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Mitigating the Effects of BPH on Lifespan and Quality of Life
Dr. Ronald Klatz and Dr. Bob Goldman Benign prostate hyperplasia (BPH), a nonmalignant enlargement of the prostate gland, alters the normal flow of urine. BPH is characterized by symptoms of bladder obstruction, such as increases urinary frequency (dysuria), nighttime awakening to empty the bladder (nocturia), and reduced force and speed of urinary flow. Over fifty percent of men will develop an enlarged prostate in their lifetime. Left untreated, BPH will eventually obstruct the bladder outlet, resulting in urine retention and, eventually, kidney damage. High-risk invasive surgery is required at that point. Thus, BPH is a condition that affects the quality of life and can grossly shorten lifespan. As such, BPH is a primary concern of anti-aging physicians. In Europe, physicians use plant-based agents as the first-line of treatment for BPH, and 90% of BPH cases are managed by botanical means. Clinical success is correlated to degree of obstruction. As indicated by residual urine content, levels below 50 mld frequently result in excellent results of botanical therapy; where residual urine content is above 150 mld, botanical therapy is not likely to produce any significant improvement. BPH is thought to be primarily the result of hormonal changes associated with aging. In aging men, levels of the main male sex hormone, testosterone, decreases, while levels of the female hormones, namely estrogen, prolactin, LH, and FSH, all increase. Consequently, net concentration of testosterone within the prostate gland rises. Furthermore, due to a decreased rate of removal coupled with an increased rate of enzymatic activity acting on the body's male and female hormones, an increase in the conversion of testosterone to its potent form as dihydrotestosterone (DHT) results. Serenoa repens (saw palmetto) is the fat-soluble extract of the fruit of the saw palmetto (Sabal serrulata) tree. It serves to inhibit DHT, inhibits the overactive enzymatic activity, and interferes with prostate estrogen receptors. As a result, saw palmetto has produced excellent clinical results in numerous scientific studies of BPH. In as little as 28 days, Champault et al (1984) found that a majority of their 110 study subjects experienced significant improvement in dysuria, nocturia, flow, and residual urine. Patients on 90 days of therapy were found to experience decreased volume of the prostate along with improvement in dysuria, nocturia, and urine flow (Tripodi et al, 1983). With regard to BPH and its impact on quality of life, saw palmetto therapy yields marked improvements. In a multicenter study involving 305 men, Bach et al (1996) found that at three months, the subjects were much more satisfied (36.8 vs 9.7% at start of study), happy (24.0 vs. 2.3%), and delighted (5.4 vs. 0.6%). Negative emotions such as unhappiness (2.4 vs. 18.5%) and hopelessness (1.0 vs. 2.3%) experienced beneficial decline. In order to achieve BPH-related benefits with saw palmetto, the extract should be fat-soluble and standardized to contain 85 to 95% fatty acids and sterols. A study by Giannakopoulos et al (2002) found that dosages of 80 mg two or three times daily decreased the International Prostate Symptom Score by improving dysuria and nocturia, while improving quality-of-life scale scores. Because of the relationship between hormonal imbalances and the onset of BPH, it is critically important that anti-aging physicians monitor their male patients. By doing so, men can live longer, more fulfilling, more rewarding lives. To locate an anti-aging physician in your geographical area, visit The World Health Network, www.worldhealth.net, and utilize the online, interactive Physician Locator. REFERENCES Buck AC, "Phytotherapy for the prostate," Brit J Urol 78 (1996): 325-36. Champault G, Bonnard AM, Cauquil J, Patel JC. "Medical treatment of prostatic adenoma: controlled trial," Ann Urol 18 (1988): 5487-52. Braeckman J, "The extract of Seronoa repens in the treatment of benign prostatic hyperplasia: a multicenter open study," Curr Ther Res 55 (1994): 776-85. Giannakopoulos X, Baltogiannis D, Giannakis D, Tasos A, Sofikitis N, Charalabopoulos K, Evangelou A. "The lipidosterolic extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a comparison of two dosage regimens," Adv Ther. 2002 Nov-Dec;19(6):285-96. Gordon AE, Shaughnessy AF. Saw palmetto for prostate disorders," Am Fam Physician. 2003 Mar 15;67(6):1281-3. Tripodi V, Giancaspro M, Pascarella M. e al. "Treatment of prostatic hypertrophy with Serenoa repens extract," Med Praxis 4 (1983), 41-6. |