Natural Remedies for Prostrate Enlargement

Enlarge Image Image Gallery Several studies show that saw palmetto relieves benign prostratic hypertrophy symptoms. Photo by Steven Foster

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Pharmacologist Jerry Cott, Ph.D., of College Park, Maryland, knows how to evaluate the safety and effectiveness of drugs. For four years, he reviewed new drug applications for the Food and Drug Administration (FDA). Cott doesn’t distinguish between pharmaceuticals and herbal medicines. “They both have pharmacological effects,” he says. He’s become an expert on herbal pharmacology, serving as an adviser to the nation’s leading herb education organization, the American Botanical Council in Austin, Texas. Every day, Cott takes an herbal medicine, saw palmetto (Serenoa repens), to prevent the urinary bane of men older than fifty—noncancerous enlargement of the prostate gland, or benign prostatic hypertrophy (BPH), also known as benign prostatic hyperplasia.

“I’m fifty-five and don’t have BPH yet,” Cott explains. “There’s no proof that saw palmetto prevents it, but based on its mechanism of action, it should help. The great thing about saw palmetto is that it’s safe. The pharmaceuticals used to treat BPH all have side effects. I wouldn’t take any of them for BPH prevention. But saw palmetto is safe and it’s cheap. So I figure: Why not?”

BPH is a men’s health condition, but it’s also of concern to women. Women are often the caretakers of family health; they are often the ones husbands and male relatives turn to for health advice. Women should recognize BPH, understand its symptoms, and encourage men who develop those symptoms to treat the condition.

Prostate primer

The prostate is a walnut-sized, donut-shaped gland located below a man’s bladder. It produces most of the fluid in semen. It also has a tube running through it, the urethra, which carries both urine and semen out of a man’s body.

Until middle age, most men hardly know they have a prostate. But after age thirty, the gland starts growing. Prostate growth might signal cancer, which is why men older than forty-five should have annual prostate checks. But most midlife prostate growth is noncancerous BPH.

As BPH progresses, the swelling prostate pinches the urethra. It’s painless, but it causes urinary difficulties: the feeling that you need to urinate immediately (urgency), difficulty getting started (hesitancy), decreased flow, difficulty finishing (dribbling), and having to get up at night to urinate (nocturia). By the time a man reaches fifty—often earlier—he can expect to get up at least once a night.

The prostate swells because of age-related hormonal changes. Blood levels of testosterone decline, while levels of other hormones, notably prolactin, increase. The ultimate result is an increase in the male sex hormone dihydrotestosterone (DHT) in the prostate. DHT causes BPH by stimulating the growth of prostate tissue. An enzyme, 5-alpha-reductase, converts testosterone to DHT. Both the herbal treatments and the main pharmaceutical treatment, Proscar (finasteride), work by interfering with this enzyme’s action.

Saw palmetto

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