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What
are Prostate Problems
Benign
Prostatic Hypertrophy
Problems with the
prostate are very common in men in western countries and one of
the main ways in which they can present is Benign Prostatic Hypertrophy
(BPH). The prostate is a walnut-sized gland that is part of the
male reproductive system. It is located below the bladder (the organ
that stores urine) and surrounds the top portion of the tube that
carries urine out of the body (the urethra). The prostate gland
makes fluid for semen, which transports sperm during ejaculation.
BPH is abnormal growth of the gland typically seen in aging men
and often responsible for various degrees of urinary problems. The
condition is not malignant - it won't invade other tissues - but
the gland is becoming larger than normal. The prostate gland surrounds
the urethra, which descends from the bladder through the penis,
and can block the flow of urine when enlarged. BPH is an almost
universal phenomenon in men as they age, beginning at around 45
years old and continuing until, by age 70, 90% of men have an enlarged
prostate. Due to this enlargement BPH is the leading cause of urinary
outflow obstruction in men.
Some researchers have suggested that BPH typically indicates low
levels of male hormones. An abnormally high activity of the enzyme
that converts testosterone to dihydrotestosterone (DHT), 5-alpha
reductase, is usually seen in BPH. DHT may be more potent stimulator
of prostate cell growth than testosterone, and is also considered
to be a factor in male pattern baldness. High levels of oestrogen
may also factor in the disease progression.
Symptoms
of BPH
The primary signs and symptoms are general problems with urination.
With a gradual progression, signs usually include: urinary frequency,
urinary urgency, nocturia (needing to get up at night to urinate),
hesitancy with decreased force of stream, terminal dribbling (the
final phase of urination as slow drips), sensation of incomplete
emptying, overflow incontinence or total retention, burning on urination,
chills and fever which indicate infection has set in (due to the
urine staying in the bladder), and possibly a palpable distended
bladder. During a digital rectal examination the prostate gland
will feel enlarged, rubbery, often with loss of median sulcus. The
median sulcus is a vertical groove in the heart-shaped gland which
tells the examining doctor that the gland is NOT enlarged or swollen.
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Diagnosis
and Pharmaceutical Interventions
After the a digital
rectal exam, a urinalysis to look for infection and a creatinine
test to assess kidney function may be performed. A blood test looking
at levels of prostate-specific antigen is usually a good diagnostic
clue, as it is elevated in 30-50% of men with BPH. It can also be
elevated in other conditions, so important questions to ask your
doctor is to include the "rule-outs" which means you want
to be sure that the diagnosis is definite and correct. Possible
problems that could mimic BPH are: neurogenic bladder, acute prostatitis,
chronic prostatitis, cancer and other obstructive pathology.
Pharmaceutical
Medications
The most used medication
used for PBH is a class called 5-alpha-reductase inhibitors with
finasteride (proscar) being the most common. It works by decreasing
the endogenous synthesis of DHT by inhibiting 5-alpha-reductase.
Finasteride reduces serum DHT levels by 60% - 75%, but it may take
six months to a year to see relief. It has the possibility of sexual
side effects, namely erectile dysfunction and decreased libido.
It may also cause breast swelling and/or tenderness, testicular
pain, skin rashes, itchiness, hives or rashes. Finasteride has the
possibilities to cause developmental problems in pregnancy, so women
who are pregnant or trying to get pregnant should not handle the
pills and should avoid exposure to partner’s semen.
Another type of medication that may be used for BPH is alpha-1 adrenergic
blockers such as tamsulosin (flomax). These cause relaxation of
the prostate and bladder and may elevate some urinary symptoms.
It should not be used in those with low blood pressure, which is
a side effect, as well as dizziness, headaches and fatigue.
Conventional surgical treatment includes removal of all or part
of the prostate, called transurethral resection of the prostate
(TURP). Most patients improve significantly after treatment but
may be rendered impotent. Surgery is not to be taken lightly, as
complications include infections, urinary retention and hemorrhage.
A complication known as the transurethral resection syndrome, caused
by too much fluid being absorbed during the surgery, can cause possible
confusion, congestive heart failure, or pulmonary edema.
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Lifestyle
and Dietary Modifications
When symptoms of
BPH are not severe, lifestyle changes will prove helpful. A good
place to start is to avoid caffeinated beverages and limit alcohol
use. Alcohol increases urine production and may cause congestion
in the prostate gland. Caffeine irritates the bladder. The amount
of liquids consumed in the evening should be reduced, with 7pm being
a cutoff time. Avoid over-the-counter antihistamines and decongestants.
These drugs tighten the muscles that control urine flow, making
it more difficult to urinate. Another thing that is helpful is too
stay warm, as being cold can lead to retention of urine. And each
time you urinate, try to empty your bladder completely.
Staying active is
important, as urine is retained when you don't move around. Even
a little increase in activity can make a difference. Walking has
been shown to be an effective exercise for men with BPH and can
help prevent it. Aerobic exercise, a minimum of 3 times weekly for
20 minutes at your target heart rate, will do wonders for not only
the prostate gland, but for your heart, lungs, bones and mental
well-being. There are some exercises that can improve circulation
to the general area as well as tone the bladder. A set of movements
commonly called “Kegel” exercises which involve pulling
up rhythmically on the pelvic floor (all the muscles around the
scrotum and the anus) with the lower abdominal muscles as you exhale,
and keep pulling up on the squeeze until you need to take a breath.
Repeat 10 times, 5 or 6 times daily. This can be done very discretely
-- nobody needs to know you're doing this exercise. It's perfect
for commuting, or while you're sitting around waiting for someone
or something, or in the shower.
A change in diet to focus on whole, unprocessed food such as whole
grains, legumes, vegetable, fruits, nuts and seeds will add more
nutrients and encourage well being. Eating organic food whenever
possible is important, as some pesticides can increase the activity
of 5-alpha-reductase and stimulate the enlargement of the prostate.
Raw pumpkin seeds are high in zinc, a mineral that is paramount
to treating BPH, should be consumed, as well as almonds, sesame
seeds and tahini.
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Nutritional
Factors Shown to be Beneficial
Omega 3
Fish Oils
A deficiency of omega 3 fatty acids has been postulated as a possible
contributing factor in BPH.
Does: 2-6 grams a day
Vitamin
E
Because taking EFAs increases the requirement for vitamin E, most
doctors recommend taking a vitamin E supplement along with EFAs.
Dose: 800-1200 IU every day
Calcium
d-Glucarate
Calcium d-glucarate (also known as calcium glucarate) is a salt
of D-glucaric acid consisting of D-glucaric acid bound to 12.5%
calcium. This form aids in the detoxification of steroid hormones.
Dose: 500 mg three times a day
Di-indoly-methane
Di-indoly-methane (DIM) is an indole phytochemical that is a natural
metabolite of compounds found in cruciferous vegetables such as
broccoli, Brussels sprouts and cabbage. It works to reduce levels
of oestrogen metabolites, some of which can contribute to disease.
Does: 100-200 mg a day
Saw Palmetto
(Serenoa repens)
The fat soluble Saw palmetto extract can reduce the activity of
the 5-alpha reductase enzyme which contributes to BPH. Saw palmetto
also blocks DHT from binding in the prostate. This reduces urinary
problems and has been shown to improve quality of life.
Dose: 160 mg of the standardized extract twice
a day
Pygeum africanum
(also know as Prunus africanum)
Pygeum, an extract from the bark of the African tree, has been approved
in Germany, France, and Italy as a remedy for BPH. It is an African
tree that has been used historically for prostate and urinary conditions.
It is especially useful for early cases of BPH conditions.
Dose: 50-100 mg of the standardized extract
twice a day
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Recommended
NaturalMeds Products for Prostate Problems
Prosta-Response
Prosta-Response is a formula that supports multiple body systems
involved with the health of the prostate gland. It contains clinically
researched amounts of saw palmetto extract and beta-sitosterol,
plus quercetin, soy, and lycopene. These antioxidants and compounds,
along with essential vitamins and minerals, help maintain tissue
and cell integrity, which are vital to prostate health.
Dose: 3 tablets a day Pack size: 45 tablets
Omega
3
Omega-3 Formula provides an excellent source of Omega-3 fatty acids
in their naturally existing ratios. This ratio provides the fatty
acids EPA and DHA in balanced amount to promote cardiac health.
Dose: 2 capsules Pack size: 60 capsules
Vitamin
E Mixed tocopherols 400 IUs
Vitamin E is a fat-soluble vitamin that is one of the body's chief
antioxidants, helping to protect cell membranes against oxidation.
This product has the addition of mixed tocopherols, of which Vitamin
E is related.
Dose: 2 softgels with food two times a day
Pack size: 50 softgels
Calcium
D-Glucurate
Calcium D-Glucarate enhances the process of glucuronidation, in
which foreign organic compounds, fat-soluble toxins and excess steroid
hormones such as estrogen are detoxified and excreted from our bodies.
Dose: 3 tablets two to three times a day with
meals Pack size: 30 tablets
Immunocare
Immunocare is an unquie blend of plant sterols, including beta-sitosterol,
combined with essential fatty acids and antioxidants.
Dose: Take 2 capsules once per day for the first 10 days followed
by 1 capsule per day thereafter on rising with water or fruit juice
45 minutes before eating or 2 hours after eating or as directed
by your health practitioner. DO NOT CONSUME WITH MILK.
Pack size: 60 capsules
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