To explain BPH, we need to review a bit of anatomy.
The prostate is a gland part of men’s reproductive organs. It secretes seminal fluid, which is the carrier for sperm. It is located just below the bladder. It is shaped like a donut surrounding the urethra canal, which carries urine out of the bladder to be expelled.
Now, the issue with the prostate is that around age 40, it tends to start growing abnormally. As the prostate grows, it squeezes the urethra making urination difficult. It is the growth of the prostate that is called Benign Prostate Hyperplasia (BPH). Benign as opposed to cancerous, and hyperplasia means enlargement by cell multiplication.
As “abnormal” as this prostate growth is, its frequency is astounding. By age 50, 50% of men are feeling symptoms. By age 80, it is 80% of men. At this rate, you would think we would hear more about it. But then, most men do not talk about health issue much, especially if it has to do with a sexual organ. Thankfully the Movember movement is doing a great job working on that.
Why is this happening?
It is known that with age, testosterone level decrease, causing prostate cells to grow and multiply. The actual mechanism of how the growth occurs is known, but unfortunately the causes are not clear. Not only are cells multiplying more than they should, but inflammation often aggravates the problem. When inflammation occurs, the prostate swell-up as well, worsening symptoms.
It is important for men to have their prostate checked by a doctor regularly starting around age 40. Prostate growth can be benign but it can also be a sign of prostate cancer , the most common type of cancer in Canada. It kills over 4000 Canadian men every year. If treated early survival rate is of 95% and that is good enough reason to test regularly.
Symptoms of BHP can be divided into 2 categories: urinary symptoms and sexual function symptoms
Urinary symptoms can severely affect quality of life and of sleep. Indeed one of the most typical symptoms is getting up frequently at night to urinate. If this wakes both you and your partner up every night, it makes for disrupted sleep and fatigue. Waking up at night is often the first symptom that men notice.
As BPH progresses, urges to urinate become more frequent and more urgent. The urine stream is diminished and weaker. In other words you have to go pee more often, it feels urgent and hardly anything comes out.
Some men also feel like their bladder is not completely empty and they need to strain to get anything out. In more advance cases, there is pain and burning sensation involved.
The worst part is that those symptoms are not temporary. They are there to stay and possibly worsen for the rest of your life, unless you get treatment.
There are possible complications as well. If urine cannot be evacuated from the bladder properly, it becomes a perfect breeding ground for bacteria. Urinary tract infections cause pain and fever.
These symptoms vary in intensity and the stage of BPH is determined on a symptom scoring system that you can take online. Treatment is recommended according to the results.
As if urinary problems were not enough, BPH also has an impact on sexual function. If you have BPH symptoms you have 50% more chance of suffering from disturbances of erectile or ejaculatory function. It can also affect sexual satisfaction and libido. With BPH, not only you are not sleeping, it’s not even for the right reasons!!
Besides age, there are other risk factors for BPH. The disease tends to be more severe in African-American men, probably because of their higher testosterone levels. On the other hand, BPH is less common in Asian men. Pre-existing conditions such as diabetes, high blood pressure and peripheral artery disease can increase the risk.
Lifestyle is also a factor. Lack of physical activity, cigarette smoking and poor diet increase risks and worsen symptoms. According to a study, obesity, particularly in the abdominal region, is one of the main risk factors for triggering of BPH symptoms.
There are a few treatment options.
There is surgery…but that is the treatment of last resort for very advance cases.
There are 2 categories of conventional medicines to help relieve BPH symptoms.
- Alpha-blockers (tamsulosin) help reduce symptoms quickly. However, they do not prevent the natural progression of the disease. They also have possible side effects, including dizziness and abnormal ejaculation.
- 5α-reductase inhibitors (finasteride) have the benefit of reducing prostate size and improving urinary symptoms or urinary retention. On the down side (no pun intended) they can also have side effects of erectile disorders. They also affect the result of the prostate health blood test (PSA value)
Both options can be effective and sometimes combined but unfortunately, they can also exacerbate the sexual dysfunctions linked to BPH.
And then there is Saw Palmetto.
Saw Palmetto is a low, sturdy dwarf palm that grows in the South of Florida. Its fruits, very rich in fatty acids, are used to make BPH remedies. Saw Palmetto extract improves mild to moderate BPH urinary symptoms. It prevents further prostate growth, curbing the multiplication of cells and halting the progress of the disease. Combined to this, Saw Palmetto also has an anti-inflammatory effect, which helps to reduce swelling of the prostate tissue. Symptoms are usually relieved within 4 to 8 weeks, sometimes faster.
Saw Palmetto does not affect PSA readings so there are no worries there.
When choosing a Saw Palmetto product, it is important to look for an extract containing about 85% of fatty acids such as Prostate 1 Sabalasan®. Those precious fatty acids can only be preserved in oil or capsules, not a tab or powder. All positive studies have been conducted with extracts containing 320mg or more of Saw Palmetto. Effectiveness depends on this.
Some might think that herbal medicines are mild treatment solutions. In this case, effectiveness is within the same range as finasteride and tamsulosin.
Prostate 1 Sabalasan has another up side (pun intended); it is the only Saw Palmetto extract proven to have a positive effect on all sexual dysfunctions linked to BPH. A study showed 40% improvement of overall sexual function after just 8 weeks. This can help waking up for good reasons!
Saw Palmetto does have a side effect. It can cause some belching or upset digestion because of its fatty acid content. It is therefore recommended to take it with a meal.
What else can help?
There are lifestyle choices – including diet and exercise.
Stinging Nettle extract is a mild, non-irritant diuretic that helps to increase urine flow. It helps with BPH symptoms.
It is also important to have a sufficient intake of vitamin A and zinc. Pumpkin seeds contain high levels of zinc, that is why you will often hear it being recommended for BPH.