Why does the prostate grow? “Good question. We don’t really know,” says Robert P. Huben, M.D., chief of urologic oncology at Roswell Park Cancer Institute in Buffalo. Dr. Huben and other experts believe the gland’s tendency to swell may have something to do with the male hormone testosterone. Eunuchs don’t get BPH. For the rest of the male population, however, the condition is extremely common. In fact, it affects as many as 60 percent of men over the age of 50 and 15 percent over age 40.
Perhaps because the condition is so prevalent and creeps up so slowly, many middle-aged men don’t realize that something’s wrong. They figure it is an inevitable change that they have no control over. But the fact is, particularly in the early stages of BPH, there’s much you can do to improve. Here are the best tips for reducing symptoms of prostate trouble:
* Don’t hold it in. If you need to urinate frequently, logic may tell you to train your bladder by waiting as long as you can. Logic has been wrong before, and it’s wrong here. “You may actually harm yourself by waiting too long,” says Patrick Walsh, M.D., chairman of urology at Johns Hopkins University. “When urine backs up too far, it can damage the kidneys.” Better to urinate as soon as you feel the need.
* Ejaculate regularly. Tough medicine, we know. But doing so may keep prostatic ducts from getting clogged and backed up. “It can only help,” says Men’s Health advisor Kenneth Goldberg, M.D., founder and director of the Male Health Center in Dallas.
* Don’t drink too much. Avoid all liquids after 6 or 7 P.M. if your sleep has been interrupted frequently (say, two or more times a night) by the urge to pee. Especially don’t drink alcohol, a central nervous system depressant that reduces muscle tone throughout the body, including in the bladder, causing it to retain urine. Day or night, limit drinks containing caffeine. These make you urinate more and increase stress on the bladder, causing it to feel full even when it isn’t.
* Limit spicy foods. Like alcohol, spicy foods may increase bladder irritability.
* Eat more vegetables. Male hormone levels drop on a vegetarian diet, and that may explain why, for example, BPH is rarer in certain Oriental cultures that are largely vegetarian.
* Lower your cholesterol. Cholesterol is converted to male hormone in the body. It’s been observed that enlarged prostate tissue is very high in cholesterol. Some doctors claim an improvement in symptoms, if not in prostate size, by getting patients to lower cholesterol.
* Get enough zinc. Concentrations of zinc tend to be low in men with prostate disease. Hence the thinking that increasing zinc intake to normal levels may help. Foods that are rich in zinc include oysters and herring. Oatmeal, wheat bran, milk, peas and nuts also contain the mineral.
* Don’t sit for too long. That’s your prostate you’re sitting on all day. Get up regularly and walk around.
* Get some exercise. No, there’s no prostate-specific workout. Rather, many physicians have observed that men in good shape, with good body tone, are less likely to have prostate trouble than sedentary men are.
If your symptoms are more severe, and none of the above methods provides adequate relief, two medications can help. The first of these is Hytrin, which relaxes the nerve endings of the bladder neck and prostate to de-stress muscles in the region. James H. Gilbaugh, Jr., M.D., clinical instructor in urology at Oregon Health Sciences University, reports that one-third to one-half of BPH patients treated with Hytrin get some relief with this method. FDA approval for Hytrin’s use in treating BPH is pending.
The other drug is Proscar, much ballyhooed as the first nonsurgical way to actually shrink the prostate gland. In the past, the trouble with a drug approach has been that you can’t block testosterone without affecting potency. Proscar works by reducing a hormone related to testosterone that is specifically responsible for prostate enlargement. There is no effect on testosterone levels bodywide, and side effects are rare. A recent study of 895 men with BPH reported in the New England Journal of Medicine found that the drug reduced the size of the prostate by about 20 percent on average, enough to boost urine flow by 23 percent. Potency problems were reported in about 5 percent.
Because these two drugs act in different ways, there are currently several studies underway to see if using them in combination would be better than using them separately. Though the results aren’t yet available, many doctors are already prescribing both, hoping for a one-two punch.