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Benign Prostatic Hypertrophy (BPH)

BPH Discussion
Medical Choices

Educational Medical Considerations are included at the end of last topic.

“ID” means Once per Day
“BID” means Twice per Day
“TID” means Three Times per Day
“QID” means Four Times per Day

BPH Discussion

Males after age 50 are prone to the development of BPH (benign prostatic hypertrophy).

As the prostate gland surrounds the male urethra, enlargement of this gland puts pressure on the urethra resulting in the symptoms of decreased force and increased frequency of urination. Men often awaken multiple times at night to urinate because they were only able to empty their bladder part way. Other symptoms may include sensation of pressure as well as dribbling after urination.

Prostatic hypertrophy or BPH is a common condition occurring in most males with age, beginning usually at 50+. In medical school we were instructed that about 50% of males over age 50 have some degree of BPH, and at age 80, 80% of males have already developed this condition. In reality, after talking to several men ages 50 to 80, the comments I received is: “No, it is more like 100% of all males …” Symptoms include a frequent and urgent need to urinate particularly at night with frequent night time awakenings, difficulty or hesitancy in urination, inability to empty the bladder and a weak urinary stream or dribbling.

The mechanism of action is actually quite simple. It is more of a mechanical, than a physiological problem. When the prostate enlarges, it not only enlarges to the outside, IE getting bigger; it also enlarges inward. As the gland enlarges inward, it reduces the area in which the male sperm duct and urethra can effectively pass through, thus effectively “squeezing” those tubules to a much smaller size. This narrower opening of the male urethra means it takes more pressure to pass fluid through the smaller passage area. Thus, the male can only empty about one half or less of his bladder before the bladder pressure drops below what it takes to get the urine through the smaller opening. The same principle occurs in high blood pressure cause by arteriosclerosis. As plague builds up on the arteries and veins, it now takes more blood pressure to get the blood to pass through the arteries and veins. The pressure the bladder exerts comes mainly from the fullness of the bladder. Think of a water balloon that is very full of water. When you let go of the neck of the fully filled water balloon, the water will begin to rush out very fast. As the water balloon begins to get smaller, IE the bladder is beginning to empty, the water (urine flow) pressure decreases. Eventually the pressure is too small to get the urine through the restricted opening. If the bladder can only empty one half or less, then the need to urinate becomes more frequent.

The issue of affecting libido is somewhat similar. The prostate gland is like a switching valve. It switches between allowing urine to pass through to that part of the urethra on the distal side of the prostate, or allowing semen to pass through. The male sperm duct passes through the prostate gland, just like the male urethra; but also attached are the male seminal vesicles. These are two sacs that add fluid to the sperm to form semen. The prostate gland adds the secretions from the seminal vesicles, to the sperm, and then directs the semen flow out the male urethra. Restricted passages through the prostate gland make this a difficult task, and thus, male libido usually is affected to some degree.

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Medical Choices

Saw Palmetto Extract: This herb has undergone extensive study and research review since 1990. Saw Palmetto is rich in fatty acids, sterols, and esters. It is believed it’s beneficial actions are due to inhibition of dihydrotestosterone in the prostate (the chemical responsible for prostate growth). Additionally, these constituents also appear to have an anti-inflammatory action within the prostate gland. It has been proven in a number of studies that 320 mg per day of the saw palmetto extract is an effective and safe treatment for BPH. In fact, it has been compared to the conventional medication, Proscar, and found to be equally effective. While Proscar has been associated with loss of libido in a small percentage of individuals, no such side effects have been seen with Saw Palmetto. (Add this to the already present, varying degree of loss of libido from BPH.) The potency of the Saw Palmetto Extract should be 45% Active Sterols, for best results.

Pumpkin Seed: Pumpkin seed is an excellent source of omega 3 and omega 6 fatty acids. These fatty acids, in conjunction with the aforementioned herbs, provide enhanced anti-inflammatory effects within the prostate and contribute to a lessening of the symptoms associated with BPH.

Essential Fatty Acids: An additional source of fatty acids besides pumpkin seeds would be very beneficial for BPH disease treatment and control. Men over 50 would benefit from taking fatty acids on a daily basis. Fatty Acids that cannot be made by the body and which must be supplied through the diet, are called Essential Fatty Acids (EFA’s), also referred to as Vitamin F. These essential fatty acids are also known as polyunsaturates, are recommended in order to lower cholesterol and blood pressure, and to reduce the risks of heart disease and stroke. EFA’s have also shown to be needed when dealing with candidiasis and coronary heart disease and to minimize blood clot formation. Omega 3 fatty acids are very important for the brain and are very important when depression is chronic. It is of critical importance to obtain both adequate levels and appropriate ratios of the different types of essential fatty acids. Both Fish Oils and Flaxseed Oil provide an excellent source of omega 3 and omega 6 essential fatty acids. I prefer Fish Oils in my practice.

My father was born in 1924. Today’s date is 2015. He is 91 years old. In 1993 his PSA (Prostate Specific Antigen) test result came back well over 12.0. PSA test scores should be below 5.0. A high test score means trouble. It can also eventually lead to prostate cancer. I had just graduated from medical school. I prescribed “Ultra Prostagen” made by Metagenics. I prescribed one tablet TID. Within six months his PSA score dropped to 5.2. He continued taking one Ultra Prostagen TID. In another six months his scored dropped down to 2.5. He continued taking one tablet TID for many more years. His PSA test scores stabilized at 2.5. He is now only taking one tablet ID. His score is remaining at 2.5. To this day my father takes one Ultra Prostagen ID for maintenance.

Educational Medical Considerations for BPH:
Click on “Visit our Online Store”
Click on “Metagenics”
Click on “Health Categories” (under picture)
Category: “Men’s Health”
Educational Suggestions: (choose one)
1) Ultra Prostagen: 1 tablet TID, with or without food
2) Ultra Prostagen Concentrated: 1 tablet ID, with or without food

Educational Medical Considerations for BPH:
Click on “Visit our Online Store”
Click on “Metagenics”
Click on “Health Categories” (under picture)
Category: “Cardiometabolic Health”
Educational Suggestions: (choose one)
1) OmegaGenics EPA-DHA 2325: 1 tsp TID with food
2) OmegaGenics EPA-DHA 300: 1 softgel TID with food
3) OmegaGenics EPA-DHA 720: 2 softgels TID with food
4) OmegaGenics EPA-DHA 750: 2 softgels TID with food

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1. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995, 286–93.
2. Barlet A, Albrecht J, Aubert A, et al. Efficacy of Pygeum africanum extract in the treatment of micturational disorders due to benign prostatic hyperplasia. Evaluation of objective and subjective parameters. A multicenter, randomized, double-blind trial. Wein Klin Wochenschr 1990;102:667–73.
3. Krzeski T, Kazón M, Borkowski A, et al. Combined extracts of Urtica dioica and Pygeum africanum in the treatment of benign prostatic hyperplasia: Double-blind comparison of two doses. Clin Ther 1993;15:1011–20.
4. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia. JAMA 1998;280:160–69.
5. Braeckman J. The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: multicenter open study. Curr Ther Res 1994;55:776–85.
6. Ziegler, K, Hölscher U. Efficacy of special extract WS 1473 from saw palmetto fruit in patients with BPH (stage I and II according to Alken). Jatros Uro 1998;3:36–43.
7. Bach D, Ebeling L. Long-term drug treatment of benign prostatic hyperplasia—results of a prospective 3-year multicenter study using Sabal extract IDS 89. Phytomedicine 1996;3:105–11 (originally published in Urologe [B] 1995;35:178–83).
8. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: A randomized international study of 1,098 patients. Prostate 1996;29:231–40.
9. Braeckman J, Bruhwyler J, Vandekerckhove K, Géczy J. Efficacy and safety of the extract of Serenoa repens in the treatment of benign prostatic hyperplasia: Therapeutic equivalence between twice and once daily dosage forms. Phytotherapy Res 1997;11:558–63.
10. Metzker H, Kieser M, Hölscher U. Efficacy of a combined Sabal-Urtica preparation in the treatment of benign prostatic hyperplasia (BPH). Urologe [B] 1996;36:292–300.
11. Sökeland J, Albrecht J. A combination of Sabal and Urtica extracts versus finasteride in BPH (stage I and II according to Alken): a comparison of therapeutic efficacy in a one-year double-blind study. Urolge [A] 1997;36:327–33.
12. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publications, 1996, 167–72.
13. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 201.
14. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: A randomized international study of 1,098 patients. Prostate 1996;29:231–40.

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DISCLAIMER This information is provided for Educational Purposes Only and has NOT been designed to diagnose, treat or cure any health conditions. Please consult a qualified Health Care Professional with Nutritional Training to diagnose your health conditions and avoid self-diagnosis. The U.S. Food and Drug Administration have not evaluated statements about these health topics or any suggested product compositions.