Natural therapies for the prostate gland: a scientific review of nutrient and herbal combinations that promote prostate health

Townsend Letter for Doctors and Patients,  Dec, 2004  by Gina L. Nick

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The prostate is a walnut-sized gland that sits at the base of the male bladder, surrounding the prostatic urethra. As part of the reproductive system, this gland secretes seminal fluid, energizes sperm and provides for it a favorable alkaline medium. The prostate is subject to several disease states including infection, hypertrophy and cancer, causing pain, urinary frequency and urgency, inability to urinate, painful urination and sexual dysfunction.

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Benign prostatic hyperplasia (BPH), prostate cancer, and prostatitis are its most common disorders. More than 50% of men in their sixties and as many as 90% of men in their seventies and eighties are diagnosed with BPH, resulting in 375,000 hospital stays each year in the United States alone. Prostate cancer is second only to cancer of the lung as the leading cause of cancer death among men. Each year, more than 100,000 new cases of prostate cancer occur in the US, and more than 30,000 deaths are caused annually by this disease. (1) The good news is that over the past 20 years, the survival rate for prostate cancer has increased from 67% to 97%. (2)

Unfortunately, benign prostatic hyperplasia (BPH) and prostate cancer do not have a known etiology, making prevention difficult and treatment less than ideal. Standard lines of treatment for these conditions, including pharmacological preparations, surgical and non-surgical procedures, hold significant risks. Additionally, as new theories about the functioning of the prostate gland develop, scientists are questioning the effectiveness and the rationale behind the continued use of these treatment modalities. A close review of the medical literature verifies the safety and efficacy of nutritional and botanical therapeutic agents such as Serenoa repens (saw palmetto), Urtica dioica (stinging nettle root), Prunus africanum (pygeum), essential fatty acids, selenium, green tea extract, tomatoes and zinc to promote and maintain prostate health and alleviate urologic symptoms. In addition, select amino acids, in relatively physiologic doses, exhibit promising clinical results for the prostate patient. These natural ingredients effect a positive change in prostate health without the associated risk of adverse reactions. Following is a review of the most common prostate conditions and available treatment options, including a comprehensive evaluation of herbal and nutrient therapies for the prostate gland, scientific validity, positive patient outcomes, and incidences of negative side effects.

Benign Prostatic Hyperplasia (BPH; Prostate Enlargement; Lower Urinary Tract Symptoms (LUTS)

As a man ages, his prostate gland typically begins to enlarge. The medical community has no well-defined reason for this phenomenon, which is identified as benign prostatic hyperplasia (BPH), benign prostatic hypertrophy, or lower urinary tract symptoms (LUTS). This condition does not generally cause symptoms until a man reaches the age of 50, with the majority of associated problems peaking by age 70. BPH causes the prostate gland to constrict the urethra, making micturition increasingly difficult. As the bladder is forced to contract against increasing resistance, the bladder muscle (the detrusor) becomes hypertrophied and irritable. As the condition progresses, the bladder becomes unable to empty completely, and finally to empty at all. Residual urine in the bladder sets the stage for serious bladder infections and kidney malfunction.

Symptoms of BPH include:

* Reduced caliber and force of urine stream

* Frequent urination (particularly in the evening)

* Urinary urgency

* Leaking or dribbling

* Urinary retention (inability to pass urine)

Occasionally, a man may not realize that he has a urinary obstruction until he finds himself unable to urinate at all. Physicians refer to this type of episode as acute urinary retention, which can be triggered by a wide variety of drugs with anticholinergic side effects, both prescription and over-the-counter, such as anti-depressants, cold and allergy medications. These medications can tighten the bladder outlet, resulting in urinary retention. Alcohol, cold temperatures or a long period of immobility can also cause urinary retention when there is a partial obstruction present. Severe BPH can have serious long-term health effects such as urinary tract infections, bladder or kidney damage, bladder stones, painful intercourse, and incontinence.

Conventional Therapies for BPH

Finasteride (Proscar[R]), terazosin (Hytrin[R]), doxazosin (Cardura[R]), and tamsulosin (Flomac[R]) are medications approved by the FDA for the treatment of BPH. These pharmaceuticals aim at blocking DHT production or relaxing the prostatic urethra sphincter. Specifically, finasteride (Proscar[R]) inhibits the production of dihydrotestosterone (DHT), while terazosin (Hytrin[R]), doxazosin (Cardura[R]), and tamsulosin (Flomac[R]) force smooth muscle relaxation of the prostate and bladder neck. Nonsurgical treatments include transurethral microwave procedures (TUMT) and transurethral needle ablation (TUNA). Surgical treatments include open, laser and transurethral (TURP) surgery. These treatments remove or destroy sections of the prostate gland. Botanical and nutritional therapies for BPH focus on decreasing the size of the prostate gland, preventing abnormal cell growth, and supplying the gland with nutrients to decrease the risk of infection, while maintaining hormonal balance and preserving the complete gland.