Prostate Enlargement

In 1990, an estimated $3 billion was spent on prostate surgery in the United States alone. But after about five years, most men find, to their dismay, that the surgery needs to be repeated. Hormone therapy, which uses drug treatments to inhibit the hormones testosterone and prolactin, also carries undesirable side effects, including possible impotence.

Before we discuss the helpful herbs, let's first consider the prostate. This small gland, which is located next to the bladder, is made of muscle, gland and connective tissue. The thin fluid that it secretes helps carry sperm down the urethra, the same tube that transports urine from the bladder. Since the urethra passes right through the prostate, when the prostate enlarges, it pinches the tube and causes urine retention. This also creates an urge to urinate more often since the bladder never fully empties. The uncomfortable result can be an inability to void, false starts, dribbling and burning pain.

Since there are usually no symptoms in the early stages, it is easy to understand why so many men let prostate problems go untreated at first. They don't even know something is wrong until the urethra is blocked and the problem can no longer be ignored!

The severity of symptoms doesn't necessarily tell you the extent of enlargement, but a doctor's examination will. You need to be examined by a doctor because problems such as an obstruction in the urinary tube, a bacterial infection and bladder or prostate cancer need to be ruled out. If a survey by the Prostate Cancer Education Council is any indication, most men are not well-informed about the health of their prostates. Studies conducted by the council show that most men don't have regular physicals and that of those who do, less than half have their prostate checked.

The most common cause of prostate enlargement is changes in hormone levels. As a man ages, his testosterone levels begin to fall. At the same time, his levels of the "female" hormones prolactin, estrogen, LH and FSH rise. This dramatic hormonal shift results in many body changes, such as weight gain, changes in fat distribution and a decrease in muscle strength. Even the testosterone itself changes. An especially potent form of testosterone called dihydrotestosterone (DHT) begins to dominate. Unfortunately, DHT can cause prostate cells to multiply excessively; four to six times the normal amount of DHT is found in most enlarged prostates. While DHT increases with age, a number of environmental pollutants (the chemicals dioxin, polyhalogenated biphenyls, and hexachlorobenzene) also make this hormone accumulate in the prostate.

The Agency for Health Care Policy and Research in the United States has recently concluded that "watchful waiting" with regard to an enlarged prostate is better than surgery or drug therapy. There is also another avenue to explore: herbs. North American doctors, less schooled in the use of herbs than their European and Asian counterparts, are just beginning to pay attention to the exciting research on herbs that can be used to correct prostate problems. I know plenty of men who have been helped by using herbs. For most of these men, herbal therapy was a last-ditch effort to avoid surgery after nothing else they tried worked.

Jesse is a good example. Like most men, he did not have prostate problems until he was in his sixties. He had looked forward to his retirement for a long time but hadn't counted on the pain and other uncomfortable symptoms of an enlarged prostate. His physician sent him to a urologist at the well-known medical center at the University of California at Los Angeles. Jesse tried to focus on sailing and his hobbies and put off thinking about the inevitable prostate surgery, but eventually the symptoms were just too much to live with.

Jesse wasn't really an "herbal convert," but he figured it couldn't hurt to try herbs. After only a few weeks of using an herbal formula similar to the one recommended below, he felt better, but he thought it was probably his imagination since nothing had helped his condition over the last year. Still, he stuck with it, and after a couple of months, the problems seemed to disappear.

His next trip to the urologist confirmed that this was true. The astonished doctor reported that the prostate was much smaller and declared that in his many years of practice he had never seen a prostate reduce in size without surgery or hormonal drugs. He even asked Jesse for the formula! Both Jesse and the urologist, unaware of ongoing research in Europe, thought that they might be on the brink of discovering new therapies to save millions of men from surgery or hormonal drug treatments.

Prostate-Reducing Tincture

1 ounce tincture of saw palmetto berries

½ ounce each tinctures of nettle root, sarsaparilla root, wild yam root, echinacea root and pipsissewa or uva ursi leaves

Combine ingredients. Take half a dropperful 3 times a day. For a maintenance dose, take once a day.

This research has been going on for many years, especially on saw palmetto. Compounds in this herb have demonstrated a remarkable ability to inhibit DHT, the hormone that causes prostate inflammation. Saw palmetto does not change the level of testosterone or other hormones in the blood, but it does stop tissues, especially those in the prostate, from utilizing it. In fact, this herb is about 25 times stronger than cyproterone, a once-common prostate anti-inflammation and cancer drug now considered too toxic for noncancerous conditions.

Clinical trials on saw palmetto have been performed in France. W. Vahlensieck, M.D., and his associate researchers found that saw palmetto greatly reduced symptoms associated with prostate enlargement—including pain and incontinence—within three months.

In Germany, 11 separate studies on saw palmetto, involving a total of 500 men, were conducted over a period of a few years. When the results for men over 60 years old were pooled, it was shown that the men who took this herb had less than half as many symptoms as those who did not. The other good news is that almost no side effects were reported.

The bad news is that saw palmetto's soapy, bitter taste is not pleasant; the best way to take this herb is to dilute the tincture in a small amount of water and chug it down.

Unfortunately, herbs have difficulty finding their way into mainstream medicine in North America. It is unlikely that anything but the standard prescription drugs suggested for prostate treatment will be available here in the near future. Alternative over-the-counter products for prostate enlargement, including saw palmetto and amino acids, were banned by the Food and Drug Administration (the U.S. governmental agency that determines which medicines—drugs or otherwise—and foods can legally be sold in the United States) in 1990 because this condition is not considered suitable for self-treatment. You can still buy saw palmetto, but the label will not dare mention anything about using it for the prostate. In Germany, however, the use of saw palmetto is approved by the health authorities and is so well-established among doctors that pharmacies sell an over-the-counter suppository containing saw palmetto and the immune stimulant echinacea, so men can self-treat prostate irritation and inflammation.

Another medicinal plant that is effective for the treatment of this condition is pygeum. In France, this herb is found in over 75 percent of all doctors' prescriptions for enlarged prostate. Doctors there report that the herb reduces symptoms in at least half of the men who try it, and it does so in less than six weeks. Pygeum, which has been under scientific investigation since the 1960s, has been used to treat thousands of men. Researchers say that it seems as effective as the pharmaceutical drugs commonly suggested for enlarged prostate. They even recommend it as a suitable replacement for such drugs.

Usually, pygeum causes swelling and uncontrollable urination to disappear fairly soon, and there are almost never side effects. Only a rare case of upset digestion has been reported. In one study on pygeum involving dozens of men who took the herb for two months, the herb improved all of their symptoms, including difficult urination, uncontrollable urination at night and problems with residual urine. It also decreased the size of the prostate.

Pygeum helps all but the most serious cases. Many researchers who have conducted studies on this herb suggest that pygeum is most effective when used at the first signs of prostate problems. Even the men who do opt for surgery find that they have fewer related problems and that their circulation improves when they take pygeum afterward. It appears that this herb decreases prolactin production and also reduces the detrimental effects of testosterone. Pygeum is currently available only as a tincture or in pill form, and is often combined with saw palmetto. The suggested dose recommended by researchers is two 100- or 200-milligram capsules a day.

Nettle leaves have long been known as an excellent diuretic and are used to stop the urine retention that often accompanies prostate inflammation. The roots of the nettle are what have drawn the attention of scientists. After conducting a study of this root at the Department of Phytotherapy in Paris, French researchers declared that the nettle root appears to be a useful therapy for milder cases of prostate inflammation and a good alternative to surgery. Men with mild prostate enlargement who took nettle root found that their symptoms disappeared after only three weeks.

These researchers added that nettle root, saw palmetto berry and pumpkin seed all help prostate problems, possibly because they contain abundant amounts of b-sitosterol, a hormonelike substance known to reduce prostate inflammation. Other researchers have proposed that the reason nettle is so effective might be that it reduces the amount of testosterone circulating in the blood or that it inhibits the enzyme responsible for making testosterone. In another study, men given both pygeum and nettle root had their prostate problems eliminated.

The French studies mentioned above and several others conducted in Germany have led German health authorities to declare nettle root an appropriate and effective treatment for the early stages of prostate inflammation. It can be taken in any form, including a tea.

Gamma linoleic acid (GLA), which is found in evening primrose, borage and black currant seed products, also helps relieve prostate inflammation. You can encourage GLA production in your body by eating a handful of pumpkin seeds or by taking one or two teaspoons of flaxseed oil every day.

Pumpkin seeds, a Ukrainian folk remedy for prostate inflammation, also contain an unusual amino acid called cucurbitin. Modern European pharmacies sell a popular enlarged prostate remedy called Curbicin that combines pumpkin seeds with saw palmetto. In 1991, A. Hasler, Ph.D., conducted a study in which he gave Curbicin to men suffering from enlarged prostates. Within three months, their urinary flow problems greatly improved, with almost no side effects.

Good circulation is imperative for good health, and a sedentary lifestyle, especially one that involves sitting in chairs for long periods of time, has been accused of contributing to prostate problems. collinsonia, Saint-John's-wort, prickly ash and horse chestnut, a popular European treatment for enlarged prostate, all improve circulation. An herbal sitz bath (a warm bath in which you sit in water up to your waist) with rosemary is also good for pelvic circulation. An anti-inflammatory oil made of Saint-John's-wort and the essential oils of rosemary and lavender can also be applied behind the scrotum to increase circulation, reduce inflammation and relax muscles.

Anti-inflammatory Prostate Oil

1/8 teaspoon each lavender and rosemary essential oils

4 drops Roman chamomile essential oil (optional)

2 ounces Saint-John's-wort oil

Combine ingredients. Rub on the skin under the scrotum once or twice a day.

Studies conducted by the American Urological Association have shown that it is common for cholesterol to build up in enlarged prostates, often to a level 80 percent higher than normal. So a second front in the war against prostate inflammation begins with the fight against cholesterol. GLA and pygeum specifically reduce the accumulation of cholesterol in the prostate. see chapters 21 - 25. for ways to use these and other cholesterol-fighting herbs.

Several other herbs can also come in handy for treating prostate problems. When the urine flow is constricted, see chapters 48. for ways to use wild yam root to relax and open the passage and to reduce pain.

Herbalists also successfully use hydrangea and joe-pye weed, some-times with uva ursi, pipsissewa, yarrow and/or horsetail, to clear up the urinary tract infections that often accompany prostate problems. Echinacea is an excellent choice to improve immunity and fend off infections. For more advice on treating a urinary tract infection, see chapters 48..

Once the size of the prostate is reduced, you may need to continue taking herbs (at a reduced level) to keep symptoms at bay. When symptoms began to recur, Jesse (who was mentioned earlier) found out he needed to take his formula every few months; after about a year, he discovered that he no longer needed the herbs. Al, who successfully used herbs to control his prostate growth, tried to discontinue them several times. About two months after stopping the herbs, he kept having flare-ups, so he decided to keep taking a small dose on a regular basis. Considering that the likely alternative is surgery or hormone therapy, he does not mind that he may need to continue taking them for the rest of his life.