Male Health: Dribbling Into Middle Age
Men! Are your nights interrupted by frequent trips to the bathroom? Do you groan in
agony when you see a "next rest stop, 69 miles" sign on the road? Have you given
up basketball games because you’re doing more dribbling than the players?
If so, you’ve truly entered middle age and are experiencing the one problem that
nearly all men share: Prostate problems, especially benign prostatic hyperplasia.
The prostate is a donut-shaped, chestnut-sized gland located below the bladder. More
important is that it surrounds the urethra, the tube through which urine flows from the
bladder. If the prostate is inflamed or enlarged, as is often the case with prostate
problems, it can push against the urethra, pinching it and causing it to narrow. The
result is the same as when you pinch your garden hose; the water dribbles out.
To compensate for the narrowing of the urethra, the muscular wall of the bladder
contracts more strongly to expel urine. This increased "exercise" leads to the
thickening of the bladder wall and a decrease in its urine capacity. The bladder will hold
less and less urine, resulting in having to urinate more and more.
Basically, there is nothing you can do to keep the prostate from enlarging as you age.
When in your 20s, 30s, and 40s, the prostate remains much the same size, but when you hit
the big five-zero it starts growing. By age 85 just about every male has some prostate
growth.
This growth is generally known as benign prostatic hyperplasia
(BPH). Known
traditionally as "old man’s disease" because so many elderly men develop
it, various reports state that 50 percent to 60 percent of men over 50 years of age and
some 85 percent of men over 80 years of age have some indication of BPH. Common symptoms
include
- An urgent
feeling that you need to urinate;
- An increased
frequency of urination, waking multiple times during the night to urinate;
- Some difficulty
when beginning to urinate;
- A urine stream
that is weak and thin;
- Difficulty
stopping urinating; often followed by dribbles; and
- A feeling that
your bladder has not completely emptied, urinary retention.
If left untreated, BPH results in stagnant urinary residue, which can lead to infection
and blockage of the bladder outlet.
Not all men experience symptoms. Only about half of all men will have noticeable
symptoms, and only half of those will experience enough discomfort to go to a doctor. The
symptoms often come and go.
Although researchers do not know exactly why BPH develops, it appears to be related to
age and increased levels of 5-alpha-dihydrotestosterone (DHT), a hormone. DHT binds to the
prostate, which results in continued prostate growth. This can eventually cause the
overproduction (hyperplasia) of prostate cells, which causes the prostate gland to enlarge
more than it should.
Helping Out
For BPH, you can help yourself.
Drink water: Although the natural reaction to frequent
and urgent urination is to cut back on fluid intake, this is a mistake. You risk
dehydration and the likelihood of developing a bladder infection increases because your
urine becomes stronger. Drinking lots of fluid keeps the retained urine in the bladder
fairly diluted and reduces the risk of bladder infection and dehydration.
Dietary changes: Caffeine, alcohol, spicy
foods and/or acidic foods may irritate the prostate, and most doctors recommend either
eliminating them or consuming very little of them. Diets with an emphasis on soy are
helpful, as this helps eliminate DHT. Sunflower and pumpkin seeds may also be helpful. Cut
back on beer, as this stimulates hormones that may contribute to prostate growth.
Watch your weight: At least one study (
American Journal of Epidemiology; Dec. 1994) has
shown that men with larger than a 43-inch (109 cm) waist are more than twice as likely to
have enlarged prostates. It pays, then, to eat right and exercise so that your gut
doesn’t hang over your belt.
Avoid decongestants and antihistamines: Sudafed,
Tavist-D, Contact, etc., all carry warnings in fine print
not to use them if you have an enlarged prostate or BPH. These medications appear to cause
the prostate to contract, which decreases urine flow. There is also some evidence that
these tend to make the prostatic secretion thicker and more prone to forming clogs.
Stay in love: Making love can also help forestall prostate problems.
Exercise: Walking will often help relieve prostate symptoms.
Use supplements: Dietary supplements can help general prostate health. Make sure you get
sufficient amounts of zinc and B vitamins. These nutrients regulate the enzyme that
converts testosterone to DHT. Essential fatty acids may be helpful, as these influence
hormones that control inflammation.
There have been a number of animal and clinical trials on the use of pollen extract for
BPH, nonbacterial prostatitis, and prostadynia. Herbs used to maintain prostate health
include saw palmetto and pygeum africanum.
The American Urological Association BPH Symptom Index
Circle the number in the appropriate column:
| |
Never |
Less than 1 time in 5 |
Less than half the time |
About half the time |
More than half the time |
Almost always |
| 1. How often have you had a sensation of not emptying the bladder completely
after you finished urinating? |
0 |
1 |
2 |
3 |
4 |
5 |
| 2. How often have you had to urinate again less than two hours after you finished
urinating? |
0 |
1 |
2 |
3 |
4 |
5 |
3. How often have you found you stopped and started again
several times when you urinated? |
0 |
1 |
2 |
3 |
4 |
5 |
| 4. How often have you found it difficult to postpone urination? |
0 |
1 |
2 |
3 |
4 |
5 |
| 5. How often have you had a weak urinary stream? |
0 |
1 |
2 |
3 |
4 |
5 |
| 6. How often have you had to push or strain to begin urination? |
0 |
1 |
2 |
3 |
4 |
5 |
| 7. How many times did you most typically get up to urinate from the time you went
to bed at night until the time you got up in the morning? |
None
0 |
1 |
2 |
3 |
4 |
5 or more |
Total all circled numbers. 1 -
7: mild; 8 - 19: moderate; 20- 35: severe. Generally, no treatment is needed for mild
symptoms. For moderate and severe symptoms, consult a health practitioner.
| Other
prostate disorders Prostatitis is the general term for inflammation of the prostrate
gland. As with BPH, the inflamed prostate pinches the urethras, resulting in many of
the same symptoms; frequent and urgent urination, increased nighttime urinating, and a
stop-and-start urine stream. Other symptoms include pain between the rectum and the
back of the scrotum, in the lower back, above the pubic bone, in the lower
abdominals, or
in and around the groin and testicles. Prostatitis can also result in dysuria which
is painful or difficult urination Prostatitis - or have no known cause, which is
known as nonbacterial prostatitis.
Prostatodynia occurs if there are prostatitis -
like symptoms that appear to originate in the prostate (but probably do not) and no
evidence of inflammation or bacteria. This really has nothing to do with the
prostate. Pain appears to originate in the prostate, buy might actually be
coming from the pelvic area, genitals or rectum. The prostate is generally
normal or slightly tender, and you may have tension headaches. |
