HOW TO TAKE CARE OF THE PROSTATE NATURALLY
The prostate is a small gland located below the bladder, in front of the rectum and forms part of the male reproductive tract, since it produces a liquid that combines with sperm to form semen.
At birth, this gland is small and by adolescence, when testosterone levels increase, the prostate grows, doubling its size by the age of 20. This growth attenuates from here on, although at the age of 50 men experience a second enlargement that does not usually cause problems for the rest of their lives. However, in some cases this enlargement is uncontrolled and when combined with some factors such as obesity, chronic diseases (diabetes or heart disease) and family history can lead to the appearance of benign prostatic hyperplasia (BPH).
BPH is a non-cancerous enlargement of the prostate gland whose prevalence increases progressively with age. In fact, it is estimated that 80% of those over 50 years of age suffer, to a greater or lesser degree, from an enlarged prostate or BPH, with 33% of those over 50 years of age already having a well-formed adenoma, while by the age of 80 this percentage rises to 95%.1
Prostate enlargement is often accompanied by obstructive symptoms of hesitant or intermittent urination and decreased urinary force and urinary stream. Irritative symptoms such as dysuria (pain, discomfort or urgent sensation that occurs when urinating), increased urinary frequency, nocturia (increased nocturnal urinary frequency), and urgency to go to the bathroom may also occur. If left untreated, urine retained in the bladder can ascend to the kidneys, which can lead to kidney damage and kidney failure.
There is currently no treatment to prevent the onset of BPH or the urinary problems associated with the disease, but urologists recommend maintaining an adequate body weight, eating a healthy diet, exercising frequently and leading an active sex life.
Current treatments for BPH include the well-known alpha blockers that help relax the muscles at the base of the bladder and increase a man’s ability to urinate. However, these drugs often have side effects as they can cause dizziness, fatigue or hypotension. Another option is 5-α-reductase inhibitors, which can reduce prostate size and increase urine flow. Although they take three to six months to start working, they have been better than alpha-blockers in isolated cases.2
From the point of view of integrative therapies, we can opt for other natural treatments such as various plants and food supplements that can help us improve the symptoms of BPH or prevent prostate cancer without resorting to synthetic drugs that can produce undesirable side effects.
The properties are detailed below:
Epilobium parviflorumor epilobium is a very effective plant for BPH and prostate cancer. The active components of the genus epilobium that have shown most interest are its polyphenols, specifically the ellagic tannins. On the other hand, flavonoids such as quercetin, myricetin and kaempferol and their corresponding glycosides also have very interesting biological properties. There are several scientific studies on the ellagic tannins called oenotheins, mainly oenothein A and B. These assays seem to show that these compounds participate in the reduction of two enzymes (5α-reductase that metabolizes testosterone into dihydrotestosterone (DHT); and aromatase that converts testosterone into 17-β-estradiol). Both enzymes are involved in the occurrence of BPH, prostate cancer and even baldness, since by degrading testosterone hair loss or prostate damage occurs. It has been seen that with the oenotheins of this plant, these two enzymes have been reduced up to 70% and with flavonoids such as quercetin and kaempferol isolated from the same plant, 41% of the enzymes were reduced. All this seems to suggest that Epilobium parviflorum extracts could be beneficial in treating these pathologies.3
EFLA®940 (Curcubita Pepo L.) dry pumpkin seed extract is a special lipid-free pumpkin seed extract, which provides only hydrophilic substances. This means that the active compounds are more concentrated than in the seed itself by eliminating the fatty part and are more stable, as the product is prevented from becoming rancid due to lipid oxidation. Among the active compounds present in the extract are lignans (phytoestrogens) and another substance with a possible structural and functional similarity to testosterone that has not yet been identified. EFLA® 940 has been shown to inhibit 5-α-reductase, helping to decrease these altered DHT levels and increase testosterone levels, thereby alleviating symptoms in cases of stage I and II BPH, including overflow urinary incontinence.4
Sabal berry extract or wild palmetto (Serenoa repens) has a beneficial action on the prostate and other male characteristics thanks to its mixture of unsaturated fatty acids, phytosterols and flavonoids, among other components. Like lignans or ellagic tannins, the action of these compounds is to inhibit the enzyme 5-α-reductase, which acts on testosterone by converting it into DHT. In addition, the anti-inflammatory effect of Sabal has no side effects and reduces incontinence and discomfort that occurs in BPH and other conditions of this organ. Regular consumption of Sabal is recommended for men in their 20s and older, as Sabal is not only effective in treating current problems, but also as a preventive measure.5
Nettle (Urtica dioica L.) belongs to the Urticaceae family and is one of the most widely used medicinal plants in the north of the Iberian Peninsula. The extract from the roots of the plant has been commonly used as a drug for BPH while the fresh and dried parts of the flowers are traditionally used for other purposes, such as joint pain, urinary tract infections and as a diuretic. Nettle is rich in flavonoids, carotenoids, silicic acid, tannins, phytosterols, B vitamins, C and minerals such as potassium and silicon.6 These active constituents make it an important medicinal herb for treating kidney and urinary disorders. Specifically, silicon has been studied in this field because of its involvement in the cell death of prostate cancer cells or the expression of genes and proteins against them.7 In the treatment of BPH, several mechanisms of action of the root have been postulated, including a mild diuretic effect and potent anti-inflammatory activities, probably due to the presence of scopoletin. Polysaccharides and lectins may block the binding between epidermal growth factor, secreted by the prostate, and its receptors, with suppression of organ cell metabolism and growth. In addition, lectins may contribute to the antiproliferative and anti-inflammatory activities of the prostate by inhibiting TNF-α activity, prostate cell proliferation and the aromatase activity mentioned above. The aqueous extract of nettle leaves is also able to inhibit the activity of adenosine deaminase (ADA), the key enzyme in nucleotide metabolism. The inhibition is dose-dependent and could be one of the mechanisms leading to the improvement of patients’ symptoms.5
Pygeum africanum is an evergreen tree of the Rosaceae family native to the islands of Madagascar and Comoros and the Gulf of Guinea. This plant is also known as African plum or African cherry. The bark of Pygeum africanum contains phytosterols, fatty acids, alcohols (n-docosanol and its derivatives), lignans and proanthocyanidins among others. Pygeum inhibits androgen and progesterone receptors, but not glucocorticoid and estrogen receptors; it inhibits endogenous prostate-specific antigen (PSA) expression and non-cancerous growth of prostate cells. In addition, isolation of docosanol derivatives has shown inhibition of human prostate cell proliferation. To confirm this mechanism of action, other studies showed down-regulation of TGF-β1 (a growth factor for tumours) and inhibition of proliferation of human prostatic fibroblasts and myofibroblasts. Some studies have reported that Pygeum africanum appears to significantly improve urological symptoms, and may be equally effective as wild palmetto (Serenoa repens)5.
POMANOX® P30 is a natural extract obtained from the fresh fruit of the pomegranate (Punica granatum) grown in Spain, which maintains all its natural properties and whose manufacture is protected under patent. It has a unique combination of polyphenols from fresh pomegranate, which act synergistically, including α- and ß-punicalagins and ellagic acid which are potent natural antioxidants. Pomegranate is a type of fruit rich in antioxidants and its peel and seed have potential anticancer activities. Some research using pomegranate peel extracts on apoptosis and metastasis of prostate cancer cells showed inhibition of prostate cancer cell growth. There would appear to be a link to indicate that the antioxidant compounds in the extract could induce prostate cancer apoptosis by upregulating genes encoding caspase, the apoptosis executioner molecule.8
Lycopene is a vegetable pigment that gives a reddish colour to some fruits and vegetables such as tomatoes, red peppers, radishes, pink grapefruit, watermelon, pomegranate, etc. This pigment is a powerful natural antioxidant with great benefits for the organism: antioxidant, anti-inflammatory, preventive against some cancers, chemotherapeutic, reduces the risk of cardiovascular diseases, prevents neurodegenerative diseases, etc9. Several lines of research concluded that it surpasses α- and ß-carotene in its capacity to inhibit tumour cell proliferation. Moreover, in a follow-up of a population group supplemented with lycopene, it was found that tumour development was significantly delayed. It has been suggested that it may be able to prevent or delay the onset of cancers such as breast, prostate or ovarian cancer.10 In fact, one study found that eating at least 10 servings of tomatoes a week reduced the risk of prostate cancer by 35% and that these findings were even stronger if the disease was already advanced.11 In the prevention of BPH, it suggests that high daily doses of lycopene reduce the risk of developing this condition. In the form of sauce or as tomato concentrate, lycopene has been shown to increase prostate cell apoptosis and reduce plasma PSA levels in patients with BPH.12
Piperine is an alkaloid from black and long peppers (Piper nigrum Linn and Piper longum Linn) that exhibits antitumor activities in vitro and in vivo. The antitumor mechanism of piperine has been investigated in DU145, PC-3 and LNCaP human prostate cancer cells. The Piperine treatment produced a dose-dependent inhibition of proliferation of these cell lines. Although piperine induced little apoptosis, it did promote autophagy. These results would indicate that piperine would possess an antiproliferative effect on human prostate cancer cells by inducing cell cycle arrest and autophagy by the organism.13
Next, we explain the effects of some vitamins and minerals in the prevention and/or treatment of BPH.
Vitamin D3 (cholecalciferol) is a fat-soluble vitamin found in fatty fish, fish liver oil and eggs. It can be synthesized by the body through the skin by the action of UV rays. Population studies and clinical trials have been carried out to study the effects of vitamin D on prostate cancer. Its effects appear to be related to the reduction of PSA production. In some studies a relationship between vitamin D concentration and prostate cancer was observed. However, more scientific studies are needed to support this hypothesis.14
The chronic inflammation that occurs in most cancers could increase the degradation of Vitamin B6. In addition, some experimental studies have uncovered a mechanism by which vitamin B6 could affect the activity of steroid hormone receptors and decrease their effects on gene expression. If the activity of steroid receptors for estrogen, progesterone, testosterone, or other steroid hormones can be inhibited by a lack of vitamin B6, it is possible that vitamin B6 could influence the risk of developing steroid hormone-driven diseases, such as prostate or breast cancer. Therefore, an intake of vitamin B6 could prevent the occurrence of these cancers. 15
Zinc is vital for the metabolism of bacteria, especially for their survival in the intracellular environment; for example, in E. coli there is a zinc-dependent enzyme that transports metals such as iron. A zinc-dependent intracellular antioxidative enzyme, which alters the redox potential of polymorphonuclear leukocytes through the activation of a p53 protein, has also been reported, which could also play a role in the increase of prostate infections and prostate cancer in patients with low zinc levels. The high concentration of zinc in prostatic tissues is important for defence mechanisms against genitourinary tract infections and patients with acute prostatitis have been found to have a relative lack of the zinc-dependent prostatic antibacterial factor responsible for the bactericidal properties of prostatic fluid. 16
Selenium is an essential component of cellular glutathione peroxidase, thus acting as an important antioxidant. In addition, its function is to complement the antioxidant effect of vitamin E by protecting the integrity of the cell membrane. Currently, there is evidence that selenium is related to prostate carcinogenesis. Several studies have shown an inverse relationship between serum selenium levels and the detection of advanced prostate cancer. Selenium accumulation in the prostate and local selenoprotein activity have been analysed as a potential mechanism in the prevention of prostate cancer.17
Finally, copper is an essential element that plays an important role in both the development and growth of prostate cancer. Administered in the form of copper complexes, it dramatically inhibits the growth of human prostate tumours engrafted in mice. Copper-targeted therapies for the treatment of prostate cancer are being evaluated in human clinical trials where ruthenium-copper metal complexes with new drugs (nanodrugs) have been shown to reduce toxicity compared to others used to date in this disease that have demonstrated strong antitumor activity and that can also be easily eliminated from the body in the urine and feces. 18
In summary, all the ingredients discussed stimulate in one way or another the prevention or treatment of BPH or prostate cancer, either by maintaining testosterone levels or by reducing oxidative stress, inflammation and the proliferation of cancer cells in this organ, in addition to improving incontinence and the discomfort that occurs in BPH. Consuming them can be a preventive measure that benefits prostate health.
- Lozano, J.A. (2003). Diagnóstico y tratamiento de la hiperplasia benigna de próstata. OFFARM, VOL 22 NÚM 5 MAYO 2003 ÁMBITO FARMACÉUTICO.
- Fernández Arjona M, Pereira Sanz I. Hiperplasia benigna de próstata: una afección de elevada prevalencia en el paciente de edad avanzada. Rev Esp Geriatr Gerontol. 2008 Jan-Feb;43(1):44-51.
- Ducrey, B.et al. (1997). Inhibition of 5α-Reductase and Aromatase by the Ellagitannins Oenothein A and Oenothein B from Epilobium Species. Planta Medica, 63(2), 111–114.
- Allkanjari, Olta; Vitalone, Annabella (2015). What do we know about phytotherapy of benign prostatic hyperplasia?. Life Sciences, 126(), 42–56.
- Plantas medicinales: Sanos gracias al poder de la naturaleza Escrito por Dr. Angela Fetzner.
- Durmus, I. M., Deveci, I., & Karakurt, S. (2021). Synthesis of Silica Based Nanoparticles Against the Proliferation of Human Prostate Cancer. Anti-cancer agents in medicinal chemistry, 21(18), 2553–2562.
- Deng Y. et al. The extract from Punica granatum (pomegranate) peel induces apoptosis and impairs metastasis in prostate cancer cells. Biomed Pharmacother. 2017 Sep; 93:976-984.
- EFSA. “Use of lycopene as a food colour” The EFSA Journal (2008) 674, 1-66.
- Agarwal, S., & Rao, A. V. (2000). Tomato lycopene and its role in human health and chronic diseases. CMAJ, 163(6), 739–744.
- Takeshima, M., et al (2014). Anti-proliferative and apoptosis-inducing activity of lycopene against three subtypes of human breast cancer cell lines. Cancer Science, 105(3), 252–257.
- A) Kristal AR, Arnold KB, Schenk JM, et al. Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial. Am J Epidemiol. 2008; 167:925-34. B) Edinger MS, Koff WJ. Effect of the consumption of tomato paste on plasma prostate-specific antigen levels in patients with benign prostate hyperplasia. Braz J Med Biol Res. 2006; 39:1115-9.
- Ouyang DY et al. Piperine inhibits the proliferation of human prostate cancer cells via induction of cell cycle arrest and autophagy. Food Chem Toxicol. 2013 Oct;60:424-30.
- Leklem JE. Vitamin B-6. In: Shils M, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkins; 1999:413-422.
- Gómez, Yenny, et al (2007). Niveles de zinc en líquido prostático de pacientes con patologías de próstata. Investigación Clínica, 48(3), 287-294.
- López Fontana, C.M., et al (2010). Relación entre los niveles plasmáticos de selenio y las diferentes enfermedades prostáticas. Actas Urológicas Españolas, 34(7), 625-629.
- Sanz Del Olmo N, et al. Cyclopentadienyl ruthenium(II) carbosilane metallodendrimers as a promising treatment against advanced prostate cancer. Eur J Med Chem. 2020 Aug 1;199:112414.