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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.
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 classic physical symptoms of early stage BPH include the
- 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.
valuable information on the symptoms of BPH, check out our full length report!
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 (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 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
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.
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
here for more information on Estrogen Dominance
valuable information on the causes of BPH, check out our full length report!
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.
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]
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
- 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.
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.
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.
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.
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
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
- 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
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 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
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
- 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.
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.
valuable information on the misdiagnosis of BPH, check out our full length
Changes to Make
Alternative remedy specialists note that a significant
improvement of symptoms caused by an enlarged prostate can be made with various
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.
- 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.
- 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.
valuable information on vitamins that can reduce the symptoms of BPH, check out
our full length report!
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
- Do you suspect an enlarged prostate? Why or why
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!
valuable information on talking about your prostate health, check out our full
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
- 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
- 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.
more valuable prostate wellness tips, check out our full length report!
- Have your prostate screened regularly by your
health care professional so that any problems can be addressed swiftly and
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.
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.
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
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.”
valuable information on remedies for BPH, check out our full length report!
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