The prostate gland is a walnut-sized gland in men located just behind the bladder. The prostate’s primary function is to produce seminal fluid that nourishes and transports sperm. As men age, their risk for prostate issues increases, which can lead to difficulty peeing, erectile dysfunction, incomplete bladder emptying, and waking up during the night to have to go to the bathroom. Prostate cancer risk also increases as men age. This blog discusses the two most common prostate problems—benign prostatic hyperplasia (BPH) and prostate cancer—to help men understand the warning signs and their options.

BPH

BPH is a non-cancerous enlargement of the prostate gland. The risk of getting BPH increases with age. It’s been estimated that 8% of men aged 31 to 40 years old and 50% of men aged 51 to 60 years old have BPH. The risk continues increasing with each decade of life until approximately 80% of men aged 81 to 90 years old have BPH.¹ 

Symptoms of an enlarged prostate include difficulty starting urination (urinary hesitancy), a weak urinary stream, waking up at night to pee (nocturia), weak arousal, and urine dribbling out after he urinates because of incomplete bladder emptying. 

While waking up at night pee could point to BPH as the culprit, and you should discuss this with your doctor, many people simply drink too much liquid too late in the day. They have to then get up one or more times during the night to empty their bladder. Stopping all liquids in the early evening or late afternoon might improve the nocturia and your sleep.

Medications for BPH

The main medical treatments for BPH include two categories of drugs, the alpha-blockers, and the 5-alpha-reductase inhibitors. Alpha-blockers include tamsulosin (Flomax), doxazosin, and alfuzosin. The 5-alpha-reductase inhibitors include finasteride (Propecia, Proscar), which can relieve symptoms only after 6–9 months of use. 

In 57% of patients taking Finasteride and 68% on alpha-blockers, medications can decrease symptoms.² But the drugs can also decrease sexual function, most commonly a man’s ability to have or maintain erections, and cause abnormal ejaculations. Up to 30% of patients taking tamsulosin (Flomax) long-term experience abnormal ejaculations.³ Studies on 5-alpha-reductase inhibitors report sexual dysfunctions in up to 38% of men, including difficulty getting and maintaining an erection, decreased interest in sex, and problems with ejaculation. If you’re willing to tolerate these sexual side effects, most seem to diminish in two to four years, but some have been reported after five years of use.⁴

I’ve never talked to a man who was OK with the side effects. If they absolutely had to use the medications to treat the symptoms then they’d probably do it, but fortunately, there are some natural approaches to promoting prostate health that has been shown in clinical trials to significantly improve symptoms. It’s important to recognize, however, that dietary supplements are not approved by the FDA and are not intended to diagnose, prevent, cure or treat disease. However, nutrients in dietary supplements have been shown to powerfully promote prostate health.

You can purchase dietary supplements that have just one ingredient, or you can purchase formulas that combine multiple ingredients. Regardless of which you choose, make sure the product contains the exact nutrient and dose used in the clinical trials and discuss the dietary supplement with your healthcare provider before taking it. 

Saw Palmetto for prostate health

Saw palmetto (Serenoa repens) is indigenous to Florida, was first used by white settlers in the United States for lower urinary tract health, unsatisfactory arousal, to improve testicular health, promote healthy sperm production and as a genitourinary and sexual stimulant.⁵ It is one of my favorite plants for supporting prostate health in men. More than 30 controlled clinical trials have investigated the use of saw palmetto in men with BPH, which generally consisted of taking 320 mg berry extract per day.⁶

Compared with placebo, the studies demonstrate good benefits of long-term saw palmetto use. An open-label clinical trial of 82 men (average age 57 years old) with symptomatic BPH were enrolled in a 9-week study. They took 320 mg per day of a saw palmetto extract standardized to contain 275 mg fatty acids (86% fatty acids). Prostate symptom severity is calculated based on the International Prostate Symptom Score (IPSS), which decreased by 51% by the end of the study. At the beginning of the study, 18.8% of all volunteers had severe symptoms and 78.3% had moderate symptoms. By the final visit, however, only 4.3% still had severe symptoms, 31.9% were moderate and 63.8% of patients had mild BPH symptoms.⁷  

If you’re interested in taking Saw palmetto to promote prostate health, talk to our healthcare provider to see if Saw palmetto is right for you. If you decide to try it, research supports taking 320 mg per day of Saw palmetto extract standardized to 85-95% fatty acids and sterols.

Prostate cancer

The most dangerous diagnosis is prostate cancer. Globally, prostate cancer is the second most common men’s cancer, accounting for 13.5% of all new cancer cases and the sixth leading cause of cancer-related death for men.⁸ But looking at the number of men getting prostate cancer around the world obscures important geographic differences. Men living in Western countries have a 600% greater risk than men in non-Western countries.⁹

But even that doesn’t tell the whole story. Black men have a 60% greater risk for prostate cancer than white men. Compared to Asian/Pacific Islanders, black men are three times more likely to get prostate cancer and six times more likely to die from it. Research suggests that the reason for the increased risk of prostate cancer in Black men is that they have a higher level of circulating testosterone. Testosterone can be converted in the prostate gland to dihydrotestosterone (DHT), which promotes prostate cancer.

A man’s risk for developing prostate cancer increases as his age does, according to the following general rule: 50% risk at fifty years old, 60% at sixty years old, 70% at seventy years old, and so forth. The older one gets, however, the less aggressive the cancer is likely be and the less likely it is that a man will die from the prostate cancer itself versus some other cause.

There is also a high correlation between sexual promiscuity and prostate cancer. The greater the number and frequency of a man’s sexual partners, the higher his risk becomes. The reason for this may be exposure to sexually transmitted diseases since infections can cause irritation in cells and DNA damage.

Diet for prostate cancer prevention

One of the most important things men can do to reduce their prostate cancer risk is to improve their diet and lifestyle. Lifestyle factors play such an important role in the development of cancers that research suggests that 80% of large bowel, breast, and prostate cancers are caused by poor nutrition, physical inactivity, and obesity.^10,11 The most important lifestyle-related factor for developing prostate cancer in the United States is poor diet.¹²  

If you eat like the average American you’re consuming about 2,100 calories per day and a ton (nearly 2,000 pounds) of food every year.^13,14 If all of it were healthy, nutritious food, that would be fantastic. But it’s not.

In 2014 alone, Americans ate 20 billion donuts. That’s 63 donuts per person. And since I don’t eat donuts, someone else is eating my share. Love ice cream? Apparently so do a lot of other folks—to the tune of 15 billion pints (47 pints per person) a year. There’s only so much food we can eat during the day, so if you’re filling up with poor quality foods, that means you’re not eating enough of the good stuff. Data collected by the CDC’s Behavioral Risk Factors Survey in 2019 revealed that 40% of US adults eat less than 1 fruit and 22% eat less than 1 vegetable per day.¹⁵ 

The naturally occurring nutrients are stripped out during the processing of these foods by removing the most nutrient-dense portion of the grain and applying heat during the manufacturing process that destroys vitamins. Processed foods such as white rice, pasta, potato chips, and baked goods that use white flour are nearly devoid of vitamins and minerals.^16,17 These foods are consumed in large quantities in the United States and are a cause of nutritional deficiencies. For example, about 85% of magnesium, 60% of calcium, 68% of copper, 76% of iron, 77% of potassium, 78% of zinc, 86% of manganese, 50-80% of all B vitamins, and 86% of the vitamin are lost during the process of refining wheat to make white flour for bread, muffins, cookies, and pizza dough.^18,19 

Studies show that 93% of all Americans consume less than the estimated average requirement of vitamin E, 56% consume less than the average requirement of magnesium, 31% consume less than the average requirement of vitamin C and 12% consume less than the average requirement of zinc. Over time, eating foods that are calorie-dense but nutrient-poor can create micronutrient deficiencies. Given all of this, most people would probably benefit from taking a high-quality multivitamin and mineral supplement like Supreme Multivitamin.

Eating more of whole foods, Mediterranean Diet can also help, since it’s the opposite of the Standard American Diet. The Mediterranean Diet is rich in olive oil, fruits, vegetables, and lean protein. This diet provides an ample amount of vitamins, minerals, protein, and healthy fats to promote your health and may reduce prostate cancer risk. The Mediterranean Diet has been one of the most studied dietary patterns in the world and is associated with a significantly decreased risk for prostate cancer, colorectal cancer, gastric cancer, liver cancer, head and neck cancer, breast cancer, and cancer death.²⁰  

In addition to improving your diet, you should also consider eliminating dairy. Most people are shocked when they read about the number of chemicals and other contaminants in dairy. A review of fourteen case-controlled studies and nine cohort studies concluded that dairy intake “is one of the most consistent dietary predictors for prostate cancer in the published literature.” Data from the Physicians’ Health Study, in which diet and prostate cancer incidence were documented in 20,885 male physicians for eleven years, showed that those who consumed more than 2.5 servings of dairy products per day had a 34% greater risk of getting prostate cancer compared to those who consumed 0.5 servings per day.²¹

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