Prostate enlargement treatment, vitamins, herbs, supplements, alternative and natural therapy benefits and side effects

Prostate enlargement is caused by an increase in the number of both epithelial and stromal cells. Clinically, prostate enlargement leads to voiding problems, which is most often referred to as lower urinary tract symptoms (LUTS). Doctors often prescribe 5 alpha reductase inhibitors such as finasteride and dutasteride to treat prostate enlargement. However, these drugs have sexual side effects which include impotence and decreased libido. Some doctors are not recommending their patients begin with herbal therapies in order to avoid these adverse effects. If, after a period of several months, symptoms of prostate enlargement are not ameliorated, then a patient could consider the use of prescription medications.

Prostate enlargement progression
Prostate enlargement usually occurs in males 45-50 old and progressively involves 75% of the male population over 75 years of age.

Prostate Power Rx natural and alternative therapy - Physician Formulas
Formulated by Ray-Sahelian, M.D.

 

With Saw Palmetto, Pygeum, Stinging Nettle, Gensitein, Quercetin, Phytoestrogens, and several Ingredients for support of normal prostate health and size.

Prostate Power Rx is carefully formulated with important herbs and nutrients to provide optimal prostate health.
 

Prostate Power Rx Supplement Facts
Saw-Palmetto extract
Stinging Nettle extract
Quercetin
Rosemary extract
Beta Sitosterol
Pygeum extract
Daidzein and Genistein (standardized to contain 40% isoflavones)
(treatment with the isoflavones daidzein and genistein, the estrogen-like compounds found in soy, block prostate growth in rats)
Lycopene

Symptoms of prostate enlargement
Symptoms of Prostate enlargement are related primarily to bladder outlet obstructions resulting from enlargement of the prostate gland, and from extrinsic and intrinsic sympathetic activation of alpha-adrenoceptors present in the muscle tissue of the prostate gland, the urethra portion of the prostate gland, bladder base and neck.
   The symptoms of prostate enlargement vary, but the most common ones involve changes or problems with urination, such as: A hesitant, interrupted, weak stream; Urgency and leaking or dribbling; More frequent urination, especially at night. This is called nocturia. Men who have symptoms of prostate obstruction are more likely to develop chronic kidney disease.

Prostate enlargement treatment
Historically, the only treatments for LUTS due to prostate enlargement were watchful waiting or surgery (transurethral or open prostatectomy). However, over the last three decades, medical treatment has taken a prominent role in the management of prostate enlargement symptoms.
   Several drugs are used in the treatment of a prostate gland.

Medical treatment for prostate enlargement
Current medical treatments for enlarged prostate gland include alpha-adrenergic receptor antagonists, inhibitors of the 5-alpha reductase enzyme and various herbal remedies. Many patients are unable to tolerate the side effects of these medications, or are refractory to medical management and require surgery.

Prostate enlargement Medicines - Prostate enlargement Drugs
Several drugs are currently used for an enlarged prostate gland:

5-alpha reductase inhibitors:
The enzyme 5 alpha-reductase (5 alpha R) catalyses the reduction of testosterone into the more potent androgen dihydrotestosterone. The abnormal production of dihydrotestosterone is associated with pathologies of the main target organs of this hormone: the prostate and the skin. Prostate enlargement, prostate cancer, acne, androgenetic alopecia in men, and hirsutism in women appear related to excess dihydrotestosterone production. Two isozymes of 5 alpha-reductase have been cloned, expressed and characterized (5 alpha R-1 and 5 alpha R-2).

Proscar (finasteride) for enlarged prostate gland, manufactured by Merck. Proscar blocks the conversion of testosterone into the more active dihydrotestosterone.
Fincar - Generic Proscar manufactured by Cipla;
Avodart - Dutasteride manufactured by GlaxoSmithKline;
Dutas - Generic Dutasteride manufactured by Dr. Reddy's.

Prostate enlargement is a common problem in middle-aged and elderly men. First-line medical therapy includes alpha 1blockers and 5alpha-reductase inhibitors (5ARIs), such as finasteride and dutasteride. 5ARI use has been associated with adverse sexual outcomes, including erectile dysfunction (ED), ejaculatory dysfunction (EjD), and decreased libido. Sexual side effects are reported in clinical trials at rates of 2% to 38%. The most common sexual side side effect is ED, followed by EjD and decreased libido. These effects occur early in therapy and ease over time. A proposed mechanism for sexual dysfunction involves decreased nitric oxide synthase activity due to decreased dihydrotestosterone. The connection between 5ARIs and sexual dysfunction is apparent upon review of the literature. Though theories have been proposed, little is known about the exact mechanisms behind 5ARI-related sexual dysfunction.

Alpha 1 blocker for prostate enlargement:
Alpha1-blockers are the medical therapy of choice for symptomatic patients with prostate enlargement and low risk of clinical progression (e.g. prostate volume < 30-40 ml). Alpha1-blockers have no effect on the long-term risk of acute urinary retention and the risk of surgery. The alpha 1 blocking agents (Terazosin, Doxazosin, Tamsulosin) that improve urinary symptoms.

Flomax - Tamsulosin Hydrochloride manufactured by Boehringer Ingelheim. Terazosin alpha 1 blocker appears to be useful in the treatment of patients with mild- to moderate symptomatic prostate enlargement.

The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study.
Eur Urol. 2010 Jan; Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, Morrill BB, Gagnier RP, Montorsi F; CombAT Study Group. Department of Urology, UT Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
Combination therapy with dutasteride and tamsulosin provides significantly greater benefit than either monotherapy for various patient-reported outcomes in men with moderate-to-severe lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and prostatic enlargement. OBJECTIVE: To investigate whether combination therapy is more effective than either monotherapy in reducing the relative risk for acute urinary retention (AUR), BPH-related surgery, and BPH clinical progression over 4 yr in men at increased risk of progression. The Combination of Avodart and Tamsulosin (CombAT) study was a 4-yr, multicenter, randomised, double-blind, parallel-group study in 4844 men > or =50 yr of age with a clinical diagnosis of BPH, International Prostate Symptom Score > or =12, prostate volume > or =30 cm(3), prostate-specific antigen 1.5-10 ng/ml, and maximum urinary flow rate (Q(max)) >5 and < or =15 ml/s with minimum voided volume > or =125 ml. Oral daily tamsulosin, 0.4 mg; dutasteride, 0.5 mg; or a combination of both. Combination therapy was significantly superior to tamsulosin monotherapy but not dutasteride monotherapy at reducing the relative risk of AUR or BPH-related surgery. Combination therapy was also significantly superior to both monotherapies at reducing the relative risk of BPH clinical progression. Combination therapy provided significantly greater symptom benefit than either monotherapy at 4 yr. Safety and tolerability of combination therapy was consistent with previous experience with dutasteride and tamsulosin monotherapies, with the exception of an imbalance in the composite term of cardiac failure among the three study arms. The lack of placebo control is a study limitation. CONCLUSIONS: The 4-yr CombAT data provide support for the long-term use of dutasteride and tamsulosin combination therapy in men with moderate-to-severe LUTS due to BPH and prostatic enlargement.

Hormonal treatment of prostate enlargement
LHRH analogs (Leuprorelin and Goserelin) can reduce the testicular production of androgens with reduction in prostate size.

Surgical treatment of prostate enlargement
Many potential new surgical treatment options are available for the treatment of prostate enlargement.

Prostate enlargement treatment questions
I have nocturia three times each night and prostate enlargement. Can not tolerate Avodart or Flomax. Good health 80 years old. I am on Coumadin. Should I use Prostate Power Rx or Beta-Sitosterol. Urinary frequency is the worst problem.
    We cannot make specific suggestions for prostate enlargement treatment since that is the role of your doctor, but most users prefer a combination formula for prostate health which is Prostate Power Rx.

Do you have any alternative nutritional supplemental applications when open prostatectomy on males past 75 years of age seems to be indicated in cases where their prostates become so enlarged that they prevent urination? For such persons who have taken preventive nutritional supplemental precautions for years, does research indicate further pursuit of supplemental nutritional efforts for shrinking the gland, to still be a viable alternate option, in the face of possible penis erosian due to necessary continual use of a catheter? In cases where viability of nutritional supplemental options reach "point-no-point" and open prostatectomy is necessitated, does research suggest any post-operative supplemental nutritional options or precautions that could minimize possible dangerous effects of hormones and/or other drugs that may be prescribed by their urologist?
    Not enough human research with botanical products is available to have reliable answers to these good questions.