Men with an enlarged prostate often have a condition called benign prostatic hyperplasia (BPH). This abnormal but noncancerous growth becomes a concern when it leads to lower urinary tract symptoms (LUTS), such as urinary frequency, urgency and retention, a weak urine stream, and difficulty starting and stopping urination.
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Treatment is directed at relieving symptoms. Some men opt for herbs or other dietary supplements, hoping to shrink the prostate or improve symptoms — but there is limited research on their effectiveness. Changes to lifestyle may play a role in preventing BPH or improving symptoms, however the mechanism for any benefits are unclear.
Step 1: Discuss Therapy With Your Doctor
Have a discussion with your personal doctor or urologist to understand the best management plan for your BPH. Treatment options include lifestyle changes, medications that stop the growth or shrink the size of the prostate, minimally invasive procedures or surgery. If you wish to try natural therapies, talk with your doctor so you understand what the research says about effectiveness and safety.
Step 2: Know Your Options
Although the American Urological Association's 2014 clinical guidelines#x2513) do not endorse any dietary supplement for managing BPH, certain natural therapies are popular in men affected by this condition. Saw palmetto is often linked to symptom improvement, yet a quality research trial found this supplement no more effective than placebo, even in triple the doses commonly used.
Limited evidence suggests extracts of Pygeum africanum (African plum tree) and Urtica dioica (stinging nettle) may improve LUTS, and that Urtica dioica combined with saw palmetto may improve urinary symptoms. However, the mechanism of action is not determined, and additional quality research is needed to understand effectiveness, dosing and safety.
Step 3: Emphasize Fruits and Vegetables
Eating more fruits and vegetables may play a role in reducing the progression of BPH. A study of Chinese men with BPH linked several daily servings of fruits and vegetables, and daily inclusion of dark, leafy greens, to reduced LUTS. It's unclear however, if symptoms improved due to reduced prostate size or another factor.
A diet that emphasizes vegetables, and foods rich in vitamin C, beta-carotene and lutein, a plant chemical found in yellow and orange fruits and vegetables, may also reduce the risk of BPH, according to a 14-year study of over 32,000 male health professionals. Until additional research clarifies the link between diet and BPH, men with enlarged prostate may benefit from increasing their intake of fruits and vegetables.
Step 4: Exercise Regularly
A sedentary lifestyle is linked to a higher risk of BPH, while regular physical activity cuts the risk of this condition, according to a study published in 2005. Researchers suggest that physical activity counters the hormones that encourage prostate growth.
Another study linked moderate physical activity — even yard work and household chores — to decreased LUTS, however this study showed that prostate size was not affected by exercise. However, since physical activity can improve symptoms, staying active may be beneficial to men with enlarged prostate.
Step 5: Take Steps to Manage Symptoms
Avoiding caffeine and alcohol may improve urinary symptoms, as these beverages can increase frequency of urination. It may also help to cut back on fluids before bedtime, to minimize the need to urinate overnight.
Certain medications — such as antihistamines, decongestants, nasal sprays and allergy pills — can slow urine flow or make it more difficult to urinate. Ask your doctor if there are alternatives to these medications, or any other medications that seem to make your symptoms worse.
Reviewed by Kay Peck, MPH, RD