The following information is a summary of materials featured in the “Men’s Health” Whole Health overview. It is meant to be a quick reference for use at the point of care. For more details and list of helpful references, refer to the overview.
Benign prostatic hypertrophy/hyperplasia (BPH) is one of the most common diseases faced by adult men. The most common presenting symptoms associated with BPH are frequent urination and increasing nocturia. By 80 years old up to 80% of men suffer from BPH. About one in two men will experience prostatitis in their lifetime. Men are more at risk of developing BPH if they are overweight, have a metabolic syndrome-related disorder such as type 2 diabetes, high-fasting triglycerides and low HDL cholesterol, and/or hypertension. The severity of lower urinary tract symptoms (LUTS) can be assessed using the self-administered International Prostate Symptom Score (IPSS). It is a well-validated tool for assessing response to treatment as well.
Listed below are some important tips for helping a man maintain or improve his prostate health in BPH. For more on prostatitis and prostate cancer, refer to the “Men’s Health” Whole Health overview.
Maintain an Ideal Body Weight
This is probably the most important thing a man can do. As belly fat increases, there is an increase in activity of the enzyme “aromatase” which converts testosterone in adipose tissue into estrogen. Men with a body mass index (BMI) of greater than 35 have 3.5 times the risk of developing BPH compared to men with a BMI less than 25.
Metabolic syndrome increases the risk of men having a PSA greater than 1.6 ng/mL, high post-void residual and decreased urinary max flow rate. These are all objective findings that have been linked to the progression of BPH.
Higher levels of physical activity decrease the risk of BPH. It also helps prevent common diseases such as heart disease and cancer.
Xenobiotics are compounds from the environment that mimic the body’s hormones. Bisphenol A (BPA) found in plastics has been found consistently to cause prostatic hyperplasia in animal models. Do not microwave food in plastic containers. Avoid plastic containers with the numbers 3, 6, or 7 engraved in the triangle on the product. Buy BPA-free water containers or use stainless steel. Drinking water out of containers with the numbers 2, 4, 5, or 7 (PLA- made from corn husks) is okay. Don’t drink out of Styrofoam containers.
Foods to avoid
- Excessive sugar
- Excessive caffeine
- Red meat and other sources of animal fat
- Excessive dairy products
- Food dyes
- Processed foods
Foods to include:
- Green tea
- Multicolored fruits and vegetables
- Nuts (particularly Brazil nuts which are rich in selenium – two a day is plenty)
- Fiber (covered by eating fruits and vegetables)
- Ground flax seed (1 tablespoon a day)
- Soy products (soy milk instead of cow’s milk)
Consider Dietary Supplements, As Appropriate
Note: Please refer to the Passport to Whole Health, Chapter 15 on Dietary Supplements for more information about how to determine whether or not a specific supplement is appropriate for a given individual. Supplements are not regulated with the same degree of oversight as medications, and it is important that clinicians keep this in mind. Products vary greatly in terms of accuracy of labeling, presence of adulterants, and the legitimacy of claims made by the manufacturer.
- Saw palmetto: 160 mcg-320 mcg two times a day.
- Pygeum: 50-100 mcg two times a day
- Beta-sitosterol: 60-135 mcg daily. It can take four weeks for effects to become apparent.
- Zinc: 25-50 mcg daily. This may help with prostatitis as well.
- Epigallocatechin-3-gallate (EGCG, component of green tea): 200 mcg three times a day in the form of mixed catechins.
- A combination product (like Prostate Eze Max may also be useful): 1 capsule daily. This combines pumpkins seed oil, Pygeum, Saw palmetto, lycopene, and fireweed.
In severe cases that do not respond to the options above or to prescription drugs, consider a referral to a urologist to discuss surgical options.
“Prostate Health” was written by Robert Z. Edwards, MD (2014, updated 2020).
This Whole Health tool was made possible through a collaborative effort between the University of Wisconsin Integrative Health Program, VA Office of Patient Centered Care and Cultural Transformation, and Pacific Institute for Research and Evaluation.