LIFEST YLE
Prostatic disease – an opportunity for better health? Simon Mills Herbal practitioner
Benign prostate disease becomes more common as men age. Not so long ago, the balance of research
Sixteen years ago, as a moderately prominent herbal practitioner, I published a paper for the Journal of the Royal Society of Medicine on natural approaches to the management of prostatic disease that predicted that plant constituents like beta-sitosterols and remedies like saw palmetto would become valuable adjuncts to treatment and that there was more herbal promise of this sort to come. Since then the evidence base has moved on considerably and the case for saw palmetto has been particularly dented. So by the time Kerry Bone and I updated our herbal textbook, Principles and Practice of Phytotherapy there was a substantial shift in emphasis. What we thought was the future had turned into the past. So now what is a man now to do? For many, prostatic problems can be the first big health fear. Here we look at how natural approaches can both help the three main chronic prostatic conditions and then actually unlock wider benefits for a healthy life.
evidence suggested that the herb saw palmetto could shrink benign enlarged prostate gland. However, the consensus view appears to be shifting against its efficacy in prostatic conditions. Nonetheless, lifestyle changes may have powerful positive effects on this and other prostate disorders. And in addition such improvements are likely to benefit other conditions associated with ageing.
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Benign prostatic hyperplasia Benign prostatic hyperplasia (BPH) is a progressive, benign growth of the prostate gland that gradually narrows the urethra leading to obstruction of the flow of urine. Urine remaining in the bladder stagnates, leaving the patient vulnerable to infections, bladder stones and kidney damage. Complicating many cases of BPH therefore is a linked range of lower urinary tract symptoms (LUTS). However, there is no exact correlation between the size of the prostate and the degree of LUTS, suggesting that other factors are involved. Various theories have been proposed to explain BPH itself. Recent evidence downplays androgens, both testosterone and dihydrotestosterone; their role is now said to be permissive. A higher oestrogen/testosterone ratio could be a causative hormonal factor, and increased peripheral conversion of testosterone to oestradiol by aromatase could be at play (Roehrborn, 2008). There is, however,
a strong link between BPH and chronic prostatitis (Sciarra, 2008) and one theory has proposed that BPH is an immune-mediated inflammatory disease caused by auto-immunity or possibly infection (Kramer, 2007). Another theory proposes that higher circulating insulin stimulates prostate growth, hence linking BPH to insulin resistance (Vikram, 2010), and an association with obesity has also been observed (Parsons, 2009). The sympathetic overactivity linked to obesity, metabolic syndrome and hypertension may specifically increase the risk of manifesting LUTS (Moul, 2010; Sarma, 2009). LUTS and metabolic syndrome have been shown to be comorbid, as has LUTS and erectile dysfunction. Improving testosterone can help symptoms of LUTS (Yassin, 2008) and inflammation may also play a role (insulin resistance is a pro-inflammatory condition); elevated serum C-reactive protein correlates well with severity of LUTS (Sarma, 2009). Increased levels of physical activity have been associated with a decreased
Š Journal of holistic healthcare
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Volume 14 Issue 3 Autumn 2017
