Special Reports
Visiting the bathroom too many times at night? Pygeum may help.
Frequent night-time urination may be an indication of an underlying prostate problem, a common condition among men as they age. Herbs & Health gets the lowdown from naturopath Tracey Yeend on how to manage and treat mild prostate problems.
H&H: Tracey, let’s start with the basics. What is the prostate and why do men need it?
The prostate gland is a male reproductive organ that is shaped like a walnut. It is located at the base of the bladder, in front of the anal passage. Running through the prostate gland is the urethra, a tube that empties urine from the bladder through the penis.
Sometimes referred to as the sex gland, the prostate also produces seminal fluid that carries sperm during ejaculation. This fluid provides nutritional support for sperm and an acidic environment for its survival.
H&H: How do men know if they have prostate problems?
As men age, the prostate may become enlarged and press against the urethra, causing discomfort or changes to their normal pattern of urination. Over time, the bladder wall thickens and becomes irritated, eventually weakening. This results in the bladder being unable to empty itself completely, giving rise to various symptoms (see box). Most of the time these symptoms indicate Benign Prostatic Hyperplasia (BPH), a treatable condition.
In addition to BPH, prostate conditions also include prostatitis and prostate cancer. All three conditions have similar features, which is why a visit to the doctor for correct diagnosis is very important. The latter two conditions should be managed only under the supervision of a healthcare professional.
If you suffer any changes in urination or discomfort, I would recommend a visit to your doctor for a check-up. Your doctor will do a simple examination and a blood test to check PSA (Prostate Specific Antigen) levels. For men over the age of 40, these checks should be part of an overall yearly check-up.
H&H: So, let’s focus on BPH. What causes it?
Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate. It is quite common in men over the age of 40 and becomes more prevalent as men age. Around 50 per cent of men in their 60s will experience it and up to 90 per cent of those in their 70s and 80s are affected. While BPH is not normally a life-threatening condition, it can severely affect quality of life, which is why treatment options should be considered as soon as symptoms appear.
While the causes of BPH are not well understood, it appears that the prostate gland generally undergoes two main growth spurts – one during puberty and the other sometime after the age of 40. This enlargement is thought to happen when testosterone is activated by the enzyme 5-alpha-reductase and changed to dihydrotestosterone (DHT), which is considered to play a role in the development of BPH. As an interesting aside, some researchers have speculated that DHT is the primary contributing factor in male pattern baldness.
H&H: You have indicated that there are solutions to this condition. Tell us more!
I can’t stress how important it is to visit your doctor for correct diagnosis before thinking about any treatment plan! Herbally, my choice would be Pygeum, one of the most significant and well-researched herbs of our time. It is from the bark of the African tree Pygeum africanum (or Prunus africanum). Traditionally, South African healers made a tea from the bark of the tree and used it to help alleviate bladder and urinary discomfort in older men. Pygeum has an anti-inflammatory effect on the prostate that helps to counteract the structural and biochemical changes occurring with BPH. Pygeum’s beneficial effects appear to be due to the therapeutically active sitosterols and sitosterol glycosides contained in it. These are thought to work by interfering with the binding site for DHT, thus preventing the development of BPH.
While the exact science is a little vague, we do know that Pygeum is effective, with several research studies giving conclusive results. One such study, conducted in Europe (Curr Med Res Opin, 1998), involved 85 men who had mild-to-moderate BPH. Each were given a Pygeum extract supplement containing 50mg of standardised sitosterol twice daily. At the end of two months, the patients reported a 40 per cent decrease in the severity of symptoms and, furthermore, a 32 per cent decrease in frequency of nocturia (night-time urination) and a 31 per cent improvement in quality of life. To demonstrate Pygeum’s lasting therapeutic effects, a follow-up trial on these same men, a month after they had stopped supplementation, showed the need to urinate three or more times per night decreased by 44 per cent.
H&H: So what dose would you recommend to men suffering BPH?
I would suggest 50mg, twice daily of standardised sitosterol Pygeum extract (100mg standardised sitosterol Pygeum extract is equivalent to about 20g of dried Pygeum bark). While it does depend on the severity of the symptoms, a general rule of thumb is to take this dose for at least two months to see an improvement on symptoms. Once symptoms do improve, you can halve the dose. And, of course, you should continue to have regular check-ups with your doctor.
H&H: Is it safe to take Pygeum with other medications?
As urinary symptoms may affect sex life, it is quite likely that some men may also be taking medications to improve libido. To date, there are no recorded side effects or reasons why you couldn’t take Pygeum with these prescription drugs. However, always discuss taking any supplements in conjunction with prescription drugs with your doctor.
Tracey Yeend ND, RN/RM, Cert Pharm, is a registered nurse, midwife and naturopath practicing in South Australia. (Clinics include: Stirling 08 8370 9777, Victoria Square Health 08 8231 9454 and Eden Hills 0403 430 970)
|
