The prostate gland is situated at the base of the male bladder, where the urethra enters the bladder. (Please see Medical Diagram of Prostate Gland location)
In Western Societies the prostate enlarges with age. Almost certainly this is due to consumption of dairy products. These contain growth promoters (yes! even organic milk does) to which the prostate is sensitive. As the prostate enlarges (so called benign prostatic hypertrophy) it may obstruct the flow of urine. Therefore with age, the imperative to avoid dairy and eat a Stone Age Diet increases! More often I now prescribe the ketogenic diet - please see Ketogenic diet - the practical details and My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds.
This obstruction of urine may cause symptoms of:
- Hesitancy - the time it takes to start peeing.
- Poor stream.
- Takes a long time to pee.
- Terminal dribbling.
- Sometimes double micturition (peeing twice).
- Stop/start peeing.
- Enlargement of the bladder and/or ureters (tubes made of smooth muscle fibers that propel urine from the kidneys to the urinary bladder) and possibly back pressure on the kidneys.
- Failure to empty the bladder fully with stagnation of urine and infection.
Any prostate symptom should be investigated because the enlargement may be due to a cancer. The usual screening test would be a rectal examination and a blood test for PSA (prostate specific antigen). A rectal examination alone has its limitations because it only feels the back of the prostate gland.
Recently a new test to diagnose prostate cancer has become available called PCA3 available through the Doctors' Laboratory - please see The Doctors' Laboratory PCA test and then, if you are interested, please contact the office for more details about this test and its cost. This sample calls for cells collected in urine before and after prostatic massage. A biopsy is therefore not necessary. I am generally opposed to biopsies for cancer because this may spread cancer cells up the needle tract.
The commonest cause of an enlarged prostate is "benign hypertrophy". Please see Medscape article on Benign Prostatic Hypertrophy It is generally assumed that this is as a result of lifelong exposure to testosterone. But this does not square with the fact that testosterone levels are at their highest in young men and decline with age. The explanation that I like best is that it is a failure of the enzyme systems which normally break down testosterone and one ends up with excessive oestrogen. This conversion is inhibited by a substance in cabbage called Indole-3-carbinol. So eat up your greens! Please see Linus Pauling Institute webpage on Indole-3-carbinol which includes details of other foods containing this substance.
All cases of benign hypertrophy need assessment by a urologist. For benign hypertrophy, one can try 5 alpha reductase inhibitors such as saw palmetto (Please see Biocare Saw Palmetto product and elsewhere on the internet), or drugs such as Proscar (Please see Drugs.com page on Proscar). However many men require a minor operation to pare down the prostate gland - so-called TURP (transurethral resection of prostate). Please see Wikipedia article on TURP)
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