Imagine going to your doctor for an ear infection. Instead of giving you treatment options, your doctor says he can either wait to see if the infection gets worse, or he can remove your ear so that it won't get infected again. This is of course absurd. But it is similar to what many men experience when they see their doctors about a swollen prostate.

The American Urological Association (AUA) has recently revised its treatment guidelines for enlarged prostate. Their recommendations? Your doctor should do nothing and wait or you should have surgery.

Half of men in their 60s suffer from a swollen prostate or benign prostatic hyperplasia (BPH). There is a good chance that you may be or know a man who will have to deal with BPH. The constant feeling of needing to urinate, not being able to fully urinate, and painful urination cause many men to seek help. You should know that the AUA are a group of surgeons. To us non-surgeons, the surgical option appears extreme. You should also understand that there are natural, safer alternatives.

* Take a Number and Wait *

I just read an article in a medical journal marketed to physicians. It is what many physicians use to guide their treatment decisions. The AUA's treatment guidelines will prompt more doctors to turn to extreme measures of treatment. Here are the 2 major treatment categories:

Watchful Waiting: Many doctors will suggest that a man take no action if his BPH symptoms are moderate. What's worse is that some doctors tell elders to watchfully wait just because of their age. This means that the prostate will continue to swell with no intervention. Watchful waiting usually leads to another extreme option: surgery.

Surgery: Whether a doctor suggests removing the prostate for shaving pieces off of it, surgery is an extreme option. Surgery has a range of side effects including infection, incontinence, and sexual dysfunction. The AUA boasts that surgery is an appropriate initial option for BPH. Initial? Surgery should be a last resort.

* What Works *

I would advise nearly the exact opposite of these two extremes. The old adage “a stitch in time saves nine” is applicable to prostate treatment. The truth is that it is much easier to prevent enlargement of your prostate than it is to reverse it. And it's easier to halt or reverse existing enlargement if you catch it early.
I believe that you should avoid extreme options for the treatment of BPH. Treat BPH as soon as symptoms develop. Waiting makes no sense. The earliest symptom is usually waking at night to urinate.

Most prostate swelling is in reaction to a substance called DHT. Block the production and action of DHT and you prevent your prostate from growing.

The hair loss drug called Propecia and the prostate drug Proscar both work by blocking the enzyme that produces DHT. (That's right, the same chemicals cause your hair to fall out and your prostate to swell.) Proscar will reduce the symptoms of BPH and is a reasonable option. But like all drugs, Proscar has potential side effects.

Luckily, there are natural alternatives to Proscar. Beta sitosterol is the most effective. Beta sitosterol is a plant sterol that blocks DHT. Plant extracts like saw palmetto, pumpkin seed, and pygeum bark contain beta sitosterol. These extracts are good alternatives to waiting and drugs.

You can find supplements with all three of these herbs. Many newer prostate formulas will offer the beta sitosterol extract itself. About 100 mg of beta sitosterol or 300mg of saw palmetto daily should ease the symptoms of BPH.

You can also make lifestyle changes that will relieve symptoms:

• Exercise: Inactivity can cause urinary retention.
• Avoid caffeine: Caffeine increases urine production and is an irritant to the bladder.
• Stop drinking liquids after dinner.
• Bundle up: The cold can cause urine retention.

Al Sears MD