The normal prostate should be about as large as a walnut without the shell and it should have a rubbery consistency on palpation. The prostate gland surrounds the urethra, the tube that transports urine from urinary bladder to outside, and is just below the urinary bladder. The size of the prostate gland may vary just a little depending on the individual’s body weight and size. There should not, however be any nodules or bumps present on the prostate and the exam should not produce any unusual pain and discomfort to the patient.
Benign prostatic hyperplasia (BPH) is a very common health concern among older men. Its symptoms are classified as obstructive or irritative. Obstructive symptoms include hesitancy, intermittency, incomplete voiding, weak urinary stream and straining. Irritative symptoms include frequency of urination especially at night time and urgency. These obstructive and irritative symptoms are evaluated using the International Prostate Symptom Score (IPSS) questionnaire, designed to assess the severity of BPH.
BPH can be a progressive disease, especially if left untreated. Incomplete voiding results in not being able to flush out the bacteria from the urinary bladder and having them settle there. This will increase the risk of urinary tract infections and bladder infections.
There will also be a higher risk for formation of bladder stones since the urine residue is stagnant in the bladder and there will be an oppurtunity for the crystals to form. Urinary retention if left untreated, once it becomes chronic can eventually lead to kidney failure and death. It is therefore very important to treat the symptoms associated with BPH.
Some dietary behaviors that increase the risk of BPH are:
■ High animal fats
■ Pan fried and barbequed meats
■ Drinking alcohol since it generates free radicals
■ Lack of folic acid in the diet since it can lead to cell and DNA damage
To prevent enlargement of the prostate gland it is important to supplement early on and perhaps start as early as 40 years of age. A few botanical supplements have been researched and proven to be effective in preventing BPH:
Saw Palmetto (Serenoa repens) that is standardized to 90% fatty acids and sterols has been researched extensively and is present in most supplements. This botanical is used to relieve the symptoms of BPH in most patients since it works as an anti-androgenic and an anti-exudative. It is also thought that the phytosterols in the saw palmetto berry extract compete with dihydrotestosterone for receptor sites in the prostate thus again reducing the effect of dihydrotestosterone. Clinical studies show that Saw Palmetto extract is more effective in relieving the symptoms of enlarged prostate than the most commonly prescribed drug finasteride (ProscarTM). Objective observations have shown that Saw Palmetto extract was able to increase urine flow rate and decrease prostate size.
African Pygeum (Prunus africana) consists of active constituents like phytosterols (e.g., beta-sitosterol) that have anti-inflammatory effects by inhibiting production of pro-inflammatory prostaglandins in the prostate gland. This plant also contains pentacyclic triterpenes (ursolic and oleanic acids) that have anti-edema properties, and ferulic acid nesters (n-docosanol and tetracosanol) that reduce prolactin levels and block the accumulation of cholesterol in the prostate. Prolactin is believed to increase the uptake of testosterone by the prostate gland, and cholesterol increases binding sites for dihydrotestosterone (DHT). This will then lead to further increasing the prostate size. The clinical trial studies done on this plant demonstrate that Pygeum reduces noturia, residual urine volume in the urinary bladder and it increases the peak urine flow. These unpleasant symptoms are all associated with BPH and hence taking this herb will improve these symptoms.
Nettle (Urtica dioica) is also scientifically researched and used to treat the symptoms associated with BPH. The root of this plant consists of isolactones, 3βsistosterol, 3D glucosides, lignans, fatty acids, scopoletin and tannins. The use of the root inhibits cell growth in the prostate gland and thus helps to relieve the irritating symptoms of BPH.