The symptoms associated with prostate problems are urging, pain on urination (dysuria), urinary frequency, incomplete emptying of the bladder, hesitancy and dribbling. This may be caused by an acute or chronic infection (prostatitis), or be the result of chronic benign prostatic hyperplasia (BPH). Urinalysis, a test for prostate specific antigen (PSA), and a physical exam (DRE) will help differentiate prostatitis, BPH, kidney disease, diabetes and prostate cancer.

Prostatitis may result in a discharge, blood in the urine, or fever and chills. There may be localised pain in the pubic region, and it may radiate to the lower back, kidneys or thighs. Untreated BPH can result in bladder obstruction, uraemia and kidney damage.

BPH is a benign increase in the size of the prostate gland which surrounds the urethra,  resulting in constriction (hyperplasia). This results from an altered hormone profile due to greater activity of the enzymes aromatase and 5α reductase. This increased activity means increased conversion of testosterone to the more active androgen dihydrotestosterone (DHT) and oestrogen, with a corresponding fall in testosterone. DHT stimulates growth, protein synthesis and inflammatory prostaglandin PGE2 in the prostate gland. Smooth muscle contraction contributes to symptoms due to an increased adrenergic tone.

Medical treatment relies on both drugs and surgery: alpha-blocking agents are used to relax muscles in the prostate and bladder neck (Tamsulosin Terazosin); 5α reductase inhibitors reduce DHT synthesis (Finasteride, Dutasteride); surgery widens the urethra (TURP); and prostatic artery embolisation (PAE) causes atrophy of the gland. Side-effects of treatment can result in a loss of sexual function.

Treatment:

General

The first step is the same for treating other metabolic diseases, that is to stop the decline in health due to poor eating habits, insulin resistance, weight gain, lack of exercise, and any possible adverse environmental influences. Any infection must be treated with urinary antiseptics, and then a long-term strategy employed to reduce prostate enlargement.

Some medications contribute to symptoms and need to be assessed by the prescribing doctor: decongestants, calcium channel blockers, anticholinergic drugs and diuretics.

Any diagnosis of cancer usually results in a wait and monitor approach due to the slow growing nature of the cancer. In fact, there is a high incidence of cancers in men beyond middle-age and most elderly men will die of old age or other causes before the symptoms of cancer are severe or the cancer metastasizes. Obesity is a major risk factor as with a diet high in red meat.

Diet

An anti-inflammatory diet is an old-fashioned wholefood diet, largely vegetarian with plenty of oily fish as we find in the traditional Mediterranean diet or Okinawan diet. Eat lots of fruit, nuts and vegetables, rich in fibre and protective antioxidant, anti-inflammatory phytonutrients. Avoid all refined sugars, factory fats and the ultra-processed foods which contain them.

Reduce stimulants such as coffee and alcohol, drink adequate water but not within four to six hours of bedtime.

Take supplements such as fish oil, vitamin E, cod liver oil, vitamin D, zinc.

Tissue Salts

Ferrum-phos—to reduce inflammation in the prostate

Herbs

Bearberry (Uva ursi)—urinary antiseptic, prostatitis

Buchu—urinary antiseptic, prostatitis

Green tea—antioxidant, anti-inflammatory, diuretic, BPH

Horsetail—anti-inflammatory, woundhealer, antihaemorrhagic, diuretic, BPH

Lesser willow herb—urinary tract infection, inflammation, BPH

Nettle—Helps with bladder obstruction, proven 5α reductase inhibitor, anti-inflammatory. Diuretic, also helps with uric acid and gout.

Saw palmetto—antiseptic, inhibits 5α reductase, prevents oestrogen excess in prostate

Garlic—antimicrobial, systemic immune support

Echinacea—immune system, liver alterative, lymphatic cleanser

Burdock—liver and kidney alterative, diuretic, BPH

Cleavers—lymphatic cleanser

Homeopathy

Apis—burning, stinging, smarting especially last drops, scanty urine, dark

Berberis—soreness in kidney extends along urethra, urine turbid, burns when not urinating

Cantharis—scanty urine by drops, burns before during and after, intolerable urge, blood

Chimaphila—thick ropey urine with pus, clots of blood, stands to urinate

Equisetum—aching full tender bladder, constant urge, passes large quantities but not better, pain while urinating, dribbles

Lycopodium—colic, burning, frequency but strains, milky or bloody, back pain worse motion, better urinating

Sabal-s—difficult, burning, frequency esp. night, parts feel cold

Nit-ac—burning, cramps, urine has an offensive odour, scanty alternating with profuse, feels cold on passing, high sex drive

Pareira-b—retention, renal colic, stringy mucous, constant urging, pain in parts and thighs, kneels to urinate.

Pulsatilla—stricture urinates by drops, bloody or thick discharge, cramps after urinating, enuresis worse lying

Thuja—sudden urging, profuse, foamy, cloudy, foul, dribbles, enuresis at night, history of STD

Disclaimer: this article is intended for the purpose of general education only, and is not a substitute for a diagnosis, treatment advice, or a prescription given in a consultation with a qualified physician.