The health of your prostate gland is a reflection of many factors, from your diet and weight to your stress level and medications. Your prostate also is intertwined with your urinary system…and many men with an enlarged prostate, or ­benign prostatic hyperplasia (BPH), also have bladder problems. If you treat only the prostate—the conventional medicine approach, and often with only conventional medications—you won’t get the best results. Here’s a better way…

The Bladder-Prostate Connection

Over the years, a man’s prostate can grow from the size of a walnut to as big as a tennis ball. The upper portion of the prostate rests against the lower section of the bladder. When the prostate enlarges—a condition that most older men have at least mildly—it can pinch the urethra (the tube that drains the bladder), causing urinary symptoms. 

Lower urinary tract symptoms (LUTS) is the name for a constellation of ­bladder-related issues including waking multiple times at night to urinate…frequent or urgent need to urinate…waiting for urine to flow while at the toilet…a slow stream…dribbling at the end of urination…and not being able to empty your bladder completely. Another problem is overactive bladder, caused by an impaired bladder muscle. An enlarged prostate can worsen these symptoms. Healing the prostate and the bladder involves a multiprong approach. 

What to Eat…What to Avoid

As with all body systems, the right diet is important to a healthy prostate. The Mediterranean diet’s anti-inflammatory nutrients—particularly vitamins D-3 and E and zinc—are associated with improved BPH and LUTS symptoms. Vitamin E is in nuts, seeds, fruits and vegetables. Take daily supplements with a meal to get adequate D-3 (2,500 ­international units to 5,000 IU) and zinc (25 mg). Since obesity is associated with BPH and LUTS, losing weight also is important.

Avoid the following foods because of their association with a higher risk of getting or aggravating BPH and LUTS… 

  • Too much animal protein
  • High-glycemic grain-based foods, such as refined bread, pasta and rice.
  • Too much caffeine, including coffee, tea, soft drinks and chocolate.
  • Carbonated beverages, excess alcohol, artificial sweeteners, citrus fruits, tomato-based products and spicy foods. 

Supplements for BPH and LUTS

Conventional drugs prescribed for BPH and LUTS often don’t help enough. Extensive research shows that, for many men, the following herbs can be as effective as or enhance the effects of prescription drugs. I almost always recommend prostate formulas that contain two or more of these ingredients, such as Life Extension Ultra Prostate Formula or Now Foods Prostate Health.

Pycnogenol, a patented form of French maritime pine bark extract, contains many therapeutic plant compounds. Daily dosage: 150 mg. Caution:
If you are on anticoagulant therapy, check with your doctor before using. 

Pygeum africanum, also known as Prunus africana, appears to lower cholesterol within the prostate, inhibit prostate growth and reduce inflammation. Daily dosage: 100 mg to 200 mg of a standardized extract (usually 14% triterpenes). 

Rye pollen extract, known as rye grass flower pollen, rye grass, flower pollen extract or Cernilton, can significantly improve LUTS, according to a study published in ­Clinical Therapeutics and, for some men, decrease prostate volume when taken along with saw palmetto, beta-sitosterol and vitamin E. Daily dosage: 126 mg three times daily. 

Saw palmetto. A study found that 90% of men noticed an improvement in mild-to-moderate urinary symptoms of BPH within four to six weeks of starting saw palmetto in a formulation containing 80% or higher fatty acids and sterols. Daily dosage: 320 mg.

Stinging nettle (Urtica dioica) is helpful in treating BPH and urinary tract infections. Daily dosage: 120 mg to 600 mg.

For overall bladder health: I like Urox, which is a combination of concentrated extracts of Crateva nurvala stem bark, Equisetum arvense (horsetail) stem and Lindera aggregata root. It improves urinary symptoms in up to 85% of users, with 60% experiencing a reduction in urinary incontinence. It can be life-changing for any man who has more than mild urinary problems. 

Important: Do not self-treat. See your doctor to diagnose urination problems. Then review these options with him/her to determine your best protocol. 

Relieve Chronic Pelvic Pain Syndrome (CPPS)

Men with CPPS have long-standing pain throughout the pelvic area, including in the groin, lower abdomen, genitals ­ (especially the tip and the testicles), perineum, rectum and lower back, as well as pain or burning during ejaculation and/or urination—without any obvious
underlying cause. CPPS often goes with prostate problems, such as prostatitis (inflammation of the prostate). 

Treating CPPS includes the same diet changes suggested on page five. Helpful: Psyllium fiber and water promote bowel movements so there’s less bladder and pelvic pressure from the intestines and colon…and chamomile tea is anti-­inflammatory. Keep a food diary to track which foods worsen your symptoms…drink 50 ounces or more of purified water daily.

Some supplements that help BPH also can relieve pelvic pain, such as rye pollen and saw palmetto, especially in combination with selenium, lycopene and quercetin (a flavonoid found in onions, kale, broccoli, apples, berries and scallions). In one study, men who took 500-mg quercetin supplements twice a day had significant symptom improvement compared with those given a ­placebo. A follow-up study found that the enzymes bromelain and papain enhance the body’s absorption of quercetin—combination supplements are available. 

Working with an osteopathic physician, chiropractor, acupuncturist and/or physical therapist may help, too. Tight muscles and nerve inflammation can be root causes of CPPS. Pelvic floor–strengthening exercises, in particular, may ease pelvic pain.   

Testosterone and Your Prostate

Many men with prostate problems also have deficiencies or imbalances in testosterone and other male-related hormones. Levels of hormones such as estrogen and ­dihydrotestosterone may be too high, contributing to BPH and even prostate cancer. 

Symptoms of low testosterone, such as fatigue and loss of muscle mass, can be related to several medical conditions, so make sure you’re not missing a serious underlying cause. Ask your doctor for comprehensive hormone testing, including free testosterone, luteinizing hormone (LH), prolactin, estradiol, cortisol, DHEA, pregnenolone, IGF-1 (a marker that reflects growth hormone activity) and sex ­hormone–binding globulin (SHBG). Also important is testing for key nutritional deficiencies—ferritin to measure iron stores, zinc, magnesium and vitamins D and B-12. These all are blood tests.

A low-testosterone diagnosis is made when results from two separate tests show total or free testosterone levels below the reference range for your age. Though some men may require testosterone replacement, it’s possible to get levels into the normal range with other treatments as long as there aren’t medical reasons behind the deficiency that need to be addressed.  

A healthy diet, good sleep and regular exercise all help to balance hormone levels withoust supplemental testosterone. If these aren’t effective after three months, then consider using the supplements below or testosterone replacement with a knowledgeable doctor. 

Two herbal extracts are particularly helpful. Younger men up to age 55 may use these for three months along with diet and exercise and then may not need to continue. Men over age 55 often need to use these indefinitely. 

Ashwagandha (Withania somnifera) helps rebalance hormones, increasing testosterone and decreasing the stress hormone cortisol. Daily dosage: 600 mg to 675 mg of a standardized extract. 

Eurycoma longifolia, also known as tongkat ali or Malaysian ginseng, can increase libido and stimulate testosterone production. Daily dosage: 200 mg to 400 mg in extract form. 

Be sure to get enough zinc (25 mg to 50 mg daily), vitamin D (2,000 IU to 5,000 IU daily) and magnesium (250 mg to 500 mg daily) as well.