Palmer, Shawn.tif

Shawn Palmer

Contributing Health Columnist

Q: I have recently been diagnosed with a mildly enlarged prostate. Why do men get an enlarged prostates, and what are some options to address this problem?

A: Having an enlarged prostate, which is known as benign prostatic hyperplasia (BPH) or hypertrophy, is extremely common and affects half of all men by the time they reach the age of 60. Some men take a saw palmetto supplement, which can help, but others may need another approach to help their BPH.

One of the problems with treating BPH is that researchers are still trying to fully determine why men get BPH. What follows are some approaches relating to why men get BPH and what to do about it.

First, the most common theory is that as men age, the body turns more testosterone into a super testosterone called dihydrotestosterone (DHT). Many researchers think DHT is responsible for BPH and also male pattern baldness. Conventional drug therapy, such as taking dutasteride or finasteride can help reduce DHT. Taking a saw palmetto supplement may also help. However, this is not the end of the story.

A second approach that is not as well known, is that some men experience a change in the testosterone-to-estrogen ratio. As men age, testosterone levels drop. But men also make estrogen and a specific estrogen called estradiol (E2) does not seem to drop with age. This means the ratio of testosterone to E2 goes down and some think this might cause BPH. You can fight this trend in a number of ways, but one effective strategy is maintaining a lean body mass and doing strength training to help to keep testosterone levels higher in relation to E2.

A third theory is that BPH may be related to dropping progesterone levels in men. Progesterone is typically considered a female hormone, but we are finding that men also need this hormone. Progesterone in men may play a role in maintaining libido, help maintain a healthy prostate size, and may even play a role in preventing prostate cancer. This is still an area under investigation, but some doctors have recommended a little topical progesterone cream for men over the age of 50 to help with these male issues. Of course, don’t try something like this until you have consulted with your primary health care provider, since it is not a good solution for everyone.

Finally, having high insulin levels in your body may increase the risk of developing BPH. This is especially true if your insulin levels are chronically high, which can happen from eating certain unhealthy foods like too much sugar and white flour. You can reduce your insulin with exercise, weight loss if you are overweight, and by avoiding foods that spike insulin. You can also take certain herbs like cinnamon and gymnema to help keep your blood sugar levels lower.

As you can see, there are a number of things that may be contributing to BPH. There are also a number of plants that are starting to hold promise for treating BPH. This includes using antioxidants like turmeric to reduce inflammation in the prostate, taking red maca that may reduce BPH without affecting hormones, and diet changes like eating at least four vegetables a day–all of which may help slow down BPH development. These treatment approaches still need more research. On the other hand, steps such as eating more vegetables and maintaining a lean body mass are steps that increase your overall health and are generally safe to try. Just be sure to first talk with your primary health care provider before doing anything new, to make sure it makes sense in your particular situation.

Shawn Palmer is a naturopathic doctor.

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