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BPH in Men

What You Should Know

(Overview*)

Having an enlarged prostate, a condition called benign prostatic hyperplasia (BPH), affects men in different ways.

Some of you can manage mild symptoms and don’t need treatment. Others find that most of the time they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events.

Many of you need the toilet a lot during the night. You wake up with an urgent need to pee. Then, before you can fall back asleep, you have to go again. This affects your sleep and makes you feel more tired during the day.

In fact, waking up to go to the bathroom several times each night and/or having urination difficult or uncomfortable is one of the most annoying health issues.

Unfortunately, the health of the prostate gland is something most men never think about – until they are forced to. There are so many men who are willing to take drugs with known, serious side effects, or to even undergo major surgery – such as transurethral resection of the prostate (TURP) or even prostatectomy (prostate removal). These facts attest to how common, how unpleasant, and how personal prostate health concerns can be.

On the other hand, for many men, unsuccessfully treated prostate conditions often mean resorting to wearing diapers (due to urinary incontinence) and/or never having sex again (due to impotence), or being sterile…

An even graver prostate health concern is prostate cancer affecting more than 2.5 million American men. It’s the most common cancer in men after skin cancer.

*Based on various sources.

Very Personal Health Concern

Benign prostatic hyperplasia (BPH) is a non-cancerous swelling of the prostate gland that affects nearly all men to some degree, usually beginning in late middle age.

While it can have serious complications, by doctors it is considered a normal part of men’s aging process due to the changes in hormone balance and in cell growth.

But if left untreated, BPH can lead to bladder, urinary tract or kidney problems. It may cause the buildup of urine in the bladder, which increases the likelihood that pathogenic bacteria will grow and trigger an infection.

Prostate issues can also cause sexual problems. The extent of any sexual problem varies according to the condition of the prostate. Some common sexual side effects include:

  • erectile dysfunction (ED),
  • problems maintaining an erection,
  • reduced sexual satisfaction,
  • decreased libido (sex drive).

Possible Causes

No one knows exactly why the prostate enlarges, but it typically happens after about age 50 or over the age of 50. Nearly 60 percent of men aged over 60 suffer from this condition. Up to 90 percent of men older than 80 have it.

The prostate goes through two main periods of growth. Early in puberty, it actually doubles in size. Later in life, around age 25, it starts to grow again. For most men, this growth happens for the rest of their lives. For some, it causes BPH.

Prostate enlargement may be a result of environmental factors such as diet. Lack of exercise, being overweight and certain medical conditions, such as heart and circulatory disease or diabetes, may leave many men more susceptible to prostate enlargement.

Also, a family history of prostate problems (a genetic predisposition) or any abnormalities with testicles may raise a risk of prostate enlargement.

Men with a father or brother who has been affected by BPH are more likely to develop the condition than men who do not have a first-degree relative who has been affected.

Besides the factors linked to aging, the main culprit seems to be the hormone dihydrotestosterone (DHT), which – as you age – the body converts from the male hormone testosterone at an increasingly higher rate.

This increase in DHT production rate is thought to trigger the proliferation of prostate cells (hyperplasia). That’s why men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH.

Also, if the testicles are removed after a man develops BPH, the prostate begins to shrink in size.

Because researchers are not positive about the cause of prostate enlargement, standard medicine is unable to prevent BPH or eradicate it completely once it becomes a nuisance.

Common Symptoms

The BPH symptoms occur because the tube that drains urine from your bladder, called the urethra, passes through the prostate gland to your penis. When the prostate enlarges, it compresses the urethra and affects urination.

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia may include:

  • Frequent need to urinate – eight or more times a day (frequency).
  • Increased frequency of trips to the bathroom at night, during periods of sleep (nocturia).
  • Diminished, weak force of the stream.
  • Difficulty holding back urination/urgent need to urinate urinary/the inability to delay urination (urgency).
  • Trouble and delay in starting the stream (hesitancy).
  • Interruption of the stream that stops and starts (intermittency).
  • Sense of incomplete emptying (also inability to completely empty the bladder).
  • Dribbling at the end of urination.
  • Incontinence – the accidental loss of urine.
  • Pain after ejaculation.
  • Painful urination.
  • Blood in the urine.

Standard Medical Treatments

Typically, you do not need medicine for an enlarged prostate unless the symptoms bother you or you have other problems such as bladder infections or bladder stones.

About 4 out of 10 men find that their symptoms improve without treatment. That means that 6 out of 10 men need medicine or surgery to help their symptoms.

However, once it is determined that the problem is an enlarged prostate, there are many standard ways to treat it, such as:

No treatment (“Wait and watch”)

One of the first and most common avenues is not to treat it at all. Symptoms vary widely from one patient to the next. If a man has only mild symptoms, perhaps getting up once a night to urinate, a conservative approach might be best.

This approach may be also advised, if the symptoms are mild and not adversely affecting quality of life. The condition is regularly monitored and treatment will be advised if symptoms worsen.

Typically, some vague dietary modifications are suggested. They include avoiding bladder irritants, such as coffee, tea and alcohol, as well as stopping or reducing smoking. Also, restricting fluid intake in the late afternoon and evening are recommended, as they can prevent the need for waking up to urinate.

Medications to free urine flow

Only 10 percent men with enlarged prostate need medical intervention. If and when an quick intervention is needed to bring relief, the first step is usually alpha blockers, such as Tamsulosin HCL (Flomax) – oral medications that relax the muscles around the prostate and bladder neck, allowing freer urine flow. The relief is generally felt within a couple of days. But this approach is not free from side effects. Alpha blockers can lead to difficulty ejaculating and cause a retrograde ejaculation (going into the bladder rather than exiting the penis). And they do not shrink the prostate.

Medications to shrink the prostate

Another commonly prescribed drug, 5-alpha reductase inhibitor (such as finasteride or dutasteride), actually helps to shrinks the prostate – but requires a longer time to take effect and has potentially problematic sexual side effects. Finasteride (Proscar) may lower the sex drive or interfere with erections, and can decrease the amount of semen/sperm released during sex. Dutasteride (Avodart) may also cause testicle pain/swelling, increased breast size, or breast tenderness.

The side effects of these drugs may be more bothersome than the symptoms.

Minimally-invasive procedures

These approaches, such as stents, heat treatments, or laser treatments can sometimes lead to erectile dysfunction (ED). The prostatic lift is a procedure, in which prostate tissue is moved away from the urethra, with a few sutures to hold it in place. As a minimally invasive, outpatient procedure, it can be done with local anesthesia. It also preserves sexual function.

Surgery

Only 10 percent men with enlarged prostate need surgical intervention. When medications are not the answer, there are surgical solutions such as:

  • Transurethral incision of the prostate (TUIP), which involves widening the urethra, sometimes results in ED.
  • Transurethral resection of the prostate (TURP), in which the inner portion of the prostate is removed, can lead to retrograde ejaculation. Although it is not harmful, as semen exits the bladder along with urine, it makes natural conceiving of a child impossible.

BPH Complications

Complications of an enlarged prostate may include:

  • Sudden inability to urinate (urinary retention). You might need to have a tube (catheter) inserted into your bladder to drain the urine. Some men with an enlarged prostate need surgery to relieve urinary retention, as the inability to pass urine can be life threatening.
  • Urinary tract infections (UTIs). Inability to fully empty the bladder can increase the risk of infection in your urinary tract. If UTIs occur frequently, you might need surgery to remove part of the prostate.
  • Bladder stones. These are generally caused by an inability to completely empty the bladder. Bladder stones can cause infection, bladder irritation, blood in the urine and obstruction of urine flow.
  • Bladder damage. A bladder that hasn’t emptied completely can stretch and weaken over time. As a result, the muscular wall of the bladder no longer contracts properly, making it harder to fully empty your bladder.
  • Kidney damage. Pressure in the bladder from urinary retention can directly damage the kidneys or allow bladder infections to reach the kidneys.

Recommended Lifestyle Changes

  • Limit beverages in the evening. Do not drink anything for an hour or two before bedtime to avoid middle-of-the-night trips to the toilet.
  • Limit coffee (caffeine) and alcohol. They can increase urine production, irritate the bladder and worsen symptoms.
  • Limit decongestants or antihistamines. These drugs tighten the band of muscles around the urethra that control urine flow, making it harder to urinate.
  • Go when you first feel the urge. Waiting too long might overstretch the bladder muscle and cause damage.
  • Schedule bathroom visits. Try to urinate at regular times — such as every four to six hours during the day — to “retrain” the bladder. This can be especially useful if you have severe frequency and urgency.
  • Follow a healthy diet. Obesity is associated with enlarged prostate. Also, eat cold-water fish, such as sardines and trout, rich in healthy fats that contain omega-3 fatty acids, helping to prevent and reduce inflammation. Have tomatoes that are packed with lycopene, an antioxidant that may benefit prostate gland cells.
  • Stay active. Inactivity contributes to urine retention. Even a small amount of exercise can help reduce urinary problems caused by an enlarged prostate.
  • Urinate and then urinate again a few moments later. This practice is known as double voiding.
  • Keep warm. Colder temperatures can cause urine retention and increase the urgency to urinate.

Enlarged Prostate and PSA Levels

A normal PSA level is considered to be under 4 nanograms per milliliter (ng/mL) of blood, while a PSA above 10 suggests a high risk of cancer. But there are many exceptions:

  • Men can have prostate cancer with a PSA less than 4.
  • A prostate that is enlarged (BPH) can boost PSA levels, yet further testing may show no evidence of cancer (the BPH symptoms can be similar to prostate cancer).
  • Some BPH drugs can lower PSA levels, despite the presence of prostate cancer, called a false negative.

BPH and Cardiovascular Disease

It has been suggested that old men with BPH and lower urinary tract symptoms have a considerably higher prevalence of cardiovascular disease. Researchers speculate an enlarged prostate can be a risk factor due to:

  • sleep disturbances (due to nocturnal polyuria),
  • depression (associated with erectile dysfunction, urinary tract infections, etc.),
  • heart rate and blood pressure variability (associated with stress),
  • increased blood levels of cortisol (stress hormone).

Natural Alternative Measures

According to standard medicine, there is no evidence that the standard prostate botanicals reduce the size (volume) of the enlarged prostate. In other words, most orthodox doctors keep warning their patients that common botanicals fail to address the prostate problems

There is no wonder then that the Food and Drug Administration has not approved (yet) any herbal medications for treatment of an enlarged prostate.

Despite the standard medicine’s “warnings,” the good news keeps on coming for the large population of prostate sufferers. One on them is European DP Extract.

It is a clinically proven proprietary blend – obviously still little known to the American public and most doctors – which has been used with success by men for generations in Europe.

The power of this unique Swedish extract is backed by numerous controlled studies, both clinical and experimental. Several open trials have found it to be helpful for chronic prostatitis and prostatodynia (Br J Urol. 1993 Apr; 71(4): 433-8]).

European DP Extract delivers support in a way that is fundamentally different from common prostate herbs. The list of its beneficial properties includes:

  • Anti-inflammatory effect (inflammation is the key marker of chronic prostatitis).
  • Shrinking effect on swollen prostate.
  • Balancing effect on the smooth muscle tone of the urethra and bladder, thus improving with bladder emptying, hesitancy, or intermittency, and urinary incontinence.
  • Exerting effect on the hormones that drive benign prostatic hyperplasia/hypertrophy, thus reducing the prostate volume (by inhibiting the enzyme which converts testosterone into the much more prostate-stimulating DHT (dihydrotestosterone), and also by decreasing the clearance of DHT.
  • Inhibiting the absorption of cadmium effect (the toxic heavy metal cadmium, which is linked with prostate cancer, as its levels are increased in both BPH and prostate cancer).

Men Write to Us

(Testimonials)

Mr. Andrew Mierzejewski:

I got a severe bladder infection, so I went to a doctor. They did their look in my bladder and also discovered I had an enlarged prostate.

I was in bad pain when I often had to go to restroom. One night I was going every 30 minutes.

They put me on sulfa antibiotics and also wanted me to take Flowmax, which I told them I would not take. I don’t like taking antibiotics if I can help it.

They also did a CAT scan. I took the antibiotics for a few days but they did not help that much.

So, they wanted to do surgery to open it up.

Since taking European DP Extract and your Uribiotic Formula for bladder infection, I am about 95% better. I wake up only about once around 3 to 4 am. My output at that time is from 12 to 14 oz.

I know it is going to take some time for the swelling of the prostate to go down. But European DP Extract has helped me tremendously over the past few weeks since I first talked to you and ordered it.

I am not considering any type of surgery at all.

I cannot express enough the thanks for your time and talking to me and for your products.

Thanks again,

Aaron Hiller

Texas, USA

Thanks, again, Andrew!

As soon as I got my order of Uribiotic in, I started taking it. After a few days I noticed feeling a little better each day.

I started going to the bathroom only about twice a night. Then just once a night. And now I never wake to go to the bathroom. My measured outflow in the morning became normal and with no pain.

I was also taking European DP Extract for my enlarged prostrate for about six weeks. I went to a specialist and he checked me and said that my prostate was normal.

He said I don’t need to come back.

Now everything is back to normal. I still take both Uribiotic and European DP Extract.

I am very thankful for your help and advice, Andrew.

Aaron Hiller

Texas, USA

I have been suffering from chronic prostatitis since I was 40 years old (I’m 54 now). I had tried many Doctor-prescribed treatments, but the symptoms continued to reoccur.

I then heard about Saw Palmetto and started taking it four years ago, which helped greatly for the first three years. Then I noticed it was not helping as much and searched for help.

I have been taking European DP Extract for a year and it has been a very successful treatment for my prostate.

I still continue to take a men’s health vitamin with 160 mg of Saw Palmetto and other vitamins and minerals. With continued treatment I have become a new man.

E. D. Christians

Sturgis, South Dakota, USA

I started taking European DP Extract, because I was beginning to have problems related to my prostate (58-year-old male). If I remember correctly, I started to notice a difference within 2 weeks.

My PSA test a few months ago was 1.5 and my previously slightly enlarged prostate had reduced in size.

I’m very glad that I took the European DP Extract because the products I had been taking for the prostate had limited or no noticeable effects.

Damon J. L.

Northridge, California, USA

How Severe is My BPH?

(Enlarged Prostate Symptoms Check)

Please answer the questions below carefully to assess severity of your symptoms in benign prostatic hypertrophy, using this seven-question test based on the International Prostate Symptom Score (IPSS).

Your confidential results will be sent to you by e-mail upon reviewing your responses. You may also expect our advice (if necessary) and additional support on what you should do next.

The information given is not intended to diagnose, prescribe or replace the advice of a doctor or other healthcare professional.

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