Men and hormonal changes? Yes, the times are changing in the field of men's health. "Prostate" is now a household word when barely a decade ago men didn't even know they had one. And the notion that a man may also experience "hormonal changes" is new to many of us. Considering the countless number of men who complain about prostate problems, it is time rethink the subject and consider the facts.
The Prostate and Hormonal Changes
The truth is, around the age of 40, testosterone levels begin to decline in men. Although not as significant and all-encompassing as the hormonal changes women experience during menopause, it does have some definite effects. And they are not all positive! As testosterone levels decline, there is also an increase in one of its metabolites, called dihydrotestosterone. This hormone causes overproduction (called hyperplasia) of cells within the prostate gland, which ultimately result in enlargement of these tissues.
Benign Prostate Hyperplasia -- BPH
This process is called benign prostatic hyperplasia or benign prostatic hypertrophy-- often simply called BPH. Because the prostate sits beneath the bladder, when inflamed it may put pressure on the urethra, creating a variety of uncomfortable urinary complaints. Quite simply, the enlarged prostate obstructs the flow of urine. This results in symptoms of incomplete emptying of the bladder, dribbling, difficulty starting urination, reduced force of the stream, frequent urination of small amounts, and sometimes the inability to urinate at all.
The data varies, but BPH interferes with the urinary system to some degree in up to 80% of men over the age of 60. It is reported that at least 50% of men over the age of 45 have some prostate enlargement, whether it is accompanied by symptoms or not. These numbers characterize benign prostatic hyperplasia as an "epidemic" rather than an isolated health concern that is troublesome to a small group of men.
Other Prostate Conditions
A secondary health problem often associated with BPH is actual infection in the prostate gland. Incomplete emptying causes "stagnation" in the bladder, which sometimes results in a bacterial infection. However, in only 5% of the cases can an identifiable bacteria be cultured from the prostatic fluids.
Cancer of the prostate also needs to be mentioned. This year the American Cancer Society estimates that 165,000 men in the US will be diagnosed with prostate cancer and 35,000 will die of it. Presently, the only malignancy killing more men is lung cancer. The overall incidence has soared 39% since 1973. However, prostate cancer is rare before the age of 50. It occurs in at least 50% of men who live to be 80 and beyond, the average age of diagnosis being 73. And men who are over 65, African-American, or whose fathers had prostate cancer are at greatest risk for developing it (1).
The purpose of this article is to focus on the treatment and prevention of BPH rather than cancer of the prostate. Conservative measures for an enlarged prostate include prostatic massage and reducing or eliminating coffee and alcohol. Antibiotics are frequently prescribed whether an identifiable pathogen is present or not. And surgery is considered in some of the more serious cases of prostate enlargement, as well as for some individuals with cancer.