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Enlarged Prostate: BPH Treatment Methods

Dr. Lisa Lawless

Dr. Lisa Lawless, CEO of Holistic Wisdom
Clinical Psychotherapist: Relationship & Sexual Health Expert

Enlarged Prostate

The swelling of the prostate (prostatic hyperplasia / BPH) is a condition that affects as many as 80% of men over the age of fifty. The prostate is typically the size of a walnut, but it can get as large as a grapefruit when it swells, which, as you can imagine, becomes quite uncomfortable.

In addition to discomfort caused by the swelling, it also causes difficulty with urination as the enlarged prostate presses up against the urethra (where your urine comes out). It can weaken and even block the urine stream, making one feel the need to urinate more frequently and urgently. It is important to note that this can also lead to urinary tract infection and bladder infections.

Male Reproductive System Diagram

The Difference Between BPH & Prostatitis

One of the differences between the two is age-related as prostatitis is more likely to affect men ages 50 or younger and BPH in men over age 50.

Prostatitis is an inflammation of the prostate and can be caused by an injury or bacteria that got into the prostate from urine or during sex. Symptoms include pain in the groin, painful orgasms, fever, penile discharge, pain during urination, and frequent urination.

Prostatitis Diagram

BPH is simply an enlarged prostate and is more common as men age. It enlarges and then blocks the urethra, making it hard to urinate. Symptoms include a frequent need to urinate, especially at night, difficulty starting to urinate, weak urine stream, incontinence, and pain during urination.

Enlarged Prostate: BPH Diagram

The Difference Between BPH & Prostate Cancer

It is important to note that although some of the signs of an enlarged prostate (BPH) and prostate cancer are the same, having BPH does not seem to increase prostate cancer chances. Nevertheless, a man who has BPH may have undetected prostate cancer at the same time or may develop prostate cancer in the future.

For this reason, the National Cancer Institute and the American Cancer Society recommend that all men over 40 have a rectal exam once a year to screen for prostate cancer. After BPH surgery, the tissue removed is routinely checked for hidden cancer cells. In about 1 out of 10 cases, some cancer tissue is found, but often it is limited to a few cells of a nonaggressive type of cancer, and no treatment is needed.

Foods For An Enlarged Prostate

Studies clearly show that a diet that is low in phytochemicals creates poor health. Specifically, a study focused on urology showed that men who consumed large quantities of refined carbohydrates and meat increased the risk of having a swollen prostate.

A healthy diet is one of the best ways that you can prevent and treat a swollen prostate, and foods that are particularly good at relieving a swollen prostate are

BPH & Green Leafy Vegetables

One of the most nutrient-rich superfoods is green leafy vegetables such as kale, chard, and spinach. These are important as they are very high in antioxidants, which in turn help prevent disease. Cruciferous vegetables improve prostate health as well as overall health. Having dark leafy greens in a smoothie daily is a great way to help you easily get your daily recommended dose. Examples of cruciferous vegetables are:

  • Arugula
  • Bok choy
  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Chinese cabbage
  • Collard greens
  • Daikon radish
  • Horseradish
  • Kale
  • Mustard greens
  • Radish
  • Rutabaga
  • Turnip
  • Watercress
  • Onions & Garlic

According to research done in the field of Urology, onions and garlic have been shown to reduce prostate swelling and strengthen the immune system. Onions and garlic are rich in compounds called alliums, which slow down aging and promote a healthy prostate and prevent cancer. Scientists have indicated that men should eat a combination of 10 grams of garlic, onions, leeks, or shallots each day for the best protection.

BPH & Foods High In Zinc

Foods rich in zinc are an essential mineral for prostate health, as verified in the Indian Journal of Urology. It was found that those men who had swollen prostates or prostate cancer often had a zinc deficiency and were 75% lower in zinc when compared with those who did not have prostate issues. Zinc is easier to absorb when consumed through food than when taking a zinc supplement, so enjoy foods high in zinc such as cocoa, spinach, wheat germ, mushrooms, cashew sesame seeds, oysters, beans, pumpkin seeds, and almonds.

BPH & Foods High In Omega-3

Eating healthy omega-3 fatty acids is key for your health and can aid in a healthy prostate. In fact, according to a study published in the Alternative Medicine Review, an omega-3 deficiency may lead to prostate problems. The best sources of omega-3 fatty acids are found in wild salmon, mackerel, sardines, anchovies, rainbow trout, albacore tuna, oysters, walnuts, oatmeal, soy milk, ground flax seeds, Brussels sprouts, kale, mint, parsley, spinach, winter squash, watercress and kidney, pinto, mung beans and more.

BPH & Foods High In Lycopene

Lycopene helps lower your risk of prostate cancer and, according to the National Cancer Institute, helps reduce the swelling of your prostate. Lycopene helps to lower antigens found in the blood, which are connected to prostate inflammation and BPH. You can get helpful carotenoids in your food from those high in Lycopene such as tomatoes, guavas, grapefruit, sweet red peppers, asparagus, red (purple) cabbage, mango, carrots, watermelon, apricots, pink grapefruit, and papaya.

BPH & Foods High in Beta-sitosterol

The Cochrane Database of Systematic Reviews has shown that foods high in beta-sitosterol can significantly reduce symptoms associated with a swollen prostate (BPH). Men who consume high amounts of food with beta-sitosterol or take supplements have shown to have better urinary flow and less residual urine volume in their bladder. Beta-sitosterol helps to strengthen the immune system and can reduce inflammation and pain. Foods rich in beta-sitosterol include avocados, pumpkin seeds, fava beans, wheat germ, soybeans, pecans, and dark chocolate.

BPH & Soy

According to a study published in The Journal of Urology, Asian men have a lower risk of developing BPH than Western men. It is thought that the higher consumption of soy and less consumption of red meat among Asian men is the reason. Healthy sources of soy are found in non-GMO sources of soy yogurt, soy milk, tempeh, soybeans, and meat substitutes made with soy. Read more about soy.

BPH & Foods High In Vitamin C

The Mayo Clinic found that vitamin C obtained from vegetables (not supplements) lowers your enlarged prostate risk. One of the best sources for vitamin C in food is through bell peppers, which offer more vitamin C than other vegetables. Just one cup of red bell peppers offers 195% of your daily intake of vitamin C. Other vegetables high in vitamin C are - chili peppers, green bell peppers, broccoli, cauliflower, papaya, kale, strawberries, pineapple, kiwi, mango, oranges, and Brussels sprouts.

Additional Nutrition Information

An excellent resource for those looking to improve their nutritional health is found in a book called "Super Immunity," by Dr. Joel Fuhrman, which includes healthy recipes. In addition, you can explore the latest in nutrition research delivered in easy to understand videos, blog posts, and podcasts on brought to you by Dr. Michael Greger M.D.

Also see our article about Nutrition Guide for Good Sex & Health

Herbs For An Enlarged Prostate

Saw Palmetto

Saw palmetto is taken in the form of an extract made from the fruit of a plant known as Serenoa repens. It contains rich fatty acids and phytosterols, which have been incredibly effective in treating a swollen prostate. Saw urologists often recommend palmetto as studies have shown that it provides prostate swelling relief in one in three men who take it. It is significant due to its chemical makeup, which is similar to the prescription drug for prostate swelling called Proscar (this drug blocks the production of hormones that cause the swelling).

Some men experience side-effects from saw palmetto, one of which can be gastrointestinal upset and is why it should be taken with food. Another side effect of saw palmetto is that it may increase the chance of bleeding or impact your hormones. Men with known heart conditions will want to review what dosage should they decide to take with a physician as it can affect cholesterol levels. Most physicians recommend taking about 320 milligrams twice a day with a waiting time of about four to six weeks for results for typical dosing of saw palmetto.

On an interesting note, it is more common for balding men to experience swelling of the prostate as well as prostate cancer, and saw some had suggested palmetto extract as a potential herbal option for men who are losing their hair. Studies related to this pattern show that men who have lost some or all of their hair have a 69% greater risk of developing prostate cancer. Even more alarming is the pattern that the younger a man is when he loses his hair (especially at the front of his head) are six times more likely to receive a diagnosis of advanced prostate cancer by the time they reach the age of sixty.

Please remember that it is crucial to research whether an herbal remedy is right for you by exploring if it will have side effects or interfere with medications you are already taking. Any herb is a drug, and some can have quite powerful impacts on the body and is why we recommend reviewing your herbal and vitamin supplements with your physician and pharmacist before using them.

Pygeum Bark

Pygeum is an evergreen tree found in the higher elevations of central and southern Africa and is also known as pygeum africanum. The bark is often used for prostate swelling, and while it is typically safe for most people to use, some side effects include nausea and abdominal pain.

Historically, the powdered bark was used in tea to relieve urinary disorders, and today it continues to be used for symptoms such as decreased urine flow. European scientists developed the modern fat-soluble extract that is used today as results have been quite positive. Most physicians, when they recommend, pygeum recommend 50-100 mg twice a day.

Rye Grass Pollen Extract

Ryegrass pollen extract, which is made from three types of grass pollen: corn, timothy, and rye, and men who took this extract showed improvement in their swollen prostate symptoms compared to those taking a placebo. It has been shown to help men urinate more fully and less frequently.

Stinging Nettle

Nettle root has been found to reduce BPH symptoms and is widely used in Europe, often combined with other herbs such as pygeum or saw palmetto. Stinging nettle is used in various forms, such as teas, tinctures, breams, and extracts. The most popular form prescribed by physicians is the freeze-dried leaf capsules. Be aware that some side effects from nettle are a mild upset stomach and skin rash and may lower blood pressure, among other things, so be sure to research if this herb is right for you.

Prostate Massage

Gentle prostate massage may be helpful in some cases. However, it is essential to discuss this with your physician before you perform prostate massage. Prostate massage using fingers or prostate massagers can help drain the prostate, creating less swelling and reducing symptoms such as discomfort and difficulty urinating. It can also ease tension, especially within the nerve endings of the prostate.

Prostate Massage Diagram

However, please note that if you do prostate massage for those men with an infection such as prostatitis, you may inadvertently be releasing harmful bacteria into your system, causing septicemia (blood poisoning). That is why it is always a good idea to discuss if prostate massage is right for you based on your health and medical condition.

Read More About How to do Prostate Massage.

Why You Need To See A Physician

In most cases, symptoms such as the ones provided in this article are typically a simple swelling of the prostate; however, it can also be prostate cancer, and a physician should rule this out. It is also a good idea to have your urine tested to see if you have an infection caused by the urine backing up in the urethra and bladder, leading to urinary tract infections (UTIs).

See our article on Holistic UTI Remedies for more information.

Several tests will help your physician identify the problem and decide if surgery is needed. Below are the most common tests that are done to discern this:

Digital Rectal Exam (DRE)

This exam is typically done before any others. Your doctor will insert his gloved finger into the rectum to feel the prostate to determine its size and its condition.

Digital Rectal Exam, DRE Diagram

Prostate-Specific Antigen (PSA)

The next test that is typically done is a blood test that will rule out cancer. Your physician will be evaluating your PSA levels, which are proteins that are produced by your prostate. Men who have cancer will have elevated PSA levels.

Rectal Ultrasound

If there is a suspicion of prostate cancer, your doctor may recommend a rectal ultrasound. This is when the physician will insert a probe into the rectum to evaluate it using sound waves. The sound waves' echo patterns form an image of the prostate gland, allowing a clearer picture of its condition.

Urine Flow Study

Sometimes the doctor will ask a patient to urinate into a special device that measures how quickly the urine is flowing. A reduced flow often suggests a swollen prostate and possibly cancer. Again, it is essential to note that 8 out of 10 men with such symptoms do not have cancer.


In this test, a small tube (cystoscope) is placed into the urethra opening in the penis after being numbed to prevent discomfort. This device allows your physician to see the inside of the urethra and bladder to determine what is causing the obstruction.

BPH Prescription Treatment Options

Over the years, researchers have tried to find a way to shrink or at least stop the prostate's growth without using surgery. The Food and Drug Administration (FDA) has approved several drugs to relieve common symptoms associated with an enlarged prostate.

  • Finasteride, FDA-approved in 1992 (marketed under the name Proscar)
  • Dutasteride, FDA-approved in 2001 (marketed as Avodart)
  • Terazosin (marketed as Hytrin) in 1993
  • Doxazosin (marketed as Cardura) in 1995
  • Tamsulosin (marketed as Flomax) in 1997
  • Alfuzosin (marketed as Uroxatral) in 2003

The drugs act by relaxing the smooth muscle of the prostate and bladder neck to improve urine flow and reduce bladder outlet obstruction.

BPH Minimally Invasive Therapy

As not all herbal and prescription drug treatments are effective, some other options may be explored for a swollen prostate:

Transurethral Microwave Procedures

This device uses microwaves to heat and removes excess tissue found in the prostate.

Targis System

This treatment also uses microwaves to destroy unwanted parts of the prostate, and while it does not cure prostate swelling, it can reduce symptoms.

Transurethral Needle Ablation

This treatment uses a low-level radio frequency to burn away the tissue of the prostate and has been reported to have fewer side effects that Transurethral resection procedures.

Surgical Treatment

For chronic swelling of the prostate, some doctors recommend surgery to remove part of the prostate. Below are examples of the types of surgery performed for chronically swollen prostate:

Transurethral Surgery

An instrument called a resectoscope is inserted into the urethra, which has an electrical component that cuts the prostate, where it puts pressure on the urethra to prevent urinary symptoms and infections. It also is then able to seal blood vessels, and any loose pieces of tissue are then passed into the bladder and then flushed out at the end of the operation. This can also be done using a laser. Transurethral procedures such as this take about 90 minutes and are less invasive as well as require shorter recovery times.

Open Surgery

In a rare situation, when a transurethral surgery cannot be performed, such as when the prostate gland is severely enlarged, or damage to the bladder has occurred; a surgeon can also perform open surgery. There are three types of open surgery for these conditions, and which type depends on the damage that needs to be repaired.

Prostate Swelling & Sexual Function

After surgery, many men worry about whether surgery for BPH will affect their ability to enjoy sex. Some sources state that sexual function is rarely affected, while others claim that it can cause up to 30 percent of all cases. However, most doctors say that even though it takes a while for sexual function to return fully, most men can enjoy sex again with time.

Complete recovery of sexual function may take up to 1 year, lagging behind a person's general recovery. The exact length of time depends on how long after symptoms appeared that BPH surgery was done and the type of surgery. Following is a summary of how surgery is likely to affect the following aspects of sexual function.


Most doctors agree that if you could maintain an erection shortly before surgery, you would probably have erections afterward. Surgery rarely causes a loss of erectile function. However, surgery cannot usually restore function that was lost before the operation.


Although most men can continue having erections after surgery, a prostatectomy frequently makes them sterile (unable to father children) by causing a condition called "retrograde ejaculation" or "dry climax." During sexual activity, sperm from the testes enters the urethra near the opening of the bladder. Normally, a muscle blocks off the bladder entrance, and the semen is expelled through the penis. However, the coring action of prostate surgery cuts this muscle as it widens the bladder's neck.

Following surgery, the semen takes the least resistance path and enters the wider opening to the bladder rather than being expelled through the penis. Later it is harmlessly flushed out with urine. This condition can be treated with a pseudoephedrine drug, found in many cold medicines, or imipramine. These drugs improve muscle tone at the bladder neck and keep semen from entering the bladder.


Most men find little or no difference in the sensation of orgasm, or sexual climax, before and after surgery. Although it may take some time to get used to retrograde ejaculation, you should eventually find sex as pleasurable after surgery. Many people have found that sexual function concerns can interfere with sex as much as the operation itself. Understanding the surgical procedure and talking over any doctor's worries before surgery often helps men regain sexual function earlier. Many men also find it helpful to talk to a counselor during the adjustment period after surgery.

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