Dribbling Into Middle Age

Men! Are your nights interrupted by frequent trips to the bathroom?

We apologize for the inconvenience. Please visit our blogging site instead for the most uptodate version of this page: http://infertilityworkshop.com/blog/dribbling-into-middle-age/

Do you groan inagony when you see a "next rest stop, 69 miles" sign on the road? Have you givenup basketball games because you’re doing more dribbling than the players?

If so, you’ve truly entered middle age and are experiencing the one problem thatnearly all men share: Prostate problems, especially benign prostatic hyperplasia.

The prostate is a donut-shaped, chestnut-sized gland located below the bladder. Moreimportant is that it surrounds the urethra, the tube through which urine flows from thebladder. If the prostate is inflamed or enlarged, as is often the case with prostateproblems, it can push against the urethra, pinching it and causing it to narrow. Theresult is the same as when you pinch your garden hose; the water dribbles out.

To compensate for the narrowing of the urethra, the muscular wall of the bladdercontracts more strongly to expel urine. This increased "exercise" leads to thethickening of the bladder wall and a decrease in its urine capacity. The bladder will holdless and less urine, resulting in having to urinate more and more.

Basically, there is nothing you can do to keep the prostate from enlarging as you age.When in your 20s, 30s, and 40s, the prostate remains much the same size, but when you hitthe big five-zero it starts growing. By age 85 just about every male has some prostategrowth.

This growth is generally known as benign prostatic hyperplasia(BPH). Knowntraditionally as "old man’s disease" because so many elderly men developit, various reports state that 50 percent to 60 percent of men over 50 years of age andsome 85 percent of men over 80 years of age have some indication of BPH. Common symptomsinclude:

An urgent feeling that you need to urinate;
An increased frequency of urination, waking multiple times during the night to urinate;
Some difficulty when beginning to urinate;
A urine stream that is weak and thin;
Difficulty stopping urinating; often followed by dribbles; and
A feeling that your bladder has not completely emptied, urinary retention.

If left untreated, BPH results in stagnant urinary residue, which can lead to infectionand blockage of the bladder outlet.

Not all men experience symptoms. Only about half of all men will have noticeablesymptoms, and only half of those will experience enough discomfort to go to a doctor. Thesymptoms often come and go.

Although researchers do not know exactly why BPH develops, it appears to be related toage and increased levels of 5-alpha-dihydrotestosterone (DHT), a hormone. DHT binds to theprostate, which results in continued prostate growth. This can eventually cause theoverproduction (hyperplasia) of prostate cells, which causes the prostate gland to enlargemore than it should.

Helping Out

For BPH, you can help yourself.

Drink water: Although the natural reaction to frequentand urgent urination is to cut back on fluid intake, this is a mistake. You riskdehydration and the likelihood of developing a bladder infection increases because yoururine becomes stronger. Drinking lots of fluid keeps the retained urine in the bladderfairly diluted and reduces the risk of bladder infection and dehydration.

Dietary changes: Caffeine, alcohol, spicyfoods and/or acidic foods may irritate the prostate, and most doctors recommend eithereliminating them or consuming very little of them. Diets with an emphasis on soy arehelpful, as this helps eliminate DHT. Sunflower and pumpkin seeds may also be helpful. Cutback on beer, as this stimulates hormones that may contribute to prostate growth.

Watch your weight: At least one study (American Journal of Epidemiology; Dec. 1994) hasshown that men with larger than a 43-inch (109 cm) waist are more than twice as likely tohave enlarged prostates. It pays, then, to eat right and exercise so that your gutdoesn’t hang over your belt.

Avoid decongestants and antihistamines: Sudafed,Tavist-D, Contact, etc., all carry warnings in fine printnot to use them if you have an enlarged prostate or BPH. These medications appear to causethe prostate to contract, which decreases urine flow. There is also some evidence thatthese tend to make the prostatic secretion thicker and more prone to forming clogs.

Stay in love: Making love can also help forestall prostate problems.

Exercise: Walking will often help relieve prostate symptoms.

Use supplements: Dietary supplements can help general prostate health. Make sure you getsufficient amounts of zinc and B vitamins. These nutrients regulate the enzyme thatconverts testosterone to DHT. Essential fatty acids may be helpful, as these influencehormones that control inflammation.

There have been a number of animal and clinical trials on the use of pollen extract forBPH, nonbacterial prostatitis, and prostadynia. Herbs used to maintain prostate healthinclude saw palmetto and pygeum africanum.

The American Urological Association BPH Symptom Index

Circle the number in the appropriate column:

	Never	Less than 1 time in 5	Less than half the time	About half the time	More than half the time	Almost always
1. How often have you had a sensation of not emptying the bladder completely after you finished urinating?	0	1	2	3	4	5
2. How often have you had to urinate again less than two hours after you finished urinating?	0	1	2	3	4	5
3. How often have you found you stopped and started again several times when you urinated?	0	1	2	3	4	5
4. How often have you found it difficult to postpone urination?	0	1	2	3	4	5
5. How often have you had a weak urinary stream?	0	1	2	3	4	5
6. How often have you had to push or strain to begin urination?	0	1	2	3	4	5
7. How many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?	None 0	1	2	3	4	5 or more

Total all circled numbers. 1 -7: mild; 8 - 19: moderate; 20- 35: severe. Generally, no treatment is needed for mildsymptoms. For moderate and severe symptoms, consult a health practitioner.

Other prostate disorders

Prostatitis is the general term for inflammation of the prostrate gland. As with BPH, the inflamed prostate pinches the urethras, resulting in many of the same symptoms; frequent and urgent urination, increased nighttime urinating, and a stop-and-start urine stream. Other symptoms include pain between the rectum and the back of the scrotum, in the lower back, above the pubic bone, in the lower abdominals, or in and around the groin and testicles. Prostatitis can also result in dysuria which is painful or difficult urination Prostatitis - or have no known cause, which is known as nonbacterial prostatitis.

Prostatodynia occurs if there are prostatitis - like symptoms that appear to originate in the prostate (but probably do not) and no evidence of inflammation or bacteria. This really has nothing to do with the prostate. Pain appears to originate in the prostate, buy might actually be coming from the pelvic area, genitals or rectum. The prostate is generally normal or slightly tender, and you may have tension headaches.

INfertility Workshop is getting a new face and a new place. Please visit us at InfertilityWorkshop.com/BLOG where it is all happening.