Prostate enlargement is one of those conditions that most men will ultimately endure. Similar to back pain statistics, a very high number of men will experience prostate symptoms at a given moment of their lives.
These symptoms are more common as we age. Around 90% of men have an enlarged prostate by age 85 years, but not all have symptoms. This growth is usually due to a benign condition known as benign prostate hyperplasia (BPH).
If such a high number of patients experience changes in their prostate gland, is there a way to stay healthy? Is there a way to improve the quality of life if you are already experiencing symptoms?
In this article, we’re covering the basics and answering the question “what is BPH?”. Then, we’re giving you 12 simple recommendations to cope with an enlarged prostate.
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What is BPH?
Benign prostatic hyperplasia or BPH is the most common type of prostate enlargement. It features changes in the prostate tissue characterized by an increase in the number of cells. It is different from benign prostatic hypertrophy, a term we would use when the cells increase their size and not their numbers.
BPH is a common disease in males, but not all of them develop signs and symptoms. It is not the same as cancer and does not increase your risk of cancer-both BPH and prostate cancer risk increase as we age. Thus, the correlation between BPH and prostate cancer we usually see is not because BPH leads to cancer. It is because both conditions have similar risk factors, but they are separate entities.
In symptomatic benign prostatic hyperplasia, lower urinary tract symptoms are prevalent. In some cases, it leads to chronic bladder outlet obstruction. In these cases, the consequences of BPH can be more dramatic. However, in most cases, the disease affects the quality of life without putting lives at risk (1).
The signs and symptoms of BPH usually have to do with the urinary system. However, not all patients with BPH have symptoms. The asymptomatic disease is more common in the early stages of the disease.
They usually start after the prostate gland grows very large, pressing on the urinary tract. Thus, the incidence of symptomatic BPH increases as the patient ages and his prostate grows larger. Even so, the symptoms are usually insidious. They show up very slowly, and patients may even get used to them as they become more severe.
The most common symptoms are as follows (1):
- Frequent urination: It is prevalent at night, and patients wake up several times to urinate. This is known as nocturia.
- Urinary urgency: It is a sudden need to urinate, reported as very urgent and difficult to restrain.
- Urge incontinence: On the same line, patients with urinary urgency sometimes have some degree of incontinence. They may experience urine leaks when they don’t reach the bathroom on time.
- Slow urinary stream: The urinary stream speed and caliber are compromised. Patients take longer to void and often feel they have not emptied their bladder.
- Intermittency and hesitancy: Intermittency is an interrupted urinary flow. Patients stop urinating and push again to achieve a complete voiding. Hesitancy is the need to push harder to start urinating.
- Urinary retention: In some cases, patients with severe hesitancy end up with urinary retention. Acute urinary retention can lead to a medical emergency with a risk of kidney damage.
- Post micturition and terminal dribble: Patients experience dribbling as they finish voiding (terminal dribble). When they stop urinating, they sometimes keep on dribbling urine without noticing (post-micturition dribble).
- Other symptoms: Depending on the cause of the prostate enlargement, patients may experience additional symptoms. For example, patients with advanced cancer may report blood in the semen. Those who underwent transurethral resection due to a large prostate volume may experience temporary erectile dysfunction.
12 Tips’ for coping with an enlarged prostate
The symptoms depicted above are sometimes very severe and compromise the patient’s quality of life. If that’s your case, what can you do to cope with an enlarged prostate? Here’s a list of 12 tips and recommendations to manage your symptoms:
Studies show an association between symptoms of BPH and mental health. Patients with high anxiety levels, depression, and a higher vulnerability to stress have more severe symptoms. We can use this association to our favor if we reduce our levels of stress. It can be an indirect way to reduce the severity of the urinary symptoms (2).
Reducing our stress levels can sometimes be challenging if we don’t know-how. Thus, it is essential to organize your work, stop procrastination, and other useless habits. Other sources of stress are more difficult to handle or avoid. In those cases, we recommend mindfulness techniques to destress. Practice deep breathing, visualization, meditation, and other methods to manage stress levels.
Physical activity is also an excellent way to manage stress. It is known that exercise releases endorphins and improves our mood. It can be a useful way to destress, too. Additionally, increasing your physical activity may have more direct effects on your symptoms. Men who exercise more often usually have a lower risk of severe BPH symptoms.
For example, a recent study showed that physical activity reduces nocturia incidence, one of the most common symptoms in BPH. Men with low levels of physical activity can benefit from exercise and reduce their symptoms. The severity of the disease and the progression are not altered, but it does affect the quality of life (3).
If you are not used to exercising, start gradually with light exercises and a short time. Go on increasing your physical activity levels as time goes by and according to your mobility. The minimum of physical activity you should aim for is 30 minutes of moderate exercise 5 times a week.
3) Bladder training
This technique is beneficial in patients with advanced BPH and incontinence. If this is your case, you’re probably experiencing something called overflow incontinence. It is basically a rapid fill of a partially emptied bladder. The bladder can take no more pressure, and you feel an urgent need for voiding. In these cases, bladder training can be useful to get to know your own voiding timings.
Use a notebook to write a voiding diary and measure how much it takes before you feel the urge of urinating. When you’re at home or in a controlled setting, train your bladder to resist more time. Keep on writing your voiding diary as you do, and try to increase the time between one voiding and the next. This type of re-training exercise has had good results in patients with incontinence problems. It is sometimes the first-line treatment without any additional measure to improve the symptoms (4).
4) Monitor fluid intake
Along with bladder training, it is also important to monitor your fluid intake. You can input this data in your voiding diary to make it more thorough. Taking more fluids will naturally increase your urinary output.
However, you should not restrain from drinking enough liquids every day. In most cases, aiming for 2 liters of water is enough and does the job of hydrating the body. Other fluids can also be taken, but drinking only water is vital for your urinary health.
Monitoring your fluid intake will be useful to know your urinary frequency at a given fluid volume. This data will be helpful to provide follow-up to your own symptoms and become aware of any change. As noted above, some patients with BPH get used to urinary symptoms. They are not aware of their progression. But this recommendation gives you more insight into your urinary function and any change that may come in time.
5) Remove bladder irritants
Some foods and drinks worsen the urinary symptoms of BPH. They can either irritate the urinary bladder or increase the urine output acting as diuretics. Spicy foods can cause urge incontinence. The same happens with citrus fruits because they have an acid pH. Another food you should avoid is chocolate because it has caffeine. Other natural diuretics include alcohol, tea, and coffee. You should avoid them as much as possible.
Following this simple dietary advice may improve your urinary symptoms significantly. It mainly works to reduce the frequency of urination and the incidence of nocturia. It is also useful to prevent stress incontinence. If you already have incontinence problems, this modification will reduce your symptoms’ severity (5).
6) Practice yoga
Yoga has different poses and exercises. Some of them can be very useful to help patients control their urinary symptoms. Some studies have evaluated the effect of a posture named Kshaitij Muladhara Chakra Asana. They showed that this pose is particularly useful for prostate health. It normalizes the blood circulation to the prostate tissue.
It apparently improves the metabolism of the gland and controls prostate growth. All of this contributes to reducing the severity of the disease. In some cases, patients report regression or an improvement of the urinary flow (6).
Additionally, yoga practice can be particularly useful to strengthen the pelvic floor muscles. These muscles are helpful for urinary function and control micturition. By strengthening the pelvic floor, there’s a reduced incidence of incontinence in men. They experience fewer symptoms with reduced intensity.
7) Eliminate dairy
Patients with BPH are recommended to reduce their intake of saturated fats. This macromolecule stimulates a chemical pathway associated with inflammation. In the prostate, saturated fats cause an invasion of inflammatory blood cells. This contributes to BPH and increases the patient’s PSA levels. Thus, it is recommended to adopt a low-fat and high-fiber diet based on plant foods (fruits, vegetables, and whole grains) (7).
Dairy has a very high level of saturated fats, and it is not recommended in the diet of a BPH patient. As an alternative, you can use fat-free dairy, but try to avoid this type of food as much as possible.
8) Eat more fruits and vegetables.
What we decide to eat has a significant burden on our prostate health. Fruits and vegetables are known to reduce the risk of BPH and its symptoms. It is not an absolute cure, but it does help to regain our quality of life. The key to dietary changes in prostate health has to do with inflammation. More inflammation in the body increases the inflammation of the bladder and the prostate. So, an anti-inflammatory diet can be beneficial to manage your symptoms.
Fruits and vegetables have a variety of polyphenols and other anti-inflammatory substances. Berries, broccoli, onions, garlic, and other fresh foods for a healthy prostate have a potent antioxidant and anti-inflammatory effect. Eating this type of food and increasing our fiber intake can thus reduce our urinary symptoms. It also relieves constipation, a condition that worsens urinary symptoms in BPH (7).
9) Maintain a healthy weight
Obesity mediates several mechanisms to increase the risk of BPH and worsen its symptoms. It increases the abdominal pressure, working against the bladder and reducing its volume capacity. It causes alterations in the endocrine status, including insulin and testosterone levels. This leads to an increase in the risk of hyperplasia and prostate cancer.
It also increases the activity of the sympathetic nervous system. This is particularly relevant for urinary function and contributes to urinary retention. It is also associated with a sustained increase of inflammation and a higher level of oxidative stress. All of this favors BPH.
By maintaining our weight at healthy levels, we control all of these mechanisms at the same time. That’s why obesity is associated with a higher incidence of prostate enlargement issues. It is also why weight loss in obese patients is associated with a better prognosis and significant improvements in the patient’s urinary symptoms (8).
10) Plan travel
Patients with prostate disease and advanced urinary symptoms may start thinking twice before going out. They do not want to be caught in embarrassing situations when they need to use the bathroom, and it is not available.
If they suffer from incontinence, they often feel afraid about their symptoms and social implications. But adopting avoidance behaviors can only worsen their quality of life.
Instead of avoiding situations, you can make a smart move and manage your symptoms. If you are traveling, plan ahead for the gas stop, take absorbent pads with you, and a change of underwear just in case. Be prepared for any accident and emotionally ready to overcome the challenge.
Talk ahead to any other companion or member of your family, and don’t feel ashamed about it. Remember that most men will ultimately have prostatic enlargement, and there’s no reason to judge.
11) Review your medication with your doctor
Some drugs are not very helpful if you want to control your urinary symptoms. The clearest example is diuretics, which increase your urinary output. They overwhelm the urinary bladder and sometimes leads to incontinence problems.
Calcium-channel blockers and antidepressants worsen urinary retention and give rise to overflow incontinence. Similarly, alpha-adrenergic agonists act on the autonomous nervous system and worsen urinary retention symptoms. The opposite is also true because alpha antagonists sometimes cause excessive relaxation and incontinence problems.
It is sometimes difficult to manage this issue, especially in elderly patients with chronic disease. They have multiple health problems and medications to keep them at bay. Thus, it is sometimes difficult to find suitable alternatives.
Talk to your doctor if you think your medication is contributing to your symptoms. Do not suspend any medication before getting a professional opinion from your healthcare provider (9).
12) Natural supplements and remedies for enlarged prostate
A variety of natural remedies for enlarged prostate can also provide relief from urinary symptoms. They could sometimes slow down the progression of BPH, too. In some cases, we can consume them from natural sources. In other cases, they are only available as extracts and supplements.
Some have anti-inflammatory potential, while others have an antioxidant effect. Some of them act directly on the prostate gland, while others have an indirect action by modulating our metabolism and hormones.
The best natural supplements for BPH symptoms include:
Symptomatic BPH causes bothersome symptoms, usually associated with urinary function. They are similar to those found in urinary tract infections or an overactive bladder.
Patients with mild and moderate symptoms generally continue living without much of a problem. But the disease keeps progressing, and the symptoms ultimately affect their quality of life as the prostate size increases and the prostatic urethra becomes affected.
However, we can manage our symptoms by eating a healthy diet, reducing our stress levels, practicing mindfulness techniques and yoga, and maintaining a healthy weight. It might be advantageous to keep a voiding diary, log your liquid intake, and engage in bladder training. All of these techniques can be combined with natural remedies for enlarged prostate and a review of the patient’s medications.
Still, in some cases, BPH medications such as finasteride or tamsulosin may be required. Some patients may also be candidates for a prostatic urethral lift. Each case should be evaluated independently. Thus, talk to your doctor if you’re experiencing urinary symptoms and follow his recommendations.