It is perfectly normal for a man’s prostate to grow throughout his adult life. For some men, this does not bring serious symptoms, but for others, an enlarged prostate can lead to problems that affect not only prostate health but also their quality of life.
An enlarged prostate affects one in five men aged between 50 and 60 years and is even more common in older men. The symptoms can be quite bothersome and may even cause issues in personal life or at work. Resorting to medications or surgical interventions can complicate matters in some cases, especially when it is not entirely necessary, but there are some lifestyle and dietary changes that can make a difference when it comes to an enlarged prostate.
What is an enlarged prostate?
The prostate, a gland in the male reproductive system, is located just below the bladder. Since the prostate surrounds a part of the urethra, where urine passes, an enlarged prostate can cause urinary problems.
When the prostate grows, it can push against the bladder and urethra, making one feel the need to urinate even when the bladder is not full and preventing urine from flowing naturally. This feeling becomes stronger when the muscles at the lower part of the bladder start to contract, even when there is only a small amount of urine present. Over time, this constant pressure can weaken the bladder muscles, resulting in the bladder not being able to empty properly.
The medical term for an enlarged prostate is benign prostatic hyperplasia (BPH). The word benign means that the growth is not cancerous, and the word hyperplasia means an abnormal increase in cells. BPH is the most common non-cancerous cell growth in men and does not lead to prostate cancer.
Symptoms
When the prostate is enlarged, it pushes against the bladder and urinary tract. This can lead to problems such as:
- frequent urination, especially at night
- difficulty starting urination
- taking longer for urine to start flowing (despite the urgency to urinate)
- weaker urine flow and taking longer to finish urinating
- dribbling and leakage after urination
- feeling that the bladder is not empty after urination
There is not always a direct relationship between the size of the prostate and symptoms. Men with a very enlarged prostate may not have symptoms, while others with a less enlarged prostate may have many problems.
Approximately one-third of men with an enlarged prostate have lower urinary tract symptoms (LUTS) that can interfere with their quality of life. LUTS symptoms include filling symptoms, such as frequent urination, especially at night, and voiding symptoms, such as weak flow and incomplete urination. For some men, symptoms may improve over time, while for others, they remain the same or worsen over time, which may require surgical treatment.
Occasionally, men with an enlarged prostate may suddenly have difficulty urinating or may not be able to urinate at all. This condition is called acute urinary retention (AUR) and requires immediate medical assistance to relieve severe discomfort. AUR is an uncomfortable and potentially dangerous condition. It often occurs in men with underlying benign prostatic hyperplasia and is often triggered by an event, such as exposure to cold weather, taking a medication that prevents the bladder from contracting, or excessive alcohol consumption. Other factors can cause AUR, such as invasive procedures for treating BPH, acute bacterial prostatitis, and viral infections.
Causes
It is perfectly normal for the prostate to grow during puberty until it reaches about the size of a walnut. Around the age of 25, the prostate begins to grow again very slowly. The growth of the prostate is not the same for every man; for some, it grows much more than for others.
Changes that occur with male hormones as part of the aging process seem to play a role in prostate enlargement. Androgens, such as testosterone, affect prostate growth. The prostate converts testosterone into dihydrotestosterone (DHT), another powerful androgen, and DHT stimulates cell growth in the tissue that makes up the prostate gland. This is the main cause of prostate enlargement and usually occurs between puberty and young adulthood. Estrogen present in men may also play a role in prostate enlargement. As men age and testosterone levels decrease, the proportion of estrogen increases and may trigger prostate growth.
Risk Factors
Age is a major risk factor for an enlarged prostate. According to a review of benign prostatic hyperplasia published in Reviews in Urology, the actual enlargement of the prostate gland develops as a phenomenon strictly related to age in almost all men, starting around the age of 40. Data from autopsy studies worldwide suggest that the prevalence of BPH is about 10% for men in their 30s, 20% for men in their 40s, reaching 50% by age 60, and 80% by age 70 to 80. Researchers conclude that there is no doubt that men who live long enough will develop some characteristics consistent with BPH.
Research conducted by the Mayo Clinic has found that among the 2,119 men involved in the study, 440 (21%) reported a family history of enlarged prostate. Age-adjusted risks of having moderate or severe urinary symptoms were increased among those with a family history compared to those without. These findings suggest that men with a family history of enlarged prostate may be at increased risk of developing symptoms and signs of BPH, and this risk is higher in men with diagnosed relatives at a younger age.
An alarming study published in the International Journal of Cardiology suggests that patients with BPH and lower urinary tract symptoms have a significantly higher prevalence of cardiovascular diseases than the general population at older ages. The reasons behind this correlation are not entirely clear, but researchers speculate that by causing sleep disturbances, blood pressure variability, and increased cortisol levels, an enlarged prostate may be a risk factor for cardiovascular diseases.
Natural Treatments for an Enlarged Prostate
1. Lifestyle and Dietary Changes
Certain lifestyle modifications can help alleviate the symptoms of an enlarged prostate. For those who wish to wait before opting for medication or surgical intervention, trying these recommendations may be beneficial:
- limit or avoid alcohol and caffeine
- limit fluid intake in the evening
- try to urinate at least once every three hours
- engage in physical activity
- maintain a healthy weight
- increase intake of healthy fats (such as omega-3 foods)
2. Pelvic Floor Training
Pelvic floor training, also known as Kegel exercises, can help men strengthen the pelvic diaphragm muscles, improving involuntary or abnormal urine loss for men with an enlarged prostate. Performing these exercises, which involve contracting and then releasing the muscle, helps support the bladder and close the sphincter. Since it can be difficult to locate this muscle, try exercising while urinating. Contract the muscle, allowing the urine to slow down, and then stop urination for 20 seconds. Generally, it is recommended that men practice pelvic exercises three to five times a day.
3. Herbal Supplements
The following herbs may help:
Saw Palmetto
Saw Palmetto has been widely used as a therapeutic remedy for urinary dysfunction caused by an enlarged prostate. Research shows that saw palmetto helps improve urinary dysfunction and overactive bladder in patients with BPH. It is also known to be a safe treatment option, even for long-term use.
Nettle Root
A study conducted in Japan found that nettle contains hydrophobic constituents, such as steroids, that can inhibit the activity of the prostate membrane tissue, which may subsequently suppress the metabolism and growth of prostate cells.
Pumpkin Seed Oil
Research published in Nutrition Research and Practice found that pumpkin seed oil could reduce symptoms of an enlarged prostate within three months. Maximum urinary flow was significantly improved after three months.
Precautions for Enlarged Prostate
Men with an enlarged prostate should discuss with their doctor before taking any over-the-counter medications, such as decongestants and antihistamines. These medications, which are usually taken for colds and allergies, can worsen urinary symptoms by preventing the relaxation of the muscles around the prostate and bladder neck, allowing urine to flow freely.
Diuretics, which increase urination, can also worsen symptoms of an enlarged prostate, so men taking these medications should discuss alternatives with their doctor.
