antibiotics, but just one in 10 cases is due to bacterial infection, so they’re rarely effective. Anti-inflammatory medications, warm baths, prostate massage, and avoiding caffeine and alcohol may reduce symptoms, but they’re no cure.
Zinc (30–60 mg) may help. In a 12-week placebo-controlled clinical trial of men who had suffered with non-bacterial prostatitis for at least a year, those who took high doses of zinc reported significant improvements.
Flower pollen extract is another promising supplement, shown in several studies to reduce symptoms of prostatitis. The best-studied flower pollen extract is Cernilton/Graminex; take as directed.
And essential fatty acids (1,000–2,000 mg DHA/EPA) help suppress inflammation in this and other urological conditions as well.
The Big C
Prostate cancer is the condition men fear the most. Cancer is scary, but you need to understand that the prognosis is usually good—even without treatment. The likelihood of dying from prostate cancer is just 1 in 34.
Treatment, on the other hand, is virtually guaranteed to harm. Prostatectomy and radiation therapy are notorious for causing erectile dysfunction and urinary problems, and androgen suppression and chemotherapy have side effects of their own. If a PSA test is suggestive of cancer, look before you leap. For run-of-the-mill, low-grade disease—the kind most men have—these interventions do far more harm than good. Active surveillance with periodic monitoring is typically the way to go.
Regardless of what path you choose, I suggest you also make some significant lifestyle changes. In a year-long study of men with prostate cancer who opted for active surveillance, dietary changes, supplements, exercise, and stress reduction resulted in marked declines in PSA and tumor activity.
I’m not minimizing the scourge of prostate cancer, and aggressive and metastatic disease must be treated. But don’t forget that although autopsy reports reveal cancer in the prostates of half of men ages 70–80, most die with cancer, not of it.