Prostate Health for Men – Everything You Wanted to Know but Didn’t Want to Ask

The prostate is a small gland in the male reproductive system, located below the bladder and in front of the rectum. It is normally the size of a walnut, but tends to increase with age.

An enlarged prostate places pressure on the urethra and can cause significant urinary problems.

How The Prostate Changes With Age

Prostate size naturally increases as people age. The change isn’t related to cancer. The prostate starts out at roughly the size of a walnut. It is often the size of an apricot by the time you’re in your 40s and a lemon by the time you’re 60.

This change is called an enlarged prostate, benign prostatic hyperplasia or BPH. While an enlarged prostate is a common and natural process, it can have undesirable effects.

This happens because the prostate partly surrounds the urethra. An enlarged prostate starts to squeeze the urethra, causing urinary problems

Many men start to experience issues at some point after they turn 50. Symptoms often increase with age, but some people experience fewer problems than others.

• 50% of men aged between 50 and 60 will develop an enlarged prostate
• By 80, roughly 90% of men will have the condition

While most men experience an enlarged prostate at some point in their life, only some of them will face significant urinary problems. For some, the extent of issues is urination at night.

Symptoms of an Enlarged Prostate

Enlarged prostate symptoms vary from one person to another. They can also change over time as the condition develops.

Key symptoms include the following

• Difficulty urinating. Urination can be difficult in the early phases of prostate enlargement, as the urethra has narrowed. More effort is needed from the bladder muscle to push the urine through the urethra.
• Weak urine stream. This is a side effect of the extra effort needed from the bladder muscle.
• A urine stream that starts and stop. Again, this is linked to the extra effort needed for urination.
• Urgent and/or frequent need to urinate. The extra work involved with urination can make the bladder more sensitive to fluid. This can lead to a more frequent need to urinate. When the need does arise, it can often be urgent and occur with little to no warning. This problem can become more significant over time, to the point that some men cannot sit through a meeting or a film without needing to get up at least once.
• Waking up to urinate. The need to get up and pee during the night is one of the earliest symptoms of an enlarged prostate.
• Incomplete urination. The strength of the bladder muscle often decreases over time, which can prevent the bladder from completely emptying.
• Returning to urinate minutes after doing so. This is another side effect of incomplete urination.
• Leaking and dribbling. Incomplete urination can lead to urine leakage and dribbling – another problem that can increase with age.

What about sex? An enlarged prostate doesn’t tend to directly impact sexual performance. However, the challenges of an enlarged prostate can be embarrassing. This can be enough to discourage some men from sexual activities, or to make them more anxious about sex.

What Helps with Prostate Enlargement?

While prostate enlargement is a natural process, some lifestyle changes can help to reduce undesirable symptoms.

Lifestyle Changes

• Decrease drinks before bed (particularly alcohol and caffeinated drinks). Drinking too close to bedtime increases the likelihood that you will need to pee during the night.
• A healthy diet, especially one with plenty of dark leafy greens, other vegetables and fruits, may help to reduce prostate enlargement symptoms.
• Decreasing overall intake of sugar and alcohol symptoms.
• Keeping to a healthy weight.
• Avoid antihistamines and decongestants whenever possible.
• Getting regular exercises (kegel exercises can be especially helpful for prostate enlargement symptoms).
• Space out when you drink water, don’t drink a large amount at once.
• Urinate when you need to, don’t attempt to wait.

Supplements

Herbal supplements are often used to decrease enlarged prostate symptoms. Research shows mixed results for many such herbs.

Nevertheless, studies tend to focus on averages, rather than the effects for individuals. This means that even a supplement with statistically non-significant results may be beneficial for some individuals.

That being said, herbal supplements should be pursued with care. There is no FDA regulation, so the quality can vary from one batch to the next. Effectiveness will also vary depending on a variety of factors.

Even though they are natural, herbal supplements can still cause side effects or interact with other medications. Anyone who takes medications regularly should talk to their doctor before pursing herbal supplements.

The list below shows some of the most significant herbs that may help to improve prostate health.

• Saw palmetto. This is one of the most popular herbs for prostate health. It comes from the fruit of a type of palm tree. Some studies have found it to be effective, while others have not.
• Beta-sitosterol. This compound comes from rye grass pollen. It may help to improve urinary symptoms, although the results of studies are not encouraging.
• Pygeum. The extract is from the African plum tree and can increase urinary flow.
• Stinging nettle. Stinging nettle root is a common prostate enlargement supplement in Europe. Once again, evidence is minimal.

These herbs, along with others, are sometimes used in conjunction with one another. For example, the product Swisse Prostate (shown below) includes saw palmetto, turmeric, reishi mushroom, dyer’s woad, selenium and a variety of other ingredients.

Other products just contain a single herb, like the item below. It contains a combination of saw palmetto powder and extract.

Medication

Medication and surgery can help to address serious enlarged prostate problems, helping to restore quality of life. A key factor for treatment is how much the enlarged prostate impacts a person’s life.

If the impacts are a mild inconvenience and pose no health risk, then watching and waiting is often the best approach. A BPH Index is often used to measure the level of symptoms. Other measures can be used to evaluate symptoms as well, such as the one found on this site.

Medications for an enlarged prostate include 5-alpha reductase inhibitors (5-ARIs) and alpha blockers.

5-ARIs

• These can decrease the size of the prostate by lowering levels of dihydrotestosterone (DHT), a male hormone that plays a role in prostate growth.
• The effects of 5-ARIs take longer than alpha blockers. It may take 6 to 12 months to see whether the drugs are effective.
• 5-ARIs can decrease the risk of developing an inability to urinate and reduce the need for surgery.
• While side effects are generally mild, they can include decreases to sexual desire, less semen and erection problems.

Alpha blockers

• These don’t impact prostate size
• Instead, they relax the muscles around the prostate, making urination easier
• This type of medication can improve prostate symptoms quickly, in a day or two
• The most common side effect is dizziness. Other side effects tend to be mild, like a stuffy nose and a headache.
• Alpha bloggers are not suitable for men who experience urine retention or are prone to urinary tract infections.

Some patients will use one of the two types of medication, while others may use both. However, 5-ARIs now need to be labeled with a warning, as they may be linked to an increase in prostate cancer risk.

Non-Surgical Approaches

• Transurethral Microwave Thermotherapy (TUMT). This therapy can help to improve urinary frequency and intermittent flow, while reducing straining. The process uses microwave energy to destroy targeted tissue within the prostate.
• Transurethral Radio Frequency Needle Ablation (TUNA). This method makes use of of high-frequency radio waves that are transmitted through needles.
• Prostatic stents. This approach uses a tiny metal coil that is inserted into the urethra to widen it. Stents are not always effective and can cause serious side effects, so they’re often not a good choice.

Surgery

Transurethral Resection of the Prostate (TURP)

This common type of surgery involves removing the tissue that is pressing against the urethra, using an electric loop. The process is less traumatic than open surgery and involves a shorter recovery time.

The main side effect is retrograde ejaculation, where ejaculation occurs backwards into the bladder. This process is not painful, but it can be an issue for men who wish to remain fertile.

Erection problems can occur, with a risk of 5% to 35%. These tend to be temporary, with the ability to have orgasms and an erection returning in a few months.

Transurethral Incision of the Prostate (TUIP)

This type of surgery makes cut in the prostate. It reduces the amount of pressure placed on the urethra.

Symptom relief takes longer than with TURP, although most men are happy with the finally outcome. Retrograde ejaculation and erection problems still occur, but with retrograde ejaculation being less common.

Laser Surgery

These processes involve the use of a high energy vaporizing laser that destroys some prostate tissue. The surgery can provide immediate symptom relief. A key side effect is painful urination, which can occur for a few weeks.

When Should You See A Doctor?

It’s best to talk to your doctor when you first start experiencing symptoms of an enlarged prostate. This can help to rule out any rare issues, such as bladder damage or kidney damage.

You should also consult a doctor after any significant changes to urinary behavior, as serious issues can develop over time. Such problems include incontinence, bladder stones and blood in the urine.

See a doctor immediately if you develop a sudden complete inability to urinate. This is a medical emergency and can be dangerous.