Benign prostatic hyperplasia (BPH) is a condition affecting approximately 50% of men over the age of 50 and 90% of men over the age of 80. (13) It is currently the most common condition diagnosed in older men and its prevalence continues to increase. (5)
Benign prostatic hyperplasia, also commonly referred to as benign prostatic hypertrophy or benign prostatic obstruction, is a condition characterized by the non-cancerous enlargement of the prostate gland in men. (13) BPH involves the proliferation of stromal and epithelial cells found in the transitional zone of the prostate, resulting in an enlarged prostate. (5) The prostate undergoes two normal periods of growth, the first at puberty and the second at approximately age 25. As men age, the prostate continues to enlarge, which potentially results in pinching of the urethra and thickening of the bladder walls, causing issues with urinary retention and symptoms commonly associated with BPH. (13). Benign prostatic hyperplasia is the most commonly diagnosed health condition in men over 50.
Causes and risk factors
While the exact cause of BPH remains unclear, a number of contributing factors have been identified. As previously stated, BPH occurs primarily in older men and is believed to be related to hormonal changes and inflammation. BPH has also been linked to age-related metabolic conditions, such as obesity, dyslipidemia, diabetes, and metabolic syndrome. (10)(19) While some of the risk factors for BPH are unmodifiable, others may be addressed through diet, lifestyle, and other interventions. (5) Risk factors for BPH include:
- Age 40+
- Certain cardiovascular and metabolic conditions, such as heart and circulatory disease, obesity, and type 2 diabetes
- Erectile dysfunction
- Genetic predisposition
- Sedentary lifestyle (13)
Signs, symptoms, and complications
BPH is generally characterized by lower urinary tract symptoms (LUTS), including:
- Nocturia (frequent urination during periods of sleep)
- Pain during urination or after ejaculation
- Post-void dribbling
- Reduced void volumes
- Unusual color or smell to urine
- Urinary frequency
- Urinary hesitancy, straining, and/or trouble starting a stream
- Urinary retention, incomplete emptying
- Urinary urgency
- Urinary incontinence
- Weak and/or interrupted stream (5)(13)
Although uncommon, complications that may arise from BPH include:
- Acute or chronic urinary retention
- Blood in urine
- Bladder and/or kidney damage
- Bladder stones
- Urinary tract infections (UTIs) (13)
Supplements for prostate care
Addressing certain risk factors through lifestyle modifications and supplementation may help improve prostate health and mitigate the negative effects of BPH. The ingredients listed in this protocol have demonstrated effectiveness in supporting prostate health.
Saw Palmetto (Serenoa repens)
Serenoa repens, commonly known as saw palmetto, is an extract derived from the ripe berries of the American dwarf palm, a plant native to some areas of the southeastern United States. (7)(17) Saw palmetto has been used as a treatment for BPH-associated urinary dysfunction since the 1800s and remains the most commonly used phytotherapy for the condition. The effects of saw palmetto extract on BPH are believed to be attributed to its antiandrogenic, antiestrogenic, antiedema, and anti-inflammatory effects. (7) Proposed mechanisms of actions include inhibiting 5α-reductase (7)(17) , prolactin, and growth factor-induced cell proliferation (7), as well as binding to lower urinary tract receptors, such as α1-adrenoceptors, 1,4-dihyropyridine receptors, muscarinic cholinoceptors, and vanilloid receptors. (17) Saw palmetto has been shown to decrease inflammatory markers that can contribute to chronic prostatic inflammation and subsequent hyperplasia. (22) Additionally, saw palmetto supplementation may contribute to increased average flow rate values, decreased prostate volume, and improved International Prostate Symptom Scores (IPSS). (16)
Lycopene is a non-provitamin A found in tomatoes and tomato products.
Lycopene
Lycopene is a non-provitamin A (18) found primarily in tomatoes and tomato products. (3) Lycopene possesses anti-oxidant properties and its ability to scavenge free radicals has been found to be greater than vitamin E, α-tocopherol, and glutathione. (18) In addition to reducing oxidative damage in the body, lycopene is involved in the regulation of genes and metabolism, intercellular communication and growth, and modulation of hormones and immune function. High lycopene intake has been shown to reduce the risk of chronic diseases, such as cardiovascular diseases, cancer, and neurological conditions. (3)(18) Increased dietary and circulating lycopene has been associated with a reduction in prostate specific antigen (PSA) levels and overall improvement of IPSS. Furthermore, supplementing with lycopene may inhibit the overall progression of BPH. (15)
Beta-sitosterol
The most abundant phytosterol in the diet, beta-sitosterol can be found in the leaves, fruit, rhizomes, and tissue cultures of many plants, such as beans, nuts, and seeds. (2)(12) It is also a primary constituent of certain medicinal herbs, including stinging nettle, devil’s claw, and saw palmetto. (12) Beta-sitosterol has anti-inflammatory, antioxidant, antimicrobial, antinociceptive, angiogenic, and immunomodulatory properties. (2) Beta-sitosterol also demonstrates inhibitory effects on 5α-reductase, which may account in part for its therapeutic effects as 5α-reductase inhibitors have been shown to improve benign prostatic hyperplasia symptoms. (6) Research has shown that beta-sitosterol can improve IPSS, urinary and flow scores, and overall quality of life. (1)(11)(21)
Pygeum africanum, an extract from the African prune tree, was used traditionally in herbal medicine to treat benign prostatic hyperplasia.
Pygeum (Pygeum africanum)
Pygeum africanum, commonly referred to as pygeum, is an extract from the African prune tree, an evergreen tree native to Afromontane forests. Several active constituents of the plant have been identified, including β-sitosterol, β-sitostenone, n-docosanol, lauric acid, myristic acid, and ursolic acid. (9) Used traditionally in herbal medicine to address benign prostatic hyperplasia, (9) modern research now demonstrates the effectiveness of pygeum in improving BPH-associated urinary symptoms (4)(8)(20) and suggests that pygeum possesses antiproliferative and apoptotic effects on prostate cells. (14)
The bottom line
While certain factors associated with the development of BPH are unmodifiable, such as age and genetic predisposition, other risk factors may be addressed through dietary, lifestyle, and dietary supplement interventions. (5) A protocol using natural supplements can be used therapeutically on its own or as an adjunct to existing treatment. We recommend speaking with a health coach to find out whether these supplements are right for your wellness plan.