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Health Conditions

General Description

What is Benign Prostatic Hyperplasia?

Benign prostatic hyperplasia, also known as BPH, is a men’s health condition caused by the enlargement of the prostate gland.  While several of the symptoms of BPH mimic those of prostate cancer, the condition is not malignant; however, it can cause a variety of uncomfortable symptoms that, if left untreated, can lead to kidney, bladder, or urinary tract problems. Bladder stones and kidney stones are also potential long term effects of the condition. Untreated BPH may also lead to incontinence, which is a permanent condition.  It is widely acknowledged that the enlargement of the prostate occurs as the result of aging, but what specifically triggers this growth is yet unknown.

The National Institutes of Health estimate that 50% of men in their 60s experience BPH, and up to 90% of men in their 70s and older experience some degree of BPH-related symptoms.

Symptoms

Thanks to cutesy commercials for prostate medications and joke material used by many aging comics, the symptoms of benign prostate hyperplasia have been turned into a shoulder-shrugging punch line about men getting older. Yet the symptoms of the condition can progressively deteriorate the quality of a man’s life as he ages, both physically and emotionally.

While BPH is considered to be a completely physical condition, the stress and emotional strain the symptoms of the condition can place on a man often lead to greater incidences of anxiety, irritability, depression, and other mental symptoms.  Therefore, when considering the symptoms of BPH, it is important to treat all aspects of the condition.

The classic physical symptoms of early stage BPH include the following:

  • Difficulty initiating urination
  • Urine stream starts and stops during urination
  • Urine drips or dribbles out of the penis after urination is complete

Some serious potential results of leaving BPH untreated include the development of renal failure, blood in the urine, bladder infections and urinary tract infections.

The symptoms of BPH can not only disrupt an individual’s ability to perform daily activities as normal, but can also cause serious emotional symptoms as well. In the February 2009 edition of WholeFoods magazine, health writer Katie Agin notes that in men who experience BPH, “impotence and other sexual troubles develop, often leading to emotional, psychological, and relationship dilemmas.”

Anxiety is a common emotional symptom of men who suffer from BPH, especially those who have had an experience of not being able to control their bladder in public or private situations. A study published in the October 2004 edition of the International Journal of Urology reported that men who are diagnosed with a condition related to their urinary tract, such as BPH, are likely to experience feelings of anxiety and depression. Ironically, these emotional conditions can lead to impotence or inability to sexually climax which will cause more depression and anxiety.

For more valuable information on the symptoms of BPH, check out our full length report!

Causes

BPH is estimated to affect up to 90% of the male population over 70 years of age; however in spite of its prevalence, the medical community has not been able to identify one specific cause of the condition. There are a variety of theories as to what causes the gland to enlarge over time, most of which focus on hormonal triggers.

  • Dihydrotestosterone - Dihydrotestosterone (DHT) is a metabolic derivative, or sub-type, of testosterone.  DHT is more concentrated than testosterone and is responsible for the formation of male genitalia, including the prostate, testes, and penis. It is produced throughout a man’s life. DHT build-up has long been seen as a cause of BPH, however, there is growing concern in the medical community that DHT’s role in prostate enlargement has been misunderstood and that DHT may potentially reduce the size of the prostate.
  • Estradiol - Estradiol is the main form of estrogen found in humans; it is produced from an enzyme reaction with testosterone. As a man ages, more of his testosterone becomes converted to estradiol, which can cause other biological chemicals to accumulate in the prostate.   In a 1994 report published in the Proceedings of the National Academy of Sciences, it was concluded that increased estradiol levels led to an enlarged prostate due to a rapid accumulation of cAMP, a common cellular messenger.
  • Estrogen Dominance - Estrogen dominance occurs in men when the levels of estrogen surpass the levels of testosterone, becoming the governing hormone in the body. This causes several hallmark symptoms, including loss of muscle mass, reduced libido, and weight gain, particularly around the belly. The role of estrogen in the prostate and other male reproductive glands is still not fully understood, and many questions remain. The hormone is currently under serious scrutiny by myriad researchers around the world and is likely to emerge as an even more significant player in BPH in the coming years.
  • Additional Causes - In addition to hormonal shifts, several other theories regarding the cause of BPH have been postulated over the past twenty years. One interesting theory asserts that heavy metals, such as nickel, play a role in the enlargement of the gland. Heavy metals like nickel do not belong in the body, and when it is present attracts bacteria which lead to an enlarging of the prostate. Heavy metals are not the only damaging substances that accumulate in the prostate. Environmental toxins, such as xenoestrogens, also build up in the gland. Xenoestrogens are foreign estrogens that enter the human body and act in the same way naturally produced estrogen would, leading to a surplus of estrogen and estrogen dominance. These toxins can affect the hormonal shift men naturally experience as they age and enhance the effects estrogen has on the body. Click here for more information on Estrogen Dominance

For more valuable information on the causes of BPH, check out our full length report!

Traditional Treatments

Traditional treatment options for an enlarged prostate include everything from prescription medications to surgery. However, while it is important to review all possible options for treating your enlarged prostate, we here at Health911 would like to emphasize that over the last 10 years there has been a considerable shift among members of the medical community toward alternative therapies for this condition due to the broad range of side effects associated with most traditional treatments. If your health care professional suggests any of the following treatments, be sure you are clear on the potential side effects as some are irreversible.

  • Prescription Medication - There are several prescription medications available to treat a mildly to moderately enlarged prostate gland. In 2006, the National Institute of Diabetes and Digestive and Kidney Diseases (a division of the National Institutes of Health) reported that using these two types of drugs together “reduced the risk of BPH progression by 67 percent, compared with 39 percent of [the alpha blocker] alone and 34 percent of [the 5-alpha reductase inhibitor] alone.”
  • Alpha blockers - Alpha blockers are characterized by their ability to help muscles relax. The benefit of alpha blockers is that patients will notice an improvement in comfort and ability to urinate within a few days. Most patients also notice a reduced need to urinate. Alpha blockers can cause a variety of side effects, including headache, weight gain, and irregular or “pounding” heartbeat. After the first few doses, a patient may experience a rapid drop in blood pressure, which can cause dizziness and fainting. Men who take alpha blockers may experience retrograde ejaculation, a condition that occurs when semen backs up into the bladder instead of ejaculating out of the penis during an orgasm. Some popular brand name alpha blockers used for BPH include Hytrin, Rapaflo, Uroxatral, and Flomax.
  • 5- alpha reductase inhibitors- 5-alpha reductase inhibitors are a type of medication that can help decrease the size of the prostate by reducing the amount of dihydrotestosterone (DHT) in the gland. This class of medication, most commonly prescribed under the brand names Proscar and Avodart, can take several months to improve symptoms. They also cause several sexual side effects, including reduced libido, erectile dysfunction, and retrograde ejaculation. 
  • Transurethral Microwave Procedures - Transurethral Microwave Procedures, also known as Transurethral Microwave Thermotherapy, utilizes a machine that focuses microwaves heated to at least 111 degrees Fahrenheit to burn off and destroy enlarged prostate tissue. The procedure does not require any anesthesia and are performed on an outpatient basis.
  • Transurethral Needle Ablation - During the procedure, two needles are inserted into the pelvis and directed at the areas of abnormal prostate growth. Low levels of radio frequency energy are shot through the needles to destroy portions of the prostate to help relieve symptoms of bladder pressure and strained urine flow. This procedure is considered effective for reducing specific portions of the gland, unlike the transurethral microwave procedure which is harder to focus on a particular area. Local anesthesia is typically utilized during this procedure and it does not cause incontinence and impotence. However, in 2007 a study published in The Journal of Urology noted that the procedure has a high rate of failure and the majority of patients are required to undergo it again immediately to correct the first attempt.
  • Surgical Options - If other prescription or minimally invasive outpatient procedures are unable to reduce the size of the prostate due to size or continued regrowth, a medical professional may suggest a man undergo surgery to handle the issue. The point of the surgery is not to remove the entire prostate, but simply remove the enlarged tissue that is placing pressure on the urethra or bladder.
  • Transurethral Resection of the Prostate – This procedure is used in approximately 90% of all prostate surgeries related to BPH annually in the United States. During this surgery, the patient in placed under general anesthesia, and a resectoscope, a device that contains a light, camera, and irrigation system, is inserted through the opening at the end of the urethra. The resectoscope, which is approximately one foot long and .5 inches in diameter, also has a cutting utensil attached which can cut tissue and also clot it shut with extreme heat. Small pieces of enlarged tissue are cut off and allowed to collect in the bladder to be voided with urine after the procedure is completed. No incisions need to be made on the patient, as the entire procedure is conducted through this opening.
  • Transurethral Incision of the Prostate - Transurethral Incision of the Prostate (TUIP) requires additional incisions to be made to widen the urethra channel and bladder neck to relieve urination problems.  The goal of this procedure is to improve symptoms without placing the patient at risk for retrograde ejaculation; however, this procedure has not been used for long enough to note long term effects. Open surgery, where an external incision is made in the lower pelvis, is only used in instances where success is not achieved with TURP or TUIP or there are additional medical complications.
  • Laser Surgery - The gland is sliced off and “vaporized” with Nd: YAG lasers. It is perceived to be the next generation in prostate surgeries by many in the medical field because it allows for a quicker recovery time than TURP and reduces blood loss. However, like TUIP, the procedure has not been performed for long enough to observe long term effects or its effectiveness on non-typical glands or larger glands.

For more valuable information on the tradition of BPH, check out our full length report!

Misdiagnosis of Symptoms

Talking with a doctor frankly about sexual problems, urinating issues, or other concerns about your genitals can be uncomfortable, embarrassing, and feel “unmanly” – men are supposed to suck it up and deal with whatever discomfort they are feeling. However, the difference between BPH and some other condition can be as slight as one symptom; to receive the proper diagnosis and avoid misdiagnosis, you need to volunteer every symptom you are aware of to your health care professional. If you feel uncomfortable talking to your health care provider about your symptoms, check out Talking About Your Prostate Health for tips on making the most of your appointment.

  • Prostatitis - Prostatitis is a term used for a group of disorders of the prostate that include bacterial infection, inflammation, and a chronic form unrelated to infection. If left untreated, there is some evidence that prostatitis can increase a man’s risk for developing prostate cancer. Symptoms of prostatitis include painful urination, difficulty passing urine, dribbling urination, frequent nighttime urination, painful ejaculation, pain in the lower back and groin region. Prostatitis can be distinguished from BPH by pain. While men who are suffering from BPH may experience a sensation of pressure or discomfort due to their swollen prostate pressing against the urethra or bladder, they typically do not report pain in the back, groin, during urination, or during ejaculation. A urine and semen analysis can be conducted to verify the proper diagnosis.
  • Urinary Tract Infection - A urinary tract infection (UTI) can indicate a bacterial infection of any part of the urinary tract, including the urethra, bladder, or kidneys. Symptoms of UTIs typically include painful urination, burning when urinating, frequent need to urinate, strong smelling urine, and cloudy urine. As the infection gets worse, an individual may experience lower back pain and a fever. The symptoms of a UTI tend to come on suddenly and increase in severity at a rapid rate. A simple urine analysis can alert your health care provider to a UTI.  
  • Depression - Depression is an emotional state characterized by persistent and pervasive low mood. It may be triggered by a traumatic event, such as death, loss, or pregnancy, or a chemical imbalance in the brain. It is treatable through a variety of traditional medications and alternative practices. Depression is often a symptom of BPH and can, from the perspective of a medical professional, mask the original condition due to a heightened social sensitivity to depression and classic signs. Sexual dysfunction, inability to sleep, anxiety over not being near a bathroom, and even problems urinating can fit into a diagnosis of depression if the health care provider sees other signs. To avoid a misdiagnosis, be sure you emphasize your urinary problems as vehemently as any sexual symptoms you are having. Also, don’t feel afraid to ask for your prostate to be checked.
  • Prostate Cancer - From the perspective of most health care professionals, it is hard to tell just based on reported symptoms whether a man has BPH or prostate cancer. Further testing of the prostate is almost always performed, which may include a digital rectal exam or an ultrasound. A blood test which measures levels of PSA (prostate-specific antigen) is typically also performed. The health care professional may decide to take a sample of the prostate tissue and examine it further. Based on the results of these tests, it should be clear if an individual is suffering from BPH or prostate cancer.  

For more valuable information on the misdiagnosis of BPH, check out our full length report!

Changes to Make

Alternative remedy specialists note that a significant improvement of symptoms caused by an enlarged prostate can be made with various lifestyle adjustments.

General dietary changes can help support proper nutrition and overall health, helping the gland function at its best. Dr. Brewer recommends reducing fat consumption while increasing fiber consumption. Fat encourages estrogen production and storage, which can cause the prostate to enlarge, while fiber binds with hormones and enzymes in the body (like estrogen, DHT, and SHBG) and flushes them out along with waste.

There has also been some indication that men who consume a diet high in fruit have a lower rate of BPH, so being sure to eat at least 5 servings daily can also help other treatments work most effectively.

For more valuable information on changes you can make to support your prostate function, check out our full length report!

Vitamins & Supplements

Within the last 20 years, researchers around the world have identified several vitamins and dietary supplements that have been shown to reduce symptoms of BPH. The consensus among health care providers is that men who suffer from an enlarged prostate are typically deficient in these specific elements; while vitamin deficiency hasn’t been accepted as a cause of BPH, the link between the deficiencies and the condition is certainly striking.

  • Zinc - According to the National Institutes of Health, zinc is a mineral which is involved in some of the most important cellular functions. Interestingly, zinc is found in exceptionally high levels in the prostate. In a normal, non-deficient man, the prostate actually contains 10 times more zinc than any other organ in the body. Dr. James Balch, noted prostate specialist, points out that men who have prostate problems, like BPH, typically always are deficient in zinc. Taking a zinc supplement can shrink the gland by reducing excessive enzyme production. The NIH places their upper limit at 10 mg, while the National Academy of Sciences (USA) sets 40 mcg as the upper limit. The European Institute of Medicine sets a limit at between 7.4 and 8 mg daily.
  • Selenium - As a trace mineral, selenium is used by the body to bond with proteins to make selenoproteins, a type of enzyme that is known for its antioxidant properties. As an anti-oxidant, selenium also has the added benefits of supporting thyroid health and potentially preventing prostate cancer. While selenium can be taken as a dietary supplement, Dr. Hardy of Cedars-Sinai instead recommends getting appropriate levels of selenium through natural foods such as lamb, tuna fish, garlic, salmon, and Brazil nuts. If you need to take it in supplemental form, shoot for between 100 mg and 200 mg daily.
  • Iodine - Iodine has the ability to rectify a potential cause of BPH: estrogen dominance. Iodine is involved in the regulation of estrogen production; studies have shown that when there is a lack of iodine in the body estrogen production spikes. Tori Hudson, N.D., recommends her estrogen dominant patients try supplemental iodine as iodine can reduce the body’s sensitivity to estrogen. There are several brands of liquid iodine, such as Lugols, that can be purchased over the counter at alternative health stores.   

For more valuable information on vitamins that can reduce the symptoms of BPH, check out our full length report!

Talk with your Doctor

To make sure you get the treatment and solutions you need to maintain a healthy prostate, it is vital that you advocate for yourself through asking questions of your health care professional and educating yourself.  If you suspect you may be suffering from BPH, use the guide below to start getting the information and treatment you need from your health care providers.   

  • Keep a Symptoms Journal - The Symptoms Journal is essentially a record of your observations regarding the nature, severity, frequency, and duration of any physical and emotional symptoms you experience.  You should also include a daily record of how many times you feel the urge to urinate, how much urine you pass, how strong the urine stream was, and if you felt your bladder was completely voided. Also, be sure to note anything out of the ordinary in the bedroom, such as an inability to stay physically excited or unusual sensations during ejaculation. After you have 2-3 weeks of data recorded in your Symptoms Journal, review what you have observed and, if you feel something is out of the ordinary, call your health care provider and make an appointment to investigate.  Be sure to take your Symptoms Journal with you to the appointment!
  • Ask The Right Questions - Help direct the examination with your health care provider and also advocate for yourself by asking specific questions regarding what they are noticing.  Here are a few questions to ask as they are performing a physical exam:
  • Are you noticing anything unusual with my testicles or penis?
  • Does my prostate feel swollen or inflamed?
  • Does my lower abdomen feel swollen or bloated?
  • Have I gained or lost weight since my last visit?
  • Do you suspect an enlarged prostate? Why or why not?
  • Request Certain Tests - When you are at your appointment with your health care provider, insist they order blood tests and imaging screens to check for more serious prostate conditions.  Remember, the symptoms of BPH can be very similar to other, more serious prostate conditions; therefore, BPH should be a diagnosis given only when other potential causes of the symptoms have been ruled out.  Don’t be afraid to ask for these tests to be performed!

For more valuable information on talking about your prostate health, check out our full length report!

Wellness Plan

Supporting a healthy prostate is essential to soothing and eliminating symptoms of benign prostate hyperplasia. Incorporating the elements below into your daily lifestyle can positively influence the healing process and help alleviate your symptoms as well as lay the foundation for continued prostate health.

  • Increase your intake of foods naturally high in prostate-supporting vitamins and minerals, such as green vegetables, strawberries, eggs, seafood, Brazil nuts, and garlic.
  • Remove unnecessary toxins from your life as soon as possible. Cut down on alcohol consumption, tobacco products, recreational drugs, and high amounts of carbohydrates and sugars in your diet.
  • Have your prostate massaged regularly to keep its size in check. A prostate massage is performed by sticking two gloved fingers into the anus and pressing them against the rear wall. Light pressure is applied to the anal wall and the fingers are moved in a circular motion for several minutes.
  • Drink between 8-10 glasses of water daily. In addition to helping you stay hydrated, the water will help flush bacteria out of the urinary tract and reduce the possibility for infection.
  • Maintain a healthy weight and reduced body fat levels. Estrogen is stored in fat, so the less fat you have on your body the lower your estrogen levels will be.
  • Maintain close communication with your health care provider or natural remedy specialist to make small adjustments or tweaks in your treatment as needed and in a timely fashion.
  • Have your prostate screened regularly by your health care professional so that any problems can be addressed swiftly and effectively.
For more valuable prostate wellness tips, check out our full length report! 

Remedies

Physicians have continually praised the following herbs for their abilities to improve symptoms of BPH and reduce prostate size better than surgery or prescription medications.

  • Saw palmetto - Saw palmetto (Serenoa repens) is an herb that comes from a common type of palm tree native to warm regions. Dr. Sarah Brewer explains that the herb works because it “blocks the action of 5-alpha-reductase. It also seems to interfere with the way that DHT stimulates growth and division of prostate cells.” In clinical trials, saw palmetto has been shown to increase urine flow in 50% of those who use it, decrease residual urine volume by 42%, and decrease nighttime urination by 47%. Comparatively, the popular BPH drug Proscar only increases urine flow in 31% of those who use it and has no effect on residual volume. Over the course of 13 studies, saw palmetto has a 90% success rate for improving the symptoms of BPH.
  • Pygeum - Pygeum (Pygeum africana) is another well-respected herb that is has proven to reduce the symptoms of an enlarged prostate. Pygeum works by decreasing prolactin, a natural substance in the male body that Dr. Whitaker defines as “a hormone that increases testosterone and thus DHT production.” Dr. Balch adds that pygeum also works by reducing cholesterol, “which can promote prostate growth,” as well as acting as an anti-inflammatory in the gland.
  • Stinging Nettle - Stinging Nettle (Uritica dioica) is an herb derived from the leaves of a tree found throughout Europe and the Middle East. Stinging nettle has been shown to reduce the ability of SHBG (sex hormone binding globin) to bind with the prostate cell membrane, thus reducing a man’s estrogen levels, a potential cause of BPH. This herb is typically used in conjunction with saw palmetto or pygeum to assist in the improvement of BPH symptoms. It is rarely used on its own. 
  • Flower Pollen Extract - While not yet held in the same esteem as saw palmetto, pygeum, and stinging nettle, flower pollen supplementation is quickly gaining a reputation as an excellent treatment for an enlarged prostate.  Initial research results are very promising; Dr. Brewer notes that “A double-blind, placebo-controlled study of 60 patients with BPH showed that the flower pollen extracts improved prostate symptoms by 69 percent, compared with only 29 percent for those taking a placebo.” 
  • Brown Algae and Citrus Peel - In the aftermath of the devastating nuclear reactor meltdown in Chernobyl, Russia, in 1986, medical teams used a form of brown algae to reduce the effects of the massive dose of radiation in some of the survivors. Over the ensuing years researchers discovered that brown algae also removes heavy metals from the body. With this as background, a small research team in Florida developed a product called Nature's Orchard CitraProst using brown algae and a patent-pending combination of various components of citrus. The results in relieving the symptoms of BPH have been outstanding and Health911 believes this is the best product on the market. For more information click on our product section for Nature's Orchard CitraProst.

For more valuable information on remedies for BPH, check out our full length report!

 
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