Prostate Problems

All men over 50 are prone to prostate problems. There are only 3 common diseases that affect the prostate, but together they will affect almost all men if they live long enough. This page attempts to explain how common prostate conditions can be prevented and minimized. The 3 diseases of the prostate are:

Benign Prostate Hyperplasia (BPH)
Cancer of the Prostate - Prostate cancer nutritional and adjuvant treatment
Prostatitis both acute and chronic prostatitis.
Do you have chronic prostatitis-quiz.

Benign Prostate Hyperplasia (BPH).

As men age the prostate enlarges, this enlargement eventually puts pressure on the urethra, the tube that runs from the bladder through the core of the prostate and the to the penis. This enlargement is called BPH and causes symptoms such as dribbling after urination (slow stopping), Hesitancy (slow starting), poor pressure and flow rates of urine (poor stream) and nocturia (getting up at night to pass water) and frequency (going many times a day).

BPH is not simply a part of growing old, but is related to the changing hormone states, specifically falling available (free) testosterone as men age, and rising levels of Di hydro testosterone (DHT), and increasing levels of oestrogen especially "bad" oestrogens as men grow older. DHT and oestrogens activate receptor sites in the prostate which causes prostate enlargement.

Preventing or slowing BPH is all about slowing these hormone changes and maintaining the hormone balance found in men under the age of 40 for as long as possible. Unfortunately prostate cancer is made worse by testosterone and improved by some oestrogens so it is important to have regular checks of the prostate by digital examination and PSA blood tests. BPH usually precedes prostate cancer and there is always the risk of occult cancer in the enlarged prostate.

What hormone changes affect the prostate as men get older??

A protein called SHBG (Sex hormone binding globulin) rises as we age and more testosterone is bound up to it, reducing the amount of available (free) testosterone.
More testosterone is converted to oestrogens by an enzyme called aromatase.
More testosterone is converted to DHT by an enzyme called 5 alpha reductase.
Less testosterone is made by the aging testicles.

What can we do about it to help reduce BPH & Prostate Cancer?

Drink more water.
Lose weight.
Reduce excessive alcohol consumption.
Regular exercise. In one study men who walked daily were far less likely to develop prostate cancer.
Have regular checks of the prostate by digital examination and PSA blood tests.
Eat Cuciferous vegetables such as broccoli, cauliflower, cabbage, and brussel sprouts. Studies have shown men who eat 3 or more serves of these vegetables a week have a 41% reduction in the incidence of prostate cancer.
Serenoa repens (Saw palmetto) .Take the herb saw palmetto combined with nettle root (Urtica dioica). Saw palmetto and nettle root blocks 5 alpha reductase, reducing the conversion of testosterone to DHT. A drug called Proscar also blocks 5AR, but only gives improvement in symptoms in 30% of men who use it for more than 6 months or more. Nettle root appear to contains substances which bind to SHBG helping reduce the proportion of bound:free testosterone.
Take Pygeum africanum. One French study, published in Current Therapeutic Research, examined how Pygeum affects maximum urinary flow and “found an improvement of 91% with Pygeum africanum extract versus 4% with placebo” (Andro 1995).
Take Beta Sitosterol - a naturally occuring plant product; in one study 88% of BPH sufferers found this to be an effective therapy after 90 days treatment.
Take Lycopene. Lycopene is found in tomatoes and is best absorbed in cooked tomato products such as tomato pastes or sauces. Dr. Edward Giovannucci beginning in 1988 followed the eating habits of 47,000 men for six years. Those who had at least 10 weekly servings of tomato-based foods rich in lycopene were up to 45% less likely to develop severe prostate growths. These findings were published in the prestigious Journal of the National Cancer Institute (Giovannucci 1995). Lycopene is available as a supplement. Lycopene also enhanced surviaval and PSA reduction in men with prostate cancer (Reference)
Take flavenoids especially genistein. These are weak oestrogen like chemicals which may help prevent BPH by binding to the oestrogen receptor sites in the prostate without activating them. Examples are soy products and red clover. Soy also specifically seems to reduce SHBG by up to 10%, again potentially increasing free testosterone.
Take Zinc 50mg/day. Zinc acts as an aromatase inhibitor, potentially reducing the conversion of androgens (male hormones) to oestrogens. Chrysin is another aromatase inhibitor but is very poorly absorbed from the gut and then may be broken down by the liver. To be effective chrysin needs to be in a cream absorbed though the skin or a troche (lozenge) absorbed though the mucosa of the mouth. Arimidex is a drug which is a potent aromatase inhibitor, but is very expensive. It is used for breast cancer in a dose of 1mg/ day but 1/2mg twice a week may be enough to decrease estrodiol in men according to LEF, meaning a bottle of 28 tablets would last over 6 months.
Reduce Sex Hormone Binding Globulin.
- SHBG is increased by obesity, excess alcohol, hormones metabolised by the liver (specifically oral contraceptive pills in women) and thyroid disease. It is also increased by the drug Metformin used for diabetics, though this remains the best treatment for obese type two diabetics who need medication. So losing weight and decreasing drinking alcohol are good tactics
- SHBG is reduced by Soy products and higher circulating insulin levels.
Take the drug Minipress (Prazosin) or Flowmax . Prazosin is an old blood pressure drug, that even in low doses has the useful side effect of reducing the amount of smooth muscle in the ageing prostate. While this does not reduce prostate size it often greatly alleviates the symptoms of BPH such as frequency and nocturia.