Benign Prostatic Hyperplasia (BPH) or an enlarged prostate seem to occur in most men as they age.

I’ve never met a 25-year-old with an enlarged prostate. 

The problem with having BPH is not that the prostate is enlarged, as a big prostate does not predispose you to prostate cancer, the issue here is that it may lead to urinary symptoms. “May” is the operative word here as many men with very big prostates do not develop urinary symptoms.

For context, a normal prostate is about 25 to 30 grams, about the size of a walnut. The biggest prostate I’ve seen is about 300 grams, about the size of a small orange. So again, one can have a 300-gram prostate and not experience urinary problems. Why? How?

If the prostate area surrounding the urethra (the tube that exits urine and semen) does not squeeze, prostate-related urinary problems do not occur. So, one can have a 30-gram prostate and have prostate-related urinary symptoms (prostate squeezing the urethra), or one can have a 300-gram prostate and it not tighten, allowing urine to flow freely. Lastly, urinary problems, as in women, can occur from an overactive and dysfunctional bladder.

Now, this is not to say a big prostate is not a problem

If BPH does cause restriction of urine flow, it may cause frequent trips to the bathroom, frequent nighttime urination, and urgency. If BPH symptoms are not addressed, it can lead to retention, backflow of urine, and damage to the bladder and kidneys. While these are extreme cases, they do happen, unfortunately. Lastly, big prostate cancer is connected to erectile dysfunction (ED) and my guess, in part is because the surrounding nerves that innervate the penis for erection get obstructed by the enlarged organ. 

What to do for Urinary Problems from a Big Prostate

There’s plenty of scientific information showing the benefits of lifestyle practices for better prostate health and improved urinary function. Here’s the some of that science and how to implement it.

• Excessive animal protein intake increases the risk (Suzuki et al. 2002). Cut red meat intake to about once or twice a week at most.
• Fruits and vegetables decrease the risk of BPH (Kristal et al. 2008). Follow a plant-based diet which has many other health benefits as well.
• Green tea helps. One caveat is that green tea has caffeine, which can worsen urinary symptoms. (Liao 2001). Drink one to two cups a day during the daytime and limit nighttime consumption so that sleep is uninterrupted.
• Zinc is good but not more than 100 mg daily (Login et al. 1983). More than 100mg a day promotes prostate cancer (Leitzmann et al. 2002). Take 15 to 30 mg of zinc a day.
• (Alcohol is NOT bad for the growth of the prostate, but it can worsen urinary symptoms. (Parsons 2009). Consume alcoholic beverages moderately, if at all, and end consumption two to three hours before bedtime to avoid nighttime urination.
• Take some vitamin D – between 2000 units to 5000 units a day (Adorini 2010).
• Simple carbs, primarily pasta and white bread, are not good for BPH. (Maserejian et al. 2009) Eat whole grains; gluten-free is best for most people, instead of low nutrient simple carbs.
• Exercise consistently (Barnard et al. 2009). Exercise has many health benefits, including promoting prostate health.
• Some dietary prostate supplements work well by reducing oxidative stress, lowering inflammation, and supporting good prostate health. Mr. Happy Prostate Support is my go-to as I carefully formulated it to help men over 40 years old.

Your challenge: Start on 3 of the 9 points on this list. Go ahead – go for it. Exercise is a must, though. You get a lot of “bang for your buck” with a good workout.

Bottom line: Urinary Problems from BPH need should be addressed. Natural methods work well, but sometimes medical treatments are necessary, as discussed in this podcast episode. 

References:

1. Suzuki S, Platz EA, Kawachi I, et al. Intakes of energy and macronutrients and the risk of benign prostatic hyperplasia. Am J Clin Nutr 2002;75:689-697.
2. Kristal AR, Arnold KB, Schenk JM, Neuhouser ML, Goodman P, Penson DF, Thompson IM. Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial. Am J Epidemiol. 2008 Apr 15;167(8):925-34.
3. Barnard RJ, Aronson WJ. Benign prostatic hyperplasia: does lifestyle play a role? Phys Sportsmed. 2009 Dec;37(4):141-6.
4. Schwarz S, Obermüller-Jevic UC, Hellmis E, Koch W, Jacobi G, Biesalski HK.Lycopene inhibits disease progression in patients with benign prostate hyperplasia. J Nutr. 2008 Jan;138(1):49-53.
5. Liao S. The medicinal action of androgens and green tea epigallocatechin gallate. Hong Kong Med J 2001 Dec; 7(4): 369-74
6. Gómez Y, Arocha F, Espinoza F, Fernández D, Vásquez A, Granadillo V. Zinc levels in prostatic fluid of patients with prostate pathologies Invest Clin 2007;48:287-94.
7. Login IS, Thorner MO, MacLeod RM. Zinc may have a physiological role in regulating pituitary prolactin secretion. Neuroendocrinology 1983;37:317-320.
8. Kristal AR, Arnold KB, Schenk JM, Neuhouser ML, Goodman P, Penson DF, Thompson IM. Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial. Am J Epidemiol. 2008 Apr 15;167(8):925-34.
9. Leitzmann, M.F., Stampfer, M.J., Wu, K., Colditz, G.A., Willett, W.C., & Giovannucci, E.L. (2002). Zinc supplement use and risk of prostate cancer. Journal of the National Cancer Institute, 95(13), 1004-1007.
10. Parsons JK, I’m R. Alcohol consumption is associated with a decreased risk of benign prostatic hyperplasia. J Urol 2009; 182:1463–1468.
11.  Li H, Stampfer MJ, Hollis JB, Mucci LA, Gaziano JM, Hunter D, Giovannucci EL, Ma J. A prospective study of plasma vitamin D metabolites, vitamin D receptor polymorphisms, and prostate cancer. PLoS Med. 2007 Mar;4(3):e103.
12. Adorini L, Penna G, Fibbi B, Maggi M.Vitamin D receptor agonists target static, dynamic, and inflammatory components of benign prostatic hyperplasia. Ann N Y Acad Sci. 2010 Apr;1193:146-52. Review.
13. Maserejian NN, Giovannucci EL, McKinlay JB. Dietary macronutrients, cholesterol, and sodium and lower urinary tract symptoms in men. Eur Urol. 2009 May;55(5):1179-89.