Herbal Solutions for Benign Prostate Enlargement (BPH)
  by James Occhiogrosso, N.D.

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Benign Prostate Enlargement or BPH is a nonmalignant enlargement of the prostate gland beyond its normal size.  It is quite common in men over fifty.  According to many experts, the incidence of BPH roughly parallels men’s age groups.  In other words, approximately fifty percent of men suffer from it in their fifties, and this percentage increases to about eighty percent of men in their eighties. For many men prostate growth begins with symptoms that are barely noticeable.  Eventually though, this growth compromises prostate or urinary function.  In my opinion, the term benign in BPH is a misnomer.  Studies report that men with prostate cancer often have a history of BPH, prostatitis, or erectile dysfunction for several years before their cancer diagnosis. 

Symptoms of BPH typically include a frequent need or urgency to urinate, difficulty in starting or stopping urination, urine leakage, a weak, interrupted or split urine stream, blood in the urine, inability to void completely (urinary retention), and increased interruption of normal sleep due to the need to urinate (nocturia).  Symptoms can also include erectile or orgasm problems. The most serious problem is when the prostate growth interferes substantially with normal urinary flow.  In severe cases, the flow of urine can be totally blocked, requiring immediate medical intervention.

Typically, men with symptoms of BPH are given prescription medication.  This may solve the immediate problem, but does little to correct the cause, and—as we discuss below—often causes unpleasant side effects. Conventional medical treatment for BPH is often the drugs, Finasteride (Proscar, Propecia), Dutasteride (Avodart, Duogen), or Tamsulosin (Flomax).  Each has significant side effects that are well known.  They include a reduction in (or loss of) libido, as well as problems like pain on ejaculation, inability to have an orgasm, and erectile dysfunction.  In addition to the sexual issues, dizziness, vision problems, and excess breast growth have also been reported.  Recent studies indicate that Finasteride can reduce the risk of getting prostate cancer, and some doctors prescribe it for this purpose.  However, the prevention aspect is dulled by the under-reported detail that it also appears to increase risk of developing aggressive and potentially fatal prostate cancer.  [1]

There are many vitamin and supplement products sold to help with urinary problems, BPH, erectile dysfunction and prostatitis.  Most don’t work!  Anyone can formulate a supplement and make almost any claim about it.  As a natural health practitioner, I often see men that have tried many different supplements with little success.  This is usually because they are either taking a single, non-standardized herb, or a combination supplement that is not formulated properly.  Synergy is when several herbs used together have a significantly greater effect than any of them alone.  Professional herbalists almost always use several herbs together for this synergistic effect. 

Saw Palmetto (Serenoa repens)

Studies show that a properly formulated extract of saw palmetto can be as effective as Finasteride with fewer side effects. [2]  Traditionally, saw palmetto is the primary choice of natural practitioners for treatment for BPH.  It has also shown value in treating erectile dysfunction.  Saw palmetto is a bush-like, dwarf palm that grows mostly in the southern United States.  The medicinal part of the plant is its small bluish-purple berries.  It has a long history of use for prostate problems, particularly BPH, and is known to be quite safe. 

In recent European studies, saw palmetto provided significant improvement in maximum urinary flow, a decrease in overall prostate size, and improvement in other symptoms including sexual function.  However, while symptom improvements were noted in a month or so, the maximum benefits of treatment were not evident until the second year. [3] [4]  In one study, sexual function remained stable during the first year of treatment but improved significantly during the second year. [5]  This suggests that treatment with saw palmetto may initiate a long-term healing process within the prostate. [6]  

A meta-analysis published in the Journal of the American Medical Association in 1998 evaluated a total of eighteen controlled studies involving 2939 men.  This analysis also concluded that saw palmetto produced improvements in urinary tract symptoms and urinary flow rate without the side effects associated with the popular prescription drug, Finasteride. [7]  Another, more recent meta-analysis confirmed these results.  [8] 

Saw palmetto has very few side effects, and many men report that it enhances libido and erectile function, although this has not been shown conclusively by any studies.  It is quite possible however, that the reduction in prostate size and the improvement of overall urinary health could result in a feeling of well being that could easily account for the increased sexual performance.

Some supplement manufacturers sell ground saw palmetto berries in capsules.  While the berries are indeed healthy, to see significant improvement in prostate problems you would need to swallow a significant number of capsules.  This is one reason many of the men I’ve seen had no results.  They simply were not getting enough of the active ingredient.  With many herbal remedies, only a concentrated and standardized extract is effective—and, such extracts are expensive—hence the reason why some inexpensive supplements do nothing. All of the studies cited in this article used a standardized extract.

While saw palmetto extract is effective by itself, it is even more effective when used along with other herbs, like pygeum, nettle, and pumpkin seed oil (described below) for the synergistic effect.  

Pygeum (Pygeum africanum, Prunus africana)

Pygeum bark is traditionally used with saw palmetto for the treatment of urinary and prostate problems.  A recent analysis looked at eighteen randomized, controlled trials using extracts of pygeum.  These trials included a total of 1562 men with BPH. [9]  The review concluded that pygeum improves the urinary symptoms of BPH with few side effects.  Men using pygeum were more than twice as likely to report improvement in overall symptoms.  In other studies, a total of 348 men were treated with 50 mg of pygeum twice daily for two months. [10] [11]  Significant improvements were noted after the two-month treatment period, particularly in nighttime voiding, a persistently annoying symptom of BPH.  Nocturnal frequency was reduced by thirty-two percent, and urinary flow and volume were also significantly improved.  The beneficial effect of Pygeum appeared to last for at least one month after the two-month trial period.  Other studies have indicated that, like saw palmetto, the full effects of supplementing with pygeum are only obtained after a long period of regular use.

Stinging Nettle Root (Urtica dioica)

Stinging nettle (or simply nettle) is a weed-like plant that grows wild throughout the United States.  It has a long history of therapeutic use for many different health issues.  Both the root and the leaves of the plant are used medicinally. 

Nettle root is effective for treating BPH.  Like saw palmetto and pygeum, nettle contains many phytosterols that can help relieve symptoms of prostate dysfunction.  By itself, nettle it is not quite as effective as saw palmetto or pygeum in treating BPH, but since it operates slightly differently, it is usually combined with both for the synergistic effect.  Several studies conclude that the plant sterols in nettle root inhibited activity of certain prostate cells in such a way as to help prevent the excess growth of BPH, and possibly slow the growth of prostate cancer.  [12] [13] [14]  In animals induced in the laboratory to have four times the normal prostate tissue, nettle reduced the excess tissue by more than one-third. [15]  In addition, nettle has anti-inflammatory properties that make it effective for treating chronic prostatitis.  It also appears that nettle causes a slight increase in free testosterone which may help increase libido and erectile function. [16] [17] 

Pumpkin (Cucurbita pepo) Seed Oil

Pumpkin Seed Oil contains high amounts of omega-3 essential fatty acids, protein, amino acids, iron, phosphorous, and zinc—all of which have significant value for prostate health.  Historically, pumpkin seeds have been used in many cultures, including Native Americans, to treat BPH and prostatitis.  There is evidence that they may also help control prostate cancer.  In a study of fifty-three men with BPH, urinary flow, residual urine, urgency and frequency of urination—all symptoms of BPH—were significantly improved. [18]  Many European countries have formally approved pumpkin seeds and pumpkin seed oil for the treatment of BPH. 

Summary

As I mentioned above, synergy can significantly increase the effectiveness of a properly formulated combination of herbs and nutrients.  Thus, combination products can be more effective than a drug.  Typically, such a product also has few sexual or other side effects, and often can actually help resolve some sexual issues as well as helping with prostate enlargement.  The beneficial effects of saw palmetto, pygeum, nettle, and pumpkin seed oil all have slightly different effects on the prostate.  There is strong evidence that the synergistic effect of such a combination—can significantly improve prostate health when used regularly.  [19] [20] [21]

Prostate Support Supplement

There are other herbs and nutrients that can help support prostate health and I will discuss them in a future article.  For most men, our Saw Palmetto/Pygeum Plus Prostate Support is a good starting point.  Our Saw Palmetto Pygeum Plus softgel product contains standardized extracts of Saw Palmetto, Pygeum and Nettle in the dosages that have been studied and found to be effective.  It also contains supplemental pumpkin seed oil, zinc and lycopene and is made with the highest quality European Standardized extracts and other nutrients that work together synergistically to enhance the proven benefits of Saw Palmetto, Pygeum, Nettle, and Pumpkin Seed Oil.  

• Click here to order our Prostate Support Formula  •
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Copyright 2008, James Occhiogrosso, N.D., http://www.ProstateHealthNaturally.com, All Rights Reserved worldwide.  Parts of this article are excerpted from the book, “Your Prostate, Your Libido, Your Life: A Guide to Natural solutions for Common Prostate Problems”.  Permission is granted to reproduce this article providing it is not modified from the original and includes all web addresses and links.