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Integrative Approaches to Prostate Enlargement
The following information is a summary of materials featured in the “Men’s Health” Integrative Health overview. It is meant to be a quick reference for use at the point of care. For more details and list of helpful references, see the overview.
Benign prostatic hypertrophy/hyperplasia (BPH) is one of the most common diseases faced by adult men. The most common presenting symptoms associated with BPH are frequent urination and increasing nocturia. By 80 years old up to 80% of men suffer from BPH. About one in two men will experience prostatitis in their lifetime. Men are more at risk of developing BPH if they are overweight, have a metabolic syndrome-related disorder such as type 2 diabetes, high-fasting triglycerides and low HDL cholesterol, and/or hypertension. The severity of lower urinary tract symptoms (LUTS) can be assessed using the self-administered International Prostate Symptom Score (IPSS). It is a well-validated tool for assessing response to treatment as well.
Listed below are some important tips for helping a man maintain or improve his prostate health in BPH. For more on prostatitis and prostate cancer, see the “Men’s Health” overview.
Maintain an Ideal Body Weight
This is probably the most important thing a man can do. As belly fat increases, there is an increase in activity of the enzyme "aromatase" which converts testosterone in adipose tissue into estrogen. Men with a body mass index (BMI) of greater than 35 have 3.5 times the risk of developing BPH compared to men with a BMI less than 25.
Avoid Diabetes
Metabolic syndrome increases the risk of men having a PSA greater than 1.6 ng/mL, high post-void residual and decreased urinary max flow rate. These are all objective findings that have been linked to the progression of BPH.
Stay Active
Higher levels of physical activity decrease the risk of BPH. It also helps prevent common diseases such as heart disease and cancer.
Avoid Xenobiotics
Xenobiotics are compounds from the environment that mimic the body’s hormones. Bisphenol A (BPA) found in plastics has been found consistently to cause prostatic hyperplasia in animal models. Do not microwave food in plastic containers. Avoid plastic containers with the numbers 3, 6, or 7 engraved in the triangle on the product. Buy BPA-free water containers or use stainless steel. Drinking water out of containers with the numbers 2, 4, 5, or 7 (PLA- made from corn husks) is okay. Don't drink out of Styrofoam containers.
Eat Well
Foods to avoid:
- Excessive sugar
- Excessive caffeine
- Red meat and other sources of animal fat
- Excessive dairy products
- Food dyes
- Processed foods
Foods to include:
- Green tea
- Multicolored fruits and vegetables
- Nuts (particularly Brazil nuts which are rich in selenium - two a day is plenty)
- Fiber (covered by eating fruits and vegetables)
- Ground flax seed (1 tablespoon a day)
- Soy products (soy milk instead of cow's milk)
Consider Dietary Supplements, as Appropriate
Note: Supplements are not regulated with the same degree of oversight as medications, and it is important that clinicians keep this in mind. Products vary greatly in terms of accuracy of labeling, presence of adulterants, and the legitimacy of claims made by the manufacturer.
- Saw palmetto: 160 mcg-320 mcg two times a day.
- Pygeum: 50-100 mcg two times a day
- Beta-sitosterol: 60-135 mcg daily. It can take four weeks for effects to become apparent.
- Zinc: 25-50 mcg daily. This may help with prostatitis as well.
- Epigallocatechin-3-gallate (EGCG, component of green tea): 200 mcg three times a day in the form of mixed catechins.
- A combination product (like Prostate Eze Max may also be useful): 1 capsule daily. This combines pumpkins seed oil, Pygeum, Saw palmetto, lycopene, and fireweed.
In severe cases that do not respond to the options above or to prescription drugs, consider a referral to a urologist to discuss surgical options.
NOTE: Dietary supplements are intended to supplement the diet. They are not medicines and are not intended to treat, diagnose, mitigate, prevent, or cure disease. In some cases, dietary supplements may have unwanted effects, especially if taken before surgery or with other dietary supplements or medicines, or if you have certain health conditions. Also, supplements are not regulated with the same degree of oversight as medications. Products vary greatly in terms of accuracy of labels, presence of contaminants, and the validity of claims on the label. Work with your health care provider to determine how best to achieve optimal health.
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What we know about integrative health care has come to us thanks to the efforts, experiences, and collective wisdom of people from many cultures and backgrounds. We wish to acknowledge all the healers, researchers, patients, and peoples who have informed the content of this tool.
Author(s)
This handout was adapted for the Osher Center for Integrative Health at the University of Wisconsin-Madison from the original written by Robert Z. Edwards, MD (2014, updated 2020). Modified for UW Integrative Heath in 2021.
This Integrative Health tool was made possible through a collaborative effort between the University of Wisconsin Integrative Health Program, VA Office of Patient Centered Care and Cultural Transformation, and Pacific Institute for Research and Evaluation.
Originally Created: 2014, Updated: 2020
Modified for UW Integrative Health: 2021