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The enlargement of the prostate gland is an inevitable process that affects the majority of men as they age. The prostate, a small walnut-sized organ situated beneath the bladder, continues to grow throughout a man's life under the influence of male hormones, particularly testosterone. For many men, this process occurs asymptomatically, but for others, prostate enlargement eventually leads to the development of benign prostatic hyperplasia (BPH), also known as prostate adenoma.
BPH stands as one of the most prevalent conditions afflicting men over 50 years of age. Statistical data reveals that symptoms of prostate adenoma are present in 50% of men aged 51 to 60, and a staggering 90% of men over 80. The initial signs of prostate enlargement may manifest as early as 40 years old, although they typically develop gradually and become more pronounced with advancing age.
The most common symptoms associated with prostate adenoma include urinary issues such as:
- Frequent urges to urinate, especially during nighttime hours
- A sensation of incomplete bladder emptying
- Weak urine stream
- Difficulty initiating urination
- Intermittent urination
- Post-urination dribbling
These symptoms arise due to the enlarged prostate compressing the urethra, thereby impeding the normal flow of urine from the bladder. Over time, this can lead to serious complications, including urinary tract infections, bladder stones, and even renal insufficiency.
Furthermore, prostate adenoma is often accompanied by an elevation in prostate-specific antigen (PSA) levels in the blood. PSA is a protein produced by prostate cells, and its concentration may increase in various prostate disorders, including BPH and prostate cancer. Consequently, any elevation in PSA necessitates further examination by a urologist to rule out malignancy.
Can prostate enlargement be prevented?
Unfortunately, it is impossible to completely prevent age-related prostate enlargement, as it is a natural physiological process. However, certain measures can help slow prostate growth and reduce the risk of developing pronounced BPH symptoms:
- Maintaining a healthy weight: Excess weight and obesity are risk factors for prostate adenoma development. Therefore, it is crucial to monitor one's weight and take necessary steps to reduce it if needed.
- Regular physical exercise: Moderate physical activity, such as brisk walking, jogging, swimming, or cycling, improves blood circulation in the pelvic area and may slow prostate growth.
- Balanced diet: A diet rich in vegetables, fruits, whole grains, and legumes provides the prostate with essential nutrients and antioxidants. Simultaneously, it is advisable to limit consumption of red meat, saturated fats, and dairy products.
- Elimination of harmful habits: Smoking and excessive alcohol consumption negatively impact prostate health and can exacerbate BPH symptoms. Therefore, it is important to quit these habits or minimize them.
- Regular preventive check-ups: Men over 45 are recommended to undergo annual urological examinations, including digital rectal examination and PSA blood tests. This allows for early detection of prostate adenoma and timely initiation of treatment.
How to treat prostate adenoma?
The choice of treatment for prostate adenoma depends on the severity of symptoms, the patient's age and overall health condition, as well as personal preferences. Modern medicine offers several options for BPH treatment:
- Pharmacological therapy: For moderate BPH symptoms, medications such as alpha-adrenergic blockers and 5-alpha-reductase inhibitors are typically prescribed. These drugs relax prostate and bladder muscles, improving urine flow and alleviating lower urinary tract symptoms.
- Minimally invasive procedures: In some cases, minimally invasive methods are used to treat prostate adenoma, such as transurethral microwave therapy (TUMT), transurethral needle ablation (TUNA), and prostate water ablation (Aquablation). These procedures are performed through the urethra without incisions and help reduce prostate volume and alleviate symptoms.
- Surgical treatment: For severe prostate adenoma symptoms that do not respond to conservative therapy, surgery may be necessary. The most common method is transurethral resection of the prostate (TURP), which removes the portion of the prostate gland obstructing the urethra. In some cases, open surgery — prostatectomy — is performed.
As Dr. John F. Feller, Chief Medical Officer of HALO Diagnostics and Associate Clinical Professor of Radiology at Loma Linda University School of Medicine, notes, it is crucial not to feel embarrassed about seeking medical help when experiencing prostate adenoma symptoms. «It's better to consult a doctor than to suffer from these symptoms because there are many good options between medication, surgery, and new focal therapy methods to improve quality of life,» he says.
Natural herbs and supplements for treating enlarged prostate
Many herbal remedies have been used for centuries to treat enlarged prostate due to their anti-inflammatory and diuretic properties. However, physicians typically require more substantial evidence, such as randomized double-blind placebo-controlled studies, before recommending a specific herb or supplement.
Nevertheless, a 2015 article in the Canadian Journal of Urology echoes Dr. Feller's advice, stating that BPH patients with mild symptoms who are reluctant to try standard medications may also consider phytotherapeutic treatments, «provided the patient understands the current limitations of these agents.» The document warns that patients with moderate to severe symptoms, «including recurrent infections, bladder stones, or renal dysfunction,» should altogether avoid alternative remedies and seek traditional medical or surgical treatment.
Saw palmetto extract
Saw palmetto extract (Serenoa repens) is one of the most popular and extensively studied phytotherapeutic agents, or plant-based remedies, for prostate enlargement. Saw palmetto is a species of palm shrub native to the southeastern United States. Its berries are used in dietary supplements to support urinary tract function, reduce inflammation, decrease hair loss, and promote prostate health.
While small studies have yielded mixed but sometimes promising results in patients with prostate adenoma, more detailed studies and reviews tend to show that this remedy is no better than placebo in reducing lower urinary tract symptoms. At the very least, an 18-month study of 369 patients, sponsored by the National Institutes of Health and conducted as part of the Complementary and Alternative Medicine for Urinary Symptoms study, demonstrated that the supplement is safe at normal, double, and triple doses.
African plum tree bark
African plum tree bark (Pygeum africanum) possesses anti-inflammatory properties and is traditionally used to treat urogenital disorders. Additional research is needed to determine whether pygeum africanum bark is beneficial for reducing prostate adenoma, although preliminary studies indicate promise. Pygeum, primarily marketed for treating enlarged prostate, is also advertised as a remedy for inflammation, kidney and urinary tract diseases, and as a libido enhancer. Pygeum may cause gastrointestinal disturbances but is otherwise generally considered safe.
Rye pollen
Rye pollen (Secale cereale), also known by the trade name Cernilton, has shown modest success in treating symptomatic prostate adenoma, although researchers from the Minneapolis VA Center for Chronic Disease Outcomes Research, Virginia, and other comprehensive reviews have cautioned that longer studies and comparative trials are needed to truly determine its effectiveness. Possible side effects include increased skin sensitivity, respiratory allergies, and gastrointestinal disturbances.
Natural dietary remedies for prostate adenoma
Some natural products high in antioxidants may be beneficial for prostate health and alleviate adenoma symptoms. Continue and note these treatments in the «what you should probably do anyway» section, as all these antioxidants provide general health benefits and may also play a role in reducing PSA levels, thus lowering the overall risk of prostate cancer.
Lycopene
Lycopene is a potent antioxidant found in red and pink fruits and vegetables such as tomatoes, watermelon, pink grapefruit, and papaya. In a comprehensive review of antioxidants published in the journal Nutrition and Cancer, lycopene ranked first for its benefits in treating prostate cancer and potential prostate cancer patients.
According to a randomized controlled trial conducted at the German University of Hohenheim, lycopene also inhibits the growth of prostate adenoma. A 2013 review notes that «increasing evidence suggests that whole foods may be more effective in reducing disease risk than individual compounds,» suggesting that a fresh tomato will provide more lycopene-based benefits than a slice of tomato on a pizza with sauce — but you probably already knew that.
Green tea
Green tea is rich in antioxidants. Small studies, such as the one published in Therapeutic Advances in Urology, have shown promising results using green and black tea extracts to treat lower urinary tract symptoms. Although not strictly shown to reduce prostate adenoma, anything that reduces pain during urination, its difficulty, and frequency can still benefit those suffering from prostate enlargement.
Consuming antioxidant-rich green tea carries numerous potential dietary benefits beyond prostate health, but if caffeine exacerbates prostate adenoma symptoms, it's best avoided.
Pumpkin seeds
Pumpkin seeds are a beneficial source of fiber, healthy fats, antioxidants, and minerals, as well as a rich source of zinc — an important but understudied factor for prostate health. What is less certain is whether consuming pumpkin seeds will help reduce prostate adenoma to any significant extent. Several studies have shown that pumpkin seeds may reduce the frequency and urgency of urination associated with prostate adenoma, although there is no evidence that they can directly reduce prostate adenoma.
Healthy lifestyle for prostate adenoma
Lifestyle plays an equally important role in preventing and treating prostate adenoma as medications and natural remedies. As Dr. Feller aptly puts it, «Everything that's good for the heart and brain is good for the prostate.»
Here are some recommendations for a healthy lifestyle with prostate adenoma:
- Maintain a normal weight: Excess body weight and obesity are risk factors for BPH development and can exacerbate its symptoms. If you are overweight, try to gradually reduce it through a balanced diet and physical activity.
- Exercise regularly: Regular moderate-intensity aerobic exercises, such as brisk walking, swimming, or cycling, improve blood circulation in the pelvic area and can slow the progression of prostate adenoma. Aim for at least 30 minutes a day on most days of the week.
- Adhere to a healthy diet: Include more vegetables, fruits, whole grains, legumes, and lean protein sources in your diet. These foods are rich in fiber, vitamins, minerals, and antioxidants that support prostate health. Limit consumption of red and processed meats, saturated fats, sugar, and salt.
- Drink enough fluids: Adequate water intake helps dilute urine and prevent bladder irritation. However, avoid beverages that can exacerbate BPH symptoms, such as coffee, strong tea, and alcohol. It's especially important not to drink these beverages before bedtime to avoid provoking nighttime urination.
- Manage stress: Chronic stress and anxiety can exacerbate prostate adenoma symptoms and reduce quality of life. To reduce stress, try methods such as deep breathing, meditation, yoga, or massage. It's also important to get enough sleep and find time for enjoyable activities and socializing with loved ones.
- Practice pelvic floor exercises: Kegel exercises help strengthen the pelvic floor muscles and improve urination control. To do this, squeeze the perineal muscles as if trying to stop urination, hold the tension for 5-10 seconds, and relax. Repeat 10-15 times 3 times a day.
- Maintain sexual activity: Regular sexual activity and ejaculation promote prostate health and may reduce the risk of developing BPH and prostate cancer. If prostate adenoma causes erectile dysfunction or decreased libido, discuss this problem with your doctor. Modern medicine offers various treatments for sexual disorders.
- Don't hold back urination: When you feel the urge to urinate, try to empty your bladder as soon and as completely as possible. The habit of holding urine for long periods and urinating «just in case» can exacerbate lower urinary tract symptoms and increase the risk of infections. If you often wake up at night due to urges, try limiting fluid intake 2 hours before bedtime.
- Quit smoking: Smoking not only increases the risk of prostate cancer but also exacerbates prostate adenoma symptoms by irritating the bladder and constricting blood vessels. If you smoke, consider quitting or at least reducing the number of cigarettes. Your doctor can recommend effective smoking cessation methods.
- Undergo regular check-ups: Even if you don't have prostate adenoma symptoms, it's important to visit a urologist once a year for a preventive examination and tests. This will help detect any abnormalities at an early stage and start treatment in time. Don't be embarrassed to discuss any questions and complaints related to urination and sexual function with your doctor.
Remember that prostate adenoma is not a sentence, but a condition that can be controlled and successfully treated. Whether it's medication, surgery, or natural remedies combined with a healthy lifestyle — modern medicine offers many effective solutions to improve the quality of life for men with BPH.
The main thing is not to neglect the problem and seek specialist help in time. As Dr. John F. Feller emphasizes, «It's better to consult a doctor than to suffer from prostate adenoma symptoms because today we have all the possibilities to help the patient and restore the joy of a full life.»
Take care of yourself and stay healthy!