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Prostate Health Through Hormone Balance

​by Nicole Crane, B.S., NTP

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So often when healthy hormone balance is highlighted, the focus is on women. Healthy hormone balance is just an important for men, and little attention gets paid until there is a problem. Men's hormones impact everything from sex drive, muscle strength and energy levels, mood and sleep and even hair loss. Men's hormones, especially as they get older, also tend to greatly affect the prostate. The health of the prostate is dependent on healthy hormone balance, proper intake of several important nutrients, exposure to plastics and other synthetic hormones and even lifestyle factors like stress. It is never too early OR too late to support the health of the prostate and making the effort to balance hormones is an essential step. 

It is important that men maintain a healthy balance of testosterone. Testosterone is the primary male hormone and it is fairly sensitive to be converted into other hormones. Free testosterone can be converted into estradiol, which is a type of estrogen, though an enzyme called aromatase, which has a comparably minor consequences for prostate function.  What DOES have substantial effects on the prostate is the conversion of testosterone to dihydrotestosterone. (DHT)  DHT as an overactive form of testosterone and while it serves an important purpose, too much DHT after puberty is not a healthy thing. During puberty, DHT helps the prostate grow and reach a mature size, and this is fine and normal. However, when too much testosterone gets converted into DHT, there can be negative consequences for prostate wellness. As DHT is responsible for contributing to prostate growth, when the body loses its ability to regulate DHT, the prostate can be stimulated to grow and grow. Like all hormones, DHT must be kept in balance. Without DHT, the prostate would not be able to heal and repair itself, so some is necessary and even helpful. However, excess DHT has been implicated in conditions like BHP, which is benign prostatic hyperplasia. BPH is a benign, or noncancerous, condition characterized by an enlarged prostate. BPH is a very common condition that affects half of all men in their 50s and 80% of men in their 80s.  BPH tends to effect urination, specifically frequent, often-urgent need to urinate, especially at night, the need to strain to get urine out, the inability to completely empty the bladder, Dribbling or leaking after urination or even a weak urine stream often are the result of BPH. These symptoms can really affect sleep quality and overall quality of life. Urination issues are usually the biggest complaint among men with poor prostate health, but the good news is you can restore the health if your prostate and maybe even sleep the night through again. BPH also tends to be effected by excess inflammation. A two pronged holistic approach of modulating inflammation and balancing hormones is a powerful combination for prostate wellness.

 There is a lot that can be done holistically and nutritionally to improve prostate health, without drugs and certainly without surgery. The conversion of free testosterone into DHT has been identified as one of the causes for BPH, or enlarged prostate. There is an enzyme that prevents the conversion of testosterone to DHT that is dependent on zinc. When men have lots of zinc in their diet or in their supplements, they have a lot more testosterone because it does not get converted into the overactive DHT that makes the prostate grow in an unhealthy way. Further, prostatic fluid is also rich in zinc, measuring at concentrations 500-1000 times that of blood.ii Low levels of zinc in prostatic fluid have been correlated with prostate dysfunction, often stemming from hormone imbalanceiii. Zinc is great for prostate health and healthy hormone balance for men and it also supports immunity, so it even has a protective effect on prostate tissue. About 70% of men do not meet the recommended daily intake for zinc and this single nutrient has a huge impact on whether you can hold on to your good, well behaved testosterone, or whether it gets converted into DHT, his hyperactive, rambunctious cousin. When men have optimal levels of zinc, they have what they need to make only a healthy amount of DHT and no more. DHT is what makes the prostate grow and grow and grow, and is also associated with hair loss and baldness and acne. What is even more significant is that low levels of testosterone and high levels of estradiol, a form of estrogen, have been linked to sudden cardiac arrest. Sudden cardiac arrest is an often fatal heart rhythm disorder that is different than a heart attack. Research shows that men who have had a sudden cardiac arrest had average testosterone levels of 4.4 nanograms per milliliter, compared to 5.4 nanograms per milliliter for men who did not have sudden cardiac arrest and 68 picograms per milliliter, compared to 52 picograms per milliliter for men who did not have sudden cardiac arrest.iv

 Zinc is one of the most important nutrients for men's health; particularly for the role that it plays in controlling the rate that good, healthy testosterone gets converted into misbehaving DHT. One of the best sources of zinc is oysters, a food that is often called an aphrodisiac. Pumpkin seeds are also rich in zinc and are a food that is excellent for the prostate and hormonal wellness. Pumpkin seeds and pumpkin seed oil supports the prostate in several ways. In addition to being a good source of zinc, pumpkin seeds are rich in vitamin E, including a diversity of forms of the vitamin e family. Pumpkin seeds contain three of the four tocopherols, along with several tocomonoenols, a more bioavailable form of vitamin E that has only recently has been discovered. v Vitamin E plays a really important role in fertility and acts as a powerful antioxidant and neutralizer of inflammation inducing free radicals. Pumpkin seed oil also helps improve urinary function, including frequency of urination and difficulty fully emptying the bladder. In a 2009 study published in the journal Nutrition Research and Practice, men using 320 mg of pumpkin seed oil daily experienced a 58% improvement in urinary symptoms after one year. When the same study combined 320 mg of pumpkin seed oil with 320 mg of the herb saw palmetto, men had a 75.3% improvement in symptoms of BPH after 12 This dramatic improvement, well known in the holistic world, is garnering attention from conventional medicine as well, and deservedly so. Pumpkin seeds, whether in food or supplements, are a great addition to any men's health program. There are other herbs that shine even brighter for prostate health.

 Saw palmetto is a classic herb for the prostate. Saw palmetto supports a normal prostate size as well as healthy hormone balance. The prostate should be the size of a large walnut, but when a man has BPH, the prostate can grow to 2 or 3 times (or more) this size. This presses down on the urethra, almost like inflating a balloon around a straw, compressing the straw and narrowing it. An inflamed prostate also presses up against the bladder. When the balloon is your prostate, and the straw is the tube you pass urine through, the bigger the prostate grows, it becomes difficult to urinate, to fully empty your bladder and harder to sleep through the night. Urinary issues are not really a problem with the bladder, but are often problem with the prostate. Saw palmetto trees are native to the southeastern United States and the berry is the part used medicinally. This wonderful herb has a number of beneficial fatty acid constituents including Beta-sitosterol, capric acid, ferulic acid, palmitic acid, stearic acid. Beta sitosterol is a strong inflammation regulator that tends to work more strongly in the prostate and in the heart and other types of smooth muscle like the bladder. Beta sitosterol is one of the reasons that saw palmetto works quite effectively to restore the prostate to a healthy size. Beta sitosterol is also a powerful antioxidant so its helps protect the prostate against free radical damage that turns on inflammation and damages cells. It has also been shown to act as a mild DHT blocker, and DHT is the hormone that often makes the prostate grow in the first placevii. Caprylic acid, another fatty acid in saw palmetto, is also found in coconut oil, and it is an effective natural antimicrobial. Some aspects of BPH may be the result of a prostate infection, so it can be very helpful to take something like saw palmetto that contains caprylic acid to kill any infection that might be present. When the infection is gone, the inflammation can begin to subside. Ferullic acid, also found in saw palmetto berries is another antioxidant and free radical scavenger, protecting cells from the rusting that oxidative damage causes. It also keeps tissues healthy by inducing apoptosis, which is programmed cell death, in cells that are damaged beyond repair.viii Saw palmetto helps the prostate in several different ways, and this special berry has been used for hundreds if not thousands of years for prostate health and sexual vitality. It is important to note that low doses of saw palmetto are not as effective as high dose saw palmetto that contains a standardized amount of fatty acids. A 2001 study on beta sitosterol, one of the most important constituents of saw palmetto, showed that it dramatically improved symptoms of BPH, as assessed by The International Prostate Symptom Score (IPSS) and other measures. The IPSS is a questionnaire designed to asses symptoms of prostate dysfunction. In this study, the beta sistosterol group had an over 50% improvement in their prostate function, compared to just a 7% improvement in the placebo group after 6 months. Eighteen months later, the beta sistosterol group was maintaining a 55% improvement in symptoms of BPH.ix Saw palmetto is the go-to herb for the prostate because it addresses the problem directly, while also being safe and effective.

 Often when you hear about saw palmetto, you also hear about pygeum, and that is because they work together so effectively. Pygeum does not work like saw palmetto does, which is by affecting the conversion of testosterone to dihydrotestosterone.  Instead, it acts by acts reducing inflammation in the prostate, and also by inhibiting prostate growth factors, which are substances implicated in inappropriate prostate enlargement. Saw palmetto and pygeum are like Batman and Robin for prostate health. There is some evidence that indicates that pygeum works best with another herb called nettle, which is another superhero herb for a healthy prostate. Nettle offers a series of complex effects on the prostate, mainly by balancing the hormones that triggered the prostate to grow in the first place. Nettle inhibits the binding of testosterone to sex hormone binding globulin (SHBG). SHBG is a glycoprotein that preferably binds to testosterone and estrogen, and helps them reach their target organ, which in this case is the prostate. When testosterone and especially DHT, the bad testosterone, are unable to bind to this protein, the prostate receives less hormones and less stimulation.  Notably, SHBG is also regulated by minerals like zinc, boron, magnesium and other trace minerals.  Nettle protects the prostate by preventing DHT from stimulating the prostate to grow and grow. It is thought to be the lignans that have this effect. Nettle is also thought to have an Anti-Estrogenic Effect. While most of the other herbs used in the treatment on BPH work by preventing DHT from stimulating of the prostate, the active compounds of stinging nettle root extract also target the effects of estrogen hormones on the prostate. Estrogen also worsens the symptoms of BPH by blocking the breakdown of DHT which results in an increased level of DHT in the prostate. Nettle acts on the enzymes that turn testosterone into estrogen and blocks their action. Nettle also acts by inhibitor of the enzyme which converts testosterone to DHT, but this action is a bit weak. Saw palmetto is much more effective at this. Further, nettle prevents DHT from binding to testosterone receptors by interfering with the receptor itself. If DHT cannot bind, it cannot make the prostate grow. A 2005 study of more than 500 men showed that nettle extract improved urinary tract symptoms by an astonishing 81% in just 6 months, compared to just a 16% improvement in the placebo group.x Nettle is a great supporter of healthy hormones which is the key to a normal and healthy prostate size, and when the prostate is normal, urinary function is normal as well.

 Another classic herb for prostate wellness is a rosy carotenoid known as lycopene. Lycopene is found in red and orange fruits and vegetables, and is best sourced from cooked tomatoes. Lycopene is a powerful antioxidant, which means it protects the body from free radicals that aim to destroy body tissues to regain stability. When strong antioxidants, like lycopene, are present in our cells and tissues, the antioxidants in essence become martyrs, and give up their chemical stricter and become broken down in order to protect our body from the same fate. Free radical damage causes cellular inflammation and miscommunication, as well as damage to our DNA. This can lead to major dysfunction and premature aging of that cell or body part. When free radical damage is excessive, cells and parts of our tissues can be damaged enough to cause their death. Not only does lycopene tend to go towards and accumulate in the prostate, once present there, it seems to have a very protective effect over prostate tissue and the viability of sperm overall.xi Lycopene also seems to have a positive effect on BPH symptoms. By protecting the prostate against free radical damage, several studies have shown that lycopene drastically improves scores on the International Prostate Symptom Score (IPSS) in as little as six months.xii Lycopene is quite famous for supporting the health of prostate cells.

With so many men dealing with the limitations of BPH and the urinary tract symptoms that accompany this issue, holistic medicine offers so many safe and effective nutrients that address the problem at its core. Take the time to take in herbs that support healthy prostate cells, healthy hormone balance, inflammation control and bladder and urinary tract health. Pair up those herbs with antioxidants and nutrients that are missing from the diet of most men. If you are not happy with your prostate health and your frequency of urination as you have gotten older, give your body some all natural support. Healthy inflammation control and hormone balance will only pave the way towards normal urinary patterns, even at night, good sexual function and optimal health, at any age.

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ii. Zaichick VY  Sviridova TV, Zaichick SV; Zinc concentration in human prostatic fluid: normal, chronic prostatitis, adenoma and cancer. Int Urol Nephrol. 1996;28(5):687-94.
iii. Christudoss P, Selvakumar R, Fleming JJ, Gopalakrishnan G. Zinc status of patients with benign prostatic hyperplasia and prostate carcinoma. Indian Journal of Urology : IJU : Journal of the Urological Society of India. 2011;27(1):14-18.
vi. Hong, Heeok, Chun-Soo Kim, and Sungho Maeng. "Effects of pumpkin seed oil and saw palmetto oil in Korean men with symptomatic benign prostatic hyperplasia." Nutrition research and practice 3.4 (2009): 323-327
ix. Berges, R. R., A. Kassen, and T. Senge. "Treatment of symptomatic benign prostatic hyperplasia with β‐sitosterol: an 18‐month follow‐up." BJU international 85.7 (2000): 842-846.
x. Safarinejad, Mohammad Reza. "Urtica dioica for treatment of benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled, crossover study." Journal of herbal pharmacotherapy 5.4 (2005): 1-11.
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