Let's go through an overview of a condition known as benign prostatic hyperplasia (BPH).
BPH is a condition in which the prostate gland, located between the bladder and penis, begins to enlarge. Typically, the function of the prostate gland is to secrete prostatic fluid that protects sperm and adds majority of volume to semen, prior to ejaculation. In order to add this fluid, the urethra runs through the centre of the prostate gland. The prostate consists of three separate zones known as the peripheral, transition, and central zones. BPH is an overgrowth of cells typically located in the transition zone, that when enlarged, place pressure on the urethra and lead to a variety of symptoms.
What exactly are the symptoms associated with BPH?
We touched upon the most common in the introduction to the article where men find themselves waking to use the washroom far more frequently than normal, something known as nocturia. You may have urinary frequency and urgency during the day, or urinary hesitancy where the stream is inconsistent or requires some effort to initiate as the enlarged prostate gland squeezes the urethra. The force of the stream may suffer and you may experience inappropriate dribbling.
How is BPH diagnosed?
Your primary care provider can perform a digital rectal exam where they make contact with the peripheral zone tissue of the prostate gland, to assess characteristics such as its surface texture and size. If they detect any abnormalities, they may refer you for further evaluation. It is also quite possible to have BPH, but you are not yet experiencing symptoms.
There doesn't sound like there is much I can do if the tissue has enlarged...is there any benefit to exercise for BPH?
Research studies can tell us a lot, especially when there are a large number of participants enrolled, such as the Health Professionals Follow-Up Study which gathered data from questionnaires submitted by 30,646 men.
This cohort included 3,743 men with BPH and demonstrated that when exercise levels were higher, the risk of experiencing symptoms of BPH dropped, significantly.
This included simple activities such as walking at a moderate speed. Separately, a significant relationship was found between sitting and watching TV, and an increased risk of developing symptoms despite how much the participants were exercising.
What about Kegel Exercises?
These common exercises are meant to develop the pelvic floor muscles, which when weakened, can contribute to urinary problems. In patients who underwent a surgical procedure known as a transurethral prostatectomy (TURP), pelvic floor rehabilitation exercises following the operation led to a faster improvement of urinary symptoms and return to quality of life than those who didn't.
How much exercise is enough?
The Canadian Society for Exercise Physiology Guidelines indicate that adults should aim to achieve 150 minutes of moderate to vigorous aerobic exercise per week. While those numbers may seem daunting at first, the activities can be divided into bouts of exercise lasting at least 10 minutes. It's also recommended to achieve at least two days of strengthening exercises which can include those indicated above. Make sure you have a conversation with your primary care provider before you implement a new exercise regime.
Start chopping those veggies!
In the Prostate Cancer Prevention Trial, 4,770 men were enrolled and followed to gather information that could highlight ways to reduce future risk of developing prostate cancer or benign BPH.
Those who consumed a minimum of four servings of vegetables a day had a reduced risk of enlarged prostate tissues. Additionally, a carotenoid present mostly in tomatoes known as lycopene has some protective impacts against developing BPH. Research has been mixed and demonstrated benefits, while some have shown no effect at all. However, you would be hard pressed to find a health professional who would tell you to avoid eating vegetables, so munch away while you await further research.
You may also need some help from the herbal world.
If you're diagnosed with BPH and see your medical doctor, you will most likely be prescribed a medication known as finasteride or dutasteride, medications in the family of 5-alpha-reductase (5α-R) inhibitors. This enzyme is responsible for converting testosterone to a more potent form known as dihydrotestosterone (DHT).
DHT, through a mechanism not fully understood yet, influences the hyperplasia of the prostate tissue, and researchers have shown that men who do not produce DHT do not develop BPH.
Interestingly enough, an extract from the berries of saw palmetto (Serenoa repens) have been shown to produce the same results as the medications, acting as a 5α-R inhibitor. In human studies, the extract has been shown to reduce inflammation associated with BPH and improve urinary symptoms such as frequency, urgency, and hesitancy.
The reduction in inflammation could be related to the antioxidants contained in the berry – epicatechin and methyl gallate – which also have antiproliferative effects on prostate cells in vitro.
Products such as Prostate 1 contain the berry extract, and at one capsule a day, are an easy addition to your morning routine.