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.
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.
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
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.
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.
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.
- 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.
- 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.
Prostate surgery may be recommended if you have:
- Recurrent blood in the urine
- Inability to fully empty the bladder (urinary retention)
- Recurrent urinary tract infections
- Kidney failure
- Bladder stones
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