Contrary to what you may have heard testosterone is not the cause of BPH (prostate enlargement). It's time to stop blaming this natural hormone that makes a man a man. We men were not born with a universal design flaw. BPH is uncommon in natural hunting societies. The real cause has to be in the modern environment.

The missing link is a related steroid hormone called DHT. DHT or dihydrotestosterone is a product of your age and your modern day life. DHT can strike you where you are most vulnerable, causing swelling, impotence, and incontinence.

But DHT isn't invincible. In this, the third installment in your series on BPH (benign prostatic hyperplasia), I'll tell you how this rogue hormone can cause so much trouble. Then, I'll clue you in on how to stop DHT from harming your prostate – without sacrificing your testosterone.

* The Good, the Bad, and the Ugly *

Boosting low testosterone is one of the most important things a man can do to stay healthy. But some of my patients resist the idea. Their previous doctor blamed prostate enlargement on testosterone.

Einstein once said that an explanation should be made as simple as possible, but not more so. Many doctors have an oversimplified understanding of BPH. Yes, the cause is mostly hormonal, but not testosterone.

Testosterone is one of many related steroid hormones. Several are interconverted. Testosterone, for instance, can be converted into estrogens. You learned how to avoid that problem in Health Alert 125. But testosterone can also be converted into DHT. DHT is 9 times more powerful at stimulating growth of prostate tissue that testosterone is.

Testosterone maintains normal health of your prostate but DHT stimulates an overgrowth. DHT sends signals to the prostate tissue, making it swell. As the tissue swells, it impinges on the surrounding urinary and reproductive systems. (DHT is also the chemical that causes men to develop male pattern baldness.)

Your body converts testosterone to DHT with an enzyme called 5-alpha reductase. Exposure to stress and steroid related toxins in the environment appear to increase the activity of 5-alpha reductase. This deals a double blow to your manhood. It robs you of testosterone and it increases DHT.

But, without the presence of 5-alpha reductase, testosterone will not convert into DHT. And this is the concept behind well-designed BPH treatments. If you can block the action of the 5-alpha reductase, you can prevent and treat prostate enlargement while increasing, not lowering your testosterone.

* Eradicate Your Adversary *

Testosterone creams, gels, and patches are becoming very popular. But the only way you can use these methods safely is to closely monitor your DHT. If the cause of your falling testosterone is increased activity of 5-alpha reductase and your doctor gives you more testosterone without inhibiting 5-alpha reductase, you will just produce even more DHT. And that's not a good thing.

You can boost your testosterone safely. And many men over the age of 40 often see dramatic benefits. Just make sure that your doctor closely monitors your testosterone and DHT levels. And, a DHT level should be part of your annual physical exam.

Laboratories list “normal” DHT levels from 25 to 75. The problem is that many men in the “normal” group have elevated DHT levels without knowing it. Instead, you should maintain your DHT below 50.

I have read several studies that confirm that blocking 5-alpha reductase:

? lessened the amount of times men have to urinate
? increased urinary flow rate
? decreased urinary pain
? decreased urinary “dribble” 1

You can stop 5-alpha reductase from making DHT with natural supplements. The best inhibitors of 5-alpha reductase come to us in the form of plant sterols. I've talked about some of these supplements before. Saw palmetto, pygeum, and pumpkinseed are the “big three”.

One DHT blocker runs circles around the rest. It's so important that I'll dedicate the next Health Alert in your series to this powerful men's nutrient.

Al Sears MD

1 Carson C., et al. The role of dihydrotestosterone in benign prostatic hyperplasia. Urology 2003 Apr; 61 (4 Suppl. 1): 2-7