The Prostate Gland
The prostate is a walnut-sized gland that forms part
of the male reproductive system. The gland is made of two lobes, or regions,
enclosed by an outer layer of tissue. The prostate is located in front of the
rectum and just below the bladder, where urine is stored. The prostate also
surrounds the urethra, the canal through which urine passes out of the body.
Scientists do not know all the prostate's functions.
One of its main roles, though, is to squeeze fluid into the urethra as sperm
move through during sexual climax. This fluid, which helps make up semen,
energizes the sperm and makes the vaginal canal less acidic.
Benign Prostatic Hyperplasia: A Common
Part of Aging
It is common for the prostate gland to become
enlarged as a man ages. Doctors call this condition benign prostatic
hyperplasia (BPH), or benign prostatic hypertrophy.
As a man matures, the prostate goes through two main
periods of growth. The first occurs early in puberty, when the prostate doubles
in size. At around age 25, the gland begins to grow again. This second growth
phase often results, years later, in BPH.
Though the prostate continues to grow during most of
a man's life, the enlargement doesn't usually cause problems until late in
life. BPH rarely causes symptoms before age 40, but more than half of men in
their sixties and as many as 90 percent in their seventies and eighties have
some symptoms of BPH.
As the prostate enlarges, the layer of tissue
surrounding it stops it from expanding, causing the gland to press against the
urethra like a clamp on a garden hose. The bladder wall becomes thicker and
irritable. The bladder begins to contract even when it contains small amounts
of urine, causing more frequent urination. Eventually, the bladder weakens and
loses the ability to empty itself, so some of the urine remains in the bladder.
The narrowing of the urethra and partial emptying of the bladder cause many of
the problems associated with BPH.
Many people feel uncomfortable talking about the
prostate, since the gland plays a role in both sex and urination. Still,
prostate enlargement is as common part of aging as gray hair.
Why BPH Occurs?
The cause of BPH is not well understood. No definite
information on risk factors exists. For centuries, it has been known that BPH
occurs mainly in older men and that it doesn't develop in men whose testes were
removed before puberty. For this reason, some researchers believe that factors
related to aging and the testes may spur the development of BPH.
Benign Prostatic Hyperplasia (BPH) is a result of
Hormone Imbalance. The incidence of BPH is dependent on the action of Male
Hormones (Androgens) within the Prostate Gland. These changes within the
Prostate Gland reflect the many significant changes in both male (androgen),
female (estrogen), and pituitary hormone levels in men.
Levels of the main male sex hormone Testosterone
decrease with advancing age, but Estrogen, Prolactin, LH and FSH levels are all
increased. The exposure to Synthetic Estrogen in the environment and diet help
to accelerate these levels further. This explains the growing incidence of
Prostate Enlargement and Cancer in the last 25 years.
The ultimate effect of these changes is that there
is an increased concentration of Testosterone within the Prostate Gland and an
increased conversion of this Testosterone to an even more potent form known as
Dihydrotestosterone (DHT). The increase in levels of Testosterone and DHT is
largely due to a decreased rate of removal combined with an increase in the
activity of the enzyme 5-alpha-reductase, which converts Testosterone to DHT. Elevated
levels of Estrogen inhibit the elimination of DHT from the Prostate Gland in
cases of BPH.
Some researchers suggest that BPH may develop as a
result of "instructions" given to cells early in life. According to
this theory, BPH occurs because cells in one section of the gland follow these
instructions and "reawaken" later in life. These
"reawakened" cells then deliver signals to other cells in the gland,
instructing them to grow or making them more sensitive to hormones that
influence growth.
Dangers
Severe BPH can cause
serious problems over time. Urine retention and strain on the bladder can lead
to urinary tract infections, bladder or kidney damage, bladder stones, and
incontinence-the inability to control urination. If the bladder is permanently
damaged, treatment for BPH may be ineffective. When BPH is found in its earlier
stages, there is a lower risk of developing such complications.
As men age, Progesterone levels fall, Testosterone
becomes converted to Dihydrotestosterone (DHT) and Estrogen levels rise and
become dominant. The effect of this is weight gain, some breast enlargement, an
enlarged Prostate Gland and sometimes Prostate Cancer. Testosterone actually
protects against Prostate Cancer, whereas DHT does not protect against the
carcinogenic effects of increased Estrogen. The conversion of Testosterone to
DHT is promoted by the enzyme 5-alpha-reductase. The action of this enzyme is
inhibited by Progesterone. Progesterone is also a precursor to Testosterone
synthesis in the human body and also inhibits its conversion to DHT. This is
important since Testosterone antagonizes and limits Estrogen effects, thus
preventing Prostate Cancer.
Symptoms
Many symptoms of BPH stem
from obstruction of the urethra and gradual loss of bladder function, which
results in incomplete emptying of the bladder. The symptoms of BPH vary, but
the most common ones involve changes or problems with urination, such as
- Frequency - urinating much more often than normal.
- Urgency - having a sensation that you need to urinate immediately.
- Nocturia - getting up to urinate multiple times during the night.
- Hesitancy - difficulty starting the urine stream.
- Weak Flow - a hesitant,
interrupted, weak stream.
- Leaking - leaking or dribbling after urination.
- Dysuria - pain during urination.
The size of the prostate
does not always determine how severe the obstruction or the symptoms will be.
Some men with greatly enlarged glands have little obstruction and few symptoms
while others, whose glands are less enlarged, have more blockage and greater
problems.
Sometimes a man may not
know he has any obstruction until he suddenly finds himself unable to urinate
at all. This condition, called acute urinary retention, may be triggered by
taking over-the-counter cold or allergy medicines. Such medicines contain a
decongestant drug, known as a symptomatic. A potential side effect of this drug
may prevent the bladder opening from relaxing and allowing urine to empty. When
partial obstruction is present, urinary retention also can be brought on by
alcohol, cold temperatures, or a long period of immobility.
It is important to tell
your doctor about urinary problems such as those described above. In eight out
of 10 cases, these symptoms suggest BPH, but they also can signal other, more
serious conditions that require prompt treatment. These conditions, including
prostate cancer, can be ruled out only by a doctor's examination.
Exams and Tests
After taking a complete medical history, your doctor will perform a digital
rectal exam to feel the prostate gland. The following tests may also be
performed:
- Urine flow rate
- Post-void residual urine
test to see how much urine is left in your bladder after urination
- Pressure flow studies to
measure the pressure in the bladder as you urinate
- Urinalysis to check for
blood or infection
- Urine culture to check for
infection
- Prostate-specific antigen
(PSA) blood test to screen for prostate cancer
- Cystoscopy
In addition, you may be asked to complete a form to evaluate the severity
of your symptoms and their impact on your daily life. Your score may be
compared to past records to determine if the condition is getting worse.
Treatment
The choice of a treatment is based on the severity of your symptoms, the
extent to which they affect your daily life, and the presence of any other
medical conditions. Treatment options include "watchful waiting,"
lifestyle changes, medication, or surgery.
If you are over 60, you are more likely to have symptoms. But many men
with an enlarged prostate have only minor symptoms. Self-care steps are often
enough to make you feel better.
If you have BPH, you should have a yearly exam to monitor the progression
of your symptoms and determine if any changes in treatment are necessary.
Self-care
For mild symptoms:
- Urinate when you first get
the urge. Also, go to the bathroom when you have the chance, even if you
don't feel a need to urinate.
- Avoid alcohol and
caffeine, especially after dinner.
- Don't drink a lot of fluid
all at once. Spread out fluids throughout the day. Avoid drinking fluids
within 2 hours of bedtime.
- Try NOT to take
over-the-counter cold and sinus medications that contain decongestants or
antihistamines. These medications can increase BPH symptoms.
- Keep warm and exercise
regularly. Cold weather and lack of physical activity may worsen symptoms.
- Learn and perform Kegel
exercises (pelvic strengthening exercises).
- Reduce stress. Nervousness
and tension can lead to more frequent urination.
Medications
- Alpha 1-blockers
(doxazosin, prazosin, tamsulosin, terazosin, and alfuzosin) are a class of
medications also used to treat high blood pressure. These medications
relax the muscles of the bladder neck and prostate. This allows easier
urination. Most people treated with alpha 1-blocker medication find that
it helps their symptoms.
- Finasteride and
dutasteride lower levels of hormones produced by the prostate, reduce the
size of the prostate gland, increase urine flow rate, and decrease
symptoms of BPH. It may take 3 to 6 months before you notice much
improvement in your symptoms. Potential side effects related to the use of
finasteride and dutasteride include decreased sex drive and impotence.
- Antibiotics may be
prescribed to treat chronic prostatitis (inflammation of the prostate),
which may accompany BPH. Some men note relief of their BPH symptoms after
a course of antibiotics.
Natural Supplements
- ProstateCare is a Herbal Dietary Supplement which is known
to decongest Enlarged Prostate.
- Saw Palmeto is known to help shrink enlarged Prostate by
preventing the formation of DHT in the body by blocking the action of the
enzyme 5-alpha-reductase.
- Coriander
& Cumin are
known to help reduce burning sensation while passing urine.
- WaterX helps to increase the flow of urine.
- Kidney
Bladder Flush helps to
fight Prostate inflammation.
- Soyam is another Herbal Dietary Supplement rich in Phytosterols. It is a precursor to Progesterone which in turn is a precursor to Testosterone which can help prevent Cancer of the Prostate and also inhibit the action of Synthetic Hormones entering the Human Body.
Surgery
Prostate surgery may be recommended if you have:
- Incontinence
- Recurrent blood in the
urine
- Inability to fully empty
the bladder (urinary retention)
- Recurrent urinary tract
infections
- Kidney failure
- Bladder stones
Sources
and Additional Information:
