Benign prostatic hyperplasia (BPH)

From Health Facts
Jump to: navigation, search
Latest Edit: Hector 2014-01-02 (EDT)

Benign prostatic hyperplasia (BPH) is an increase in cell number in the prostate gland leading to a cascade of changes and subsequent enlargment of the prostate gland itself. BPH increases with age, reaching an estimated incidence of 88% in men over 80. BPH is most often associated with lower urinary tract symptoms causing significant discomfort and may lower overall quality of life.[1]

Benign prostatic hyperplasia (BPH)
Causes Environmental Chemicals, Smoking, Infections, Dietary Factors, Stress, Physical Inactivity
See Also Men's Health, Erectile Dysfunction, Liver Cirrhosis, Hypertension, Urinary Tract Infection
Books Books on Men's Health
Articles Articles on Men's Health
Check out this book Naturopathic Urology & Men's Health

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With BPH, the causes are variable and include lifestyle and environmental factors. A detailed assessment is required to determine which factors are contributing to the development of BPH.


  • Individuals with a higher consumption of beef and dairy, and a lower consumption of yellow vegetables had an increased risk of developing BPH.[1]
  • High fat diets may increase the risk of BPH.[2]
  • Light to moderate alcohol consumption is associated with lower risk of BPH. A high level of alcohol consumption is associated with increased risk of BPH.[3]
  • Obese individuals have a higher risk of developing urinary obstructive symptoms and are more likely to undergo prostatectomy.[1]
  • There is a relationship between a lack of physical activity, obesity, and elevated BMI with BPH. Increased exercise levels have been shown to be protective against BPH.[1]


  • Emotional Impact
  • The proportion of men with a negative feeling of well-being was higher in men with BPH than in men who did not have BPH. The difference was consistent for all aspects of well-being (anxiety, depression, self-control, vitality, being worried or being bothered by illness). Men with BPH had a higher level of difficulty attributed to urinary symptoms, and more interference in selected daily living activities caused by urinary dysfunction.[4]
  • Depression and BPH are often related. It is not clear if depression causes BPH or if it is due to BPH.[5]


  • Dioxin, polyhalogenated biphenyls, hexachlorobenzenes, and other dibenzofurans my increase 5-alpha reductase activity and increase the risk of BPH.[6]

Medical Interventions

  • Pharmaceuticals
  • Some prescription medications can cause or worsen the symptoms of BPH.
  • Over-the-counter medications such as cold remedies, diet aids, nasal decongestants, and caffeinated products may increase prostatic muscle tone and exacerbate symptoms.[7]


  • Hereditary BPH
  • Hereditary BPH occurs earlier in life and is autosomal dominant or co-dominant. The most common form of BPH has a weaker genetic component.[6]


  • Aging
  • Testosterone is converted to Dihydrotestosterone (DHT) at an increased rate with aging. The prostate is more sensitive to DHT than to testosterone, so an increase in DHT further stimulates hyperplasia of the prostate.[6]

Diagnostic Testing

Physical Examination[8]

  • A digital rectal exam (DRE) may be performed to assess size and contour of the prostate gland, and to assist in ruling out prostate cancer or neurologic etiology of BPH-like symptoms.

Laboratory Studies[8]

  • A urinalysis may be used to rule out alternate causes of lower urinary tract symptoms.
  • PSA levels may be evaluated in individuals with a life expectancy over 10 years.

Related Symptoms and Conditions

Medical conditions associated with BPH include:[1][8]



Common signs and symptoms associated with BPH include:[8], [9]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. BPH is typically a chronic disease and requires individualized and ongoing treatment.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Discontinuing over the counter meds such as cold remedies, diet aids, nasal decongestants, and caffeinated products as they may increase prostatic muscle tone and exacerbate symptoms.[7]


Lifestyle recommendations include:

Article Management of BPH and Urinary Tract Symptoms, NDNR [1], 2011 November
  • A diet higher vegetable protein and unsaturated oils, and lower in carbohydrates and animal fats is recommended.
  • Regular consumption of soy is recommended.
  • Avoid foods contaminated with pesticides, drugs, and hormones.
  • Ensure you drink adequate water.
  • Regular exercise to manage body composition is recommended. Specific exercises to stretch the urogenital area and increase blood flow are recommended.[6]
  • Addressing the emotional impact of BPH and its impact on quality of life is an integral part of any successful treatment strategy.

Naturopathic Therapies

Naturopathic Therapies for BPH include:

  • Acupuncture can markedly improve the symptoms of difficult urination in mild or moderate patients with BPH. It has been shown to increase maximal urinary flow rates and to reduce post-voided residual urine volumes.[15]


Reviewed by Iva Lloyd, BScH, RPE, ND [2]

  1. 1.0 1.1 1.2 1.3 1.4 Roehrborn CG (2011) Wein: Campbell-Walsh Urology 10th ed Chap 91 Benign Prostatic Hyperplasia: Etiology, Pathophysiology, Epidemiology, and Natural History Saunders
  2. Park J (2008) Complementary and alternative medicine in men's health Journal of Men's Health 5(4);305-313
  3. Rohrmann S, Platz EA, Giovanucci E (2005) Lifestyle and benign prostatic hyperplasia in older men: What do we know? J Men's Health Gend 2(2);230-235
  4. Tsang KK, Garraway WM (1993) Impact of benign prostatic hyperplasia on general well-being of men. Prostate.;23(1):1-7. PMID: 7687780.
  5. Johnson TV, Abbasi A, Ehrlich SS, Kleris RS, Chirumamilla SL, Schoenberg ED, Owen-Smith A, Raison CL, Master VA (Dec 2010) Major depression drives severity of American Urological Association Symptom Index. Urology.;76(6):1317-20. PMID: 21130246.
  6. 6.0 6.1 6.2 6.3 6.4 6.5 Murray MT, Bongiorno PB (2006) Pizzorno Textbook of Natural Medicine 3rd ed Chap 154 Benign Prostatic Hyperplasia Elsevier.
  7. 7.0 7.1 7.2 Rakel D (2007) Rakel: Integrative Medicine 2nd ed Chap 58 Benign Prostatic Hyperplasia Saunders
  8. 8.0 8.1 8.2 8.3 Edwards JL (2008) Diagnosis and management of benign prostatic hyperplasia Am Fam Physician;77(10);1403-1410
  9. 9.0 9.1 Prousky Jonathan (2008) Principles and Practices of Naturopathic Clinical Nutrition CCNM Press.
  10. 10.0 10.1 Miller AL (1996) Benign Prostatic Hyperplasia: Nutritional and botanical therapeutic options Alt Med Rev;1:18-25
  11. Wilt T, Ishani A, Mac Donald R, Rutks I, Stark G (2002) Pygeum africanum for benign prostatic hyperplasia. Cochrane Database Syst Rev.;(1):CD001044. PMID: 11869585.
  12. Wilt T, Ishani A, Mac Donald R (2002) Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2002;(3):CD001423.
  13. Macdonald R, Tacklind JW, Rutks I, Wilt TJ (May 2012) Serenoa repens monotherapy for benign prostatic hyperplasia (BPH): an updated Cochrane systematic review. BJU Int. PMID: 22551330.
  14. Hershoff Asa 2000 Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York
  15. Yang T, Zhang XQ, Feng YW (Nov 2008) Efficacy of electroacupuncture in treating 93 patients with benign prostatic hyperplasia. Zhongguo Zhong Xi Yi Jie He Za Zhi.;28(11):998-1000. PMID: 19213342.