If you're a man living in the United States, it's almost inevitable you'll eventually have to face prostate problems. Because as a man gets older the prostate gland tends to enlarge. This results in BPH (Benign Prostatic Hyperplasia) which causes a lot of annoyances like frequent urination, dribbling, discomfort, and infections. It can even lead to cancer.

What does the prostate gland do, anyway?

The prostate is the size and shape of a walnut and is located under the bladder and directly in front of the rectum. It secretes a thin, milky, acidic fluid that:

• provides about half the fluid in semen
• helps transport sperm through the vagina and cervix
• helps moisten the lining of the urethra

What causes prostate problems?

After about age 40, the prostate begins to grow in just about every male because DHT (dihydrotestosterone), a potent form of the male hormone testosterone, increases in the body. Testosterone is produced by both the testicles and the adrenal glands, and DHT accumulates in the prostate, causing prostate cells to rapidly divide. Sometimes the enlargement is a sign of cancer. But usually the result is a condition called Benign Prostatic Hyperplasia. Most doctors refer to enlarged prostate simply as BPH.
In some men, the prostate gland enlarges without causing urinary problems—probably because their urethra is wider than average, or because the gland tends to enlarge outward. In most men, however, as BPH develops, the prostate presses against the neck of the bladder or urethra, squeezing the pipe shut, like stepping on a garden hose. This pressure can make it difficult to urinate and results in a variety of symptoms.

Also, the bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH, including:

• Urgency—the need to go immediately
• During urination, there is a thin stream of urine that stops and starts instead of a full, steady stream
• Hesitancy or difficulty starting urine flow
• Dribbling after urinating
• Nocturia—having to get up frequently at night to urinate
• Increased frequency of urination
• Increased risk of infection if the bladder does not empty entirely and urine is retained

Why does BPH occur in the first place?

Although the exact cause isn't known, there are a few theories. First of all, we've known for centuries that BPH occurs mainly in older men and that it doesn't develop in men whose testes were removed before puberty. For this reason, researchers believe that factors related to aging and the testes may spur the development of BPH.

Male hormones

Men produce both testosterone, an important male hormone, and small amounts of estrogen, a female hormone throughout their lives. As men age, the amount of active testosterone in the blood decreases, leaving a higher proportion of estrogen. One theory, based on animal studies, suggests that BPH may occur because the higher amount of estrogen within the gland increases the activity of substances that promote cell growth.
Another theory focuses on dihydrotestosterone (DHT), a substance derived from testosterone in the prostate, which may help control its growth. Most animals lose their ability to produce DHT as they age. However, some research has indicated that even with a drop in the blood's testosterone level, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage the growth of cells. Scientists have also noted that men who do not produce DHT do not develop BPH.

Some researchers suggest that BPH may develop as a result of "instructions" given to cells early in life. According to this theory, BPH occurs because cells in one section of the gland follow these instructions and "reawaken" later in life. These "reawakened" cells then deliver signals to other cells in the gland instructing them to grow, or making them more sensitive to hormones that influence growth.¹

Fortunately, Americans are finally learning about Pygeum, the anti-inflammatory bark extract that European doctors have been prescribing for decades.

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