Prostate Enlargement (Benign Prostatic Hyperplasia)
The prostate is a male reproductive gland that sits at the outlet of the urinary blad- der and surrounds the urethra (the channel that carries urine away from the bladder). Normally, the prostate is about the size of a walnut. In many men, however, especially those who are middle-aged or older, the gland becomes inﬂamed or enlarged. When this happens, the prostate compresses the urethra, obstructing the ﬂow of urine and causing other problems (i.e., infection, bladder stones, etc.).
Benign prostatic hyperplasia (BPH) is the medical term, but the disorder is more commonly known as enlarged prostate. When a man reaches middle age, the prostate often starts growing. There can be several reasons why this growth occurs, but it appears to be mainly caused by hormonal changes associated with aging.
Almost half of all men over forty-ﬁve suffer from at least some degree of prostate enlargement. At ﬁrst, an enlarged prostate produces no symptoms, but as it grows and puts increased pressure on the urethra, urinary problems develop. It may be difﬁcult to start urinating, and once the ﬂow has begun, it may be hard to stop. There may be dribbling in-between urination, along with a sense that the bladder isn’t completely empty. Many men ﬁnd that they awaken several times a night to urinate. Although the symptoms are uncomfortable and disruptive, benign enlargement is usually not a sign of a more serious disease. In some cases, however, the prostate can become so enlarged that the bladder can rarely empty itself completely. This urine retention can lead to an infection of the bladder or the kidneys; in severe cases, a constantly full bladder can place a dangerous level of pressure on the kidneys and even cause them to fail. A poor diet, especially one that’s low in ﬁber and high in saturated fat, likely con- tributes to prostate enlargement as well.
As men age, their hormone balance changes. Testosterone levels decline, while the estrogen class of hormones increases. One prevailing theory as to why the prostate enlarges centers around the increased conversion of testosterone to one of its metabo- lites, known as dihydrotestosterone (DHT). The enzyme responsible for this conver- sion of testosterone to DHT is 5-alpha reductase. It is believed that the activity of this enzyme increases as men age, so that DHT levels increase. DHT is implicated in prostate growth. Recent studies show that there is more to the story than just DHT. In recent years, there has been growing evidence that estrogen plays a role in prostate enlargement. A man’s body contains the hormone estrogen, albeit in lesser amounts than in women. Some research shows that the balance between estrogen, testosterone, and DHT is the main issue with prostate cell growth. It is interesting to note that the enzyme aromatase converts testosterone to a potent form of estrogen known as estradiol. Estradiol causes prostate cells to grow and multiply. Keep in mind that pes- ticides, herbicides, and other environmental pollutants mimic estrogen in the body. It is also postulated that a rise in the estrogen-to-testosterone ratio ampliﬁes the effects
of DHT on the cell receptors of the prostate, which leads to cell growth. This rela- tive increase in estrogen also reduces the ability of the prostate cells to clear out DHT. It makes some sense that DHT may not be the major villain in prostate enlargement. Rather, it is the balance between estrogen, testosterone, and DHT—and, likely, even progesterone—that really matters. The point is that proper hormone balance through diet, exercise, nutritional supplements, and detoxiﬁcation is the key to helping this condition.
Prostatic enlargement responds well to natural treatment. Dietary and herbal ther- apies are especially effective at reducing the swelling and balancing the hormones. It’s wise, however, to have any urinary or prostate problems checked out by a doctor, preferably a urologist, just to rule out any underlying cause. And if you experience weight loss, bone pain, or bloody urine, call your doctor right away.
• Frequent urination
• Urination that is hard to start or stop
• The sensation of an incompletely emptied bladder
• Increased nighttime urination
• Burning pain with urination
• Reoccurring bladder infections
• Hormonal changes
• A diet that’s high in fat and low in ﬁber
• Nutritional deﬁciencies
A diet of basic, whole foods will provide plenty of ﬁber and will regulate hormone levels. Eat lots of whole grains and fresh vegetables, and get your protein from beans, ﬁsh, and soy products. To keep chemicals and pesticides out of your system, buy organic whenever possible.
Tomatoes are an excellent source of lycopene, a phytochemical that has an impor- tant protective effect on the prostate. This book usually recommends fresh food, but when it comes to lycopene, there’s an important exception: cooked tomato products are actually a more potent source of this phytochemical than fresh ones are. Incor-
seeds in the food porate both into your meals daily. processor for a few minutes, and you’ll have pumpkin butter. It makes a delicious spread for sandwiches or crackers.
Pumpkin seeds are a traditional remedy for prostate problems, and for good rea- son. They’re full of zinc, a nutrient that’s necessary for good prostate health. You can snack on raw pumpkin seeds throughout the day, but resist the urge to toast and salt them. You’ll just add unwanted fat and sodium.
To reduce swelling, eat cold-water ﬁsh, ﬂaxseeds (1 to 2 tablespoons daily, along with 10 ounces of water), and ﬂaxseed oil. These foods are high in essential fatty acids, which are known for their anti-inﬂammatory properties.
The following tests help assess possible reasons for prostate enlargement: Hormone testing (thyroid, DHEA, cortisol, testosterone, DHT, estrogen,Progesterone)—saliva, blood, or urine Intestinal permeability—urine
Vitamin and mineral analysis—blood
Digestive function and microbe/parasite/candida testing—stool analysis Food and environmental allergies/sensitivities—blood, electrodermal Toxic metals—hair or urine
Essential fatty acid balance—blood or urine
Drink green tea (decaffeinated) instead of coffee, as it promotes healthy detoxiﬁcation.
Take the aforementioned ﬂaxseeds daily, along with 10 ounces of water. Flaxseeds contain a phytonutrient known as lignans, which balance estrogen levels.
Drink a glass of clean water every two waking hours to keep ﬂuid moving through the urinary tract.
Food to Avoid
Eliminate all fats that are saturated, hydrogenated, or partially hydrogenated. These fats lead to inﬂammation and have been closely linked with several prostate disorders.
Sugar wreaks havoc on hormone levels and worsens inﬂammation. Radically restrict your consumption of reﬁned sugar, or, better yet, banish it from your diet alto- gether.
Processed food is full of chemicals that may cause or contribute to prostate prob- lems. Stay away from it.
Avoid alcohol and caffeine. They are irritants to the prostate gland.
The prostate gland is highly sensitive to environmental and dietary toxins. To ﬂush waste out of the prostate, do a one- to three-day juice fast. Focus on vegetable juices and broths—too much fruit juice will throw your hormone levels out of balance.
Super Seven Prescriptions—Prostate Enlargement
Super Prescription #1 Saw palmetto (Serenoa repens)
Take 320 mg daily of a product standardized to 80 to 95 percent fatty acids. Saw palmetto has been shown in numerous studies to improve the symptoms of this con- dition. It appears to reduce hormone stimulation of the prostate tissue.
Super Prescription #2 Pygeum africanum
Take 160 to 200 mg daily of a product standardized to 13 percent total sterols. Pygeum is an extract from the bark of an African tree that has a long history of use, as well as scientiﬁc validation, for reducing prostate enlargement.
study involving three urology centers looked at the effects of Pygeum africanum extract (50 mg twice daily) on the symptoms of BPH. Researchers con- cluded through urine- ﬂow measurements that pygeum induced signiﬁcant improve- ments, including with nighttime urination.
Super Prescription #3 Rye pollen extract
Take as directed on the container (generally, 3 tablets twice daily). Several stud- ies have shown that this extract lessens the symptoms of BPH.
Super Prescription #4 Nettle (Urtica diocia) root
Take 120 mg twice daily. Nettles are commonly used in prostate formulas, along with other nutrients. Studies have shown that they lessen BPH symptoms.
Super Prescription #5 Beta-sitosterol
Take 60 to 130 mg daily. Studies show that this phytonutrient improves the symp- toms of benign prostatic hyperplasia.
Super Prescription #6 Zinc
Take 100 mg daily for two months and then 50 mg as a maintenance dosage, and take 3 mg of copper, along with the zinc.
Super Prescription #7 Essential fatty acids
Take 1 tablespoon of ﬂaxseed oil or 3,000 mg of ﬁsh oil daily. Essential fatty acids reduce inﬂammation.
aw palmetto (Serenoa repens) has been found to have many favorable effects on the prostate, including
• Inhibiting the activity of the enzyme 5-alpha reductase, which reduces the conversion of testosterone to DHT
• Blocking DHT from binding to prostate cells
• Reducing the effects of estrogen and progesterone on the prostate cells
• Causing smooth muscle relaxation (theoretically allowing the urethra to open more effectively and preventing the back-up of urine)
• Reducing inﬂammation and edema by inhibiting the effects of inﬂammation-producing chemicals called prostaglandins
• Altering cholesterol metabolism in the prostate
• Modifying the levels of sex hormone–binding globulin (SHBG)
The Journal of the American Medical Asso- ciation reported a review on the therapeutic efﬁcacy and the safety of saw palmetto extract in men with symptomatic BPH. The authors reviewed 18 randomized controlled trials, involving 2,939 men with BPH. They concluded that saw palmetto was as effective as Proscar (ﬁnasteride), a commonly pre- scribed pharmaceutical medication for BPH. The beneﬁt of saw palmetto, compared to that of a pharmaceutical treatment, was the absence of side effects, such as impotence or loss of libido.
Another study, using before- and after– treatment ultrasound images, demonstrated that the combination of saw palmetto and nettle root reduced the size of prostate swelling in men with BPH.
Amino acids relieve urinary symptoms of BPH. Take glycine, alanine, and glutamic acid, as this was the combi- nation used in one successful study. Take 750 mg three times daily for two weeks and then 375 mg three times daily as a maintenance dose.
Pumpkin seed oil is often used in combination with saw palmetto (Serenoa repens) for the relief of BPH symptoms. Take 160 mg three times daily with meals.
A high-potency multivitamin provides a base of nutrients for prostate health. Take as directed on the container.
D-glucarate is a phytonutrient that assists the liver in metabolizing estrogen. Take 500 mg twice daily.
Indole-3 carbinole assists the liver in metabolizing estro- gen. Take 300 mg daily.
Milk thistle (Silybum marianum) improves liver detoxiﬁcation and, indirectly, hormone balance. Take 250 mg of an 80 to 85 percent silymarin extract three times daily.
Apis melliﬁca is for prostate enlargement when stinging pain accompanies urination. There may also be urinary retention present.
Causticum is indicated when one loses urine from coughing or sneezing. There can be a pressure sensation extending from the prostate to the bladder. Causticum is also indicated when sexual pleasure during orgasm has diminished.
Chimaphilla Umbellate is a remedy that helps with urine retention. There is often a sensation that one is sitting on a ball. The person may feel as if a ball is lodged in the pelvic ﬂoor or may experience pressure, swelling, and soreness that feel worse when sitting down.
Clematis is a speciﬁc remedy for swelling of the prostate that leads to slow urine passage or a dribbling of urine.
Lycopodium (Lycopodium clavatum) may be helpful for prostate enlargement accompanied by sexual dysfunction, such as impotence. Men who need this remedy often have digestive problems, such as gas and bloating. They tend to feel chilly and crave sweets.
Pulsatilla (Pulsatilla pratensis) is for prostate problems with bladder pain at the end of urination. Men who require this remedy tend to get warm easily and feel better in the fresh air.
Sabal Serrulata is a good remedy for urine retention, especially in elderly men. There may be a cold sensation in the prostate or the bladder. It is useful for men with prostate enlargement who are prone to bladder infections.
Selenium is for an enlarged prostate and the involuntary dribbling of urine or pro- static ﬂuid. Symptoms are worse after walking or urination. Impotence is another indi- cation for this remedy.
Staphysagria is for urinary retention and the chronic dribbling of urine. There can be a burning sensation in the urinary tract and the prostate. Men who require this rem- edy may have suppressed emotions, as well as impotence.
Thuja (Thuja occidentalis) is for an enlarged prostate and a frequent urge to uri- nate. Sometimes a forked stream of urine is seen.
See pages 668–675 for information about pressure points and administering treatment.
• All the bladder points along the groin (Bladder 27–34) regulate the reproduc- tive organs and increase circulation to the prostate. With regular work, they will help reduce inﬂammation, as well as lower back pain.
Work the areas corresponding to the prostate, the lower back/bladder, and the lymph/groin area.
Hot and cold hydrotherapy in the pelvic region stimulates circulation to the genitals and the urinary tract. Splash ﬁrst hot water, then cold, onto your lower abdomen. Repeat three times.
Constitutional hydrotherapy is a good long-term treatment for this condition. See the directions on pages 676–677.
Bergamot and chamomile reduce inﬂammation. Add them to a bath, or use them in a full-body massage.
If you have prostatitis, use a few drops of tea tree oil in a bath to ﬁght the infection. This oil can sometimes be irritating, so start by adding just 2 or 3 drops under the tap. If you do not have a reaction, you can add a few more drops the next time around.
For a constant urge to empty the bladder, use sandalwood for its diuretic effect. A
bath or a full-body massage is the best means of delivering this treatment.
General Stress-Reduction Therapies
Excess unresolved stress can alter your hormones, so keep tension in check by prac- ticing any of the therapies discussed in the Exercise and Stress Reduction chapter on a regular basis.
Bach Flower Remedies
Consult the chart on pages 648–650 to determine the best remedy for your particu- lar needs. Once you’ve chosen a remedy, place 10 drops of the liquid under your tongue. Hold the drops in place for thirty seconds and swallow. Use as often as needed.
If prostate problems make you feel ashamed, take Crab Apple for a more positive attitude.
Exercise to keep your cholesterol down and to work off stress. Low-impact workouts are best, as a jarring exercise like jogging may be painful if you have an enlarged prostate. Avoid bicycling, which puts too much pressure on the prostate.