It’s two a.m. and you’re on your way to the bathroom for the third time tonight. You woke up with an urgent need to urinate, but now you’re having trouble getting started, and when you’re done emptying your bladder, it still feels full. Sound familiar? Half of all men over 60, and 80 percent of men over age 80, suffer from benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate gland.
While the exact cause is unclear, prostate enlargement seems to result from hormonal changes in a man’s body as he ages. As the prostate grows, it can press on the urethra and obstruct the flow of urine, resulting in frequent, sometimes painful, urination (especially at night), difficulty starting to urinate, and “dribbling” at the end of urination. BPH is relatively harmless: It sometimes causes no symptoms at all and doesn’t increase your risk of prostate cancer. Left untreated, however, severe BPH can lead to acute urinary retention or infections of the urinary tract or kidneys.
If you’re experiencing symptoms that may be due to BPH, it’s important to see your doctor, who can rule out conditions with similar symptoms, including prostate cancer. Once you’ve been diagnosed with BPH, your doctor may suggest surgery or drugs, but I recommend neither, except in very severe cases. These treatments aren’t always effective, and I think the risks and side effects associated with them–including impotence, incontinence, and infection–are too great.
If your symptoms are minor, it’s likely your doctor will recommend “watchful waiting,” monitoring the condition to see if it becomes worse. I believe that watchful waiting, combined with the five natural measures discussed below, can make a real difference in both the severity of your current symptoms and the risk of further enlargement.
1. Be smart about fats.
Research has shown that a diet high in unhealthy fats can increase a man’s risk of developing BPH. Reduce your consumption of saturated fats and trans fats, and replace them with healthier monounsaturated fat (in olive oil) and omega-3 fatty acids (in salmon and flax seeds).
2. Stock up on soy.
Japanese men, who eat a lot of soy foods, have lower rates of BPH than do their Western counterparts. One possible reason? Soy foods contain plant estrogens called isoflavones that have been shown in lab studies to decrease the growth of prostate tissue. Enjoy soy products such as tofu, tempeh, and soy milk a few times a week.
3. Get moving.
In one study of some 30,000 men, those who walked just two to three hours a week had a 25 percent lower risk of developing BPH symptoms than those who exercised the least (Archives of Internal Medicine, November 23, 1998). My standard recommendation, a brisk 45-minute walk at least five times a week, more than fits the bill.
4. Avoid symptom triggers.
While an enlarged prostate is at the root of BPH symptoms, there is much you can do to avoid aggravating the discomfort. Start by reducing or eliminating your consumption of caffeine and alcohol, diuretics that can trigger the urge to urinate. If you can help it, try not to drink any liquids after 7 p.m. to avoid nighttime trips to the bathroom. Some over-the-counter antihistamines and cold remedies contain ingredients that can prevent the bladder opening from relaxing, leading to urinary retention. Counteract constipation (which can increase bladder pressure and worsen symptoms) by getting plenty of fiber in the form of fruits, vegetables, and whole grains. Finally, experiment with cutting back on spicy foods, which can act as prostatic irritants and worsen symptoms in some men.
5. Explore herbal remedies.
In a recent review of studies, researchers found the herb saw palmetto to be as effective as the drug Proscar in treating BPH, but with far fewer side effects (Journal of the American Medical Association, November 11, 1998). Unlike Proscar, saw palmetto isn’t believed to skew the results of PSA tests (used to screen for prostate cancer), but it’s still important to tell your doctor if you’re taking saw palmetto or any other supplements. The standard dose for saw palmetto is one 160-mg capsule twice a day; you’ll find reliable brands listed at ConsumerLab.com.
buying supplements, you may see products that combine saw palmetto with
other botanicals, such as pygeum and stinging nettle root. While these
substances haven’t been researched as much as saw palmetto, there’s some
evidence that they’re helpful for BPH, and I think combination products
containing them are worth a try. Follow package directions. Be aware
that it may take up to eight weeks before you see a benefit from using
any of these supplements.
(A note about zinc: While some studies have suggested that this mineral could help men with BPH, recent research has shown that high intake of zinc may actually increase risk of the disorder. Until we learn more, I think it’s prudent for men with BPH to avoid taking zinc supplements.)