What are the symptoms of enlarged prostate?
If there are minor symptoms of enlarged prostate only, then a watchful waiting (in other words a ‘wait and see’) approach may be suitable and pragmatic. Each treatment type also has its advantages and disadvantages so between us, my patients and I decide which is most appropriate here.
Symptoms of enlarged prostate include the following:
- Hesitancy: difficulty in starting the urine flow, even when the bladder feels full.
- A weak or interrupted urinary stream.
- Incomplete emptying: a feeling the bladder is not completely empty after passing urine.
- Frequency: a need to urinate often during the day and during the night. Increased need to urinate in the night is usually a very early symptom.
- Urgency: a need to urinate right away. Some men may experience involuntary discharge of urine (known as urge incontinence).
- Dribbling of urine after urination – this is known as terminal dribbling.
- A burning sensation or pain during urination, also called dysuria.
It needs to be remembered that different men get different symptoms, and that symptoms may also vary with each individual throughout the course of the disease.
The role of Saw Palmetto
When I see men in my surgery suffering from the symptoms of enlarged prostate, medically known as benign prostatic hyperplasia (BPH) they are very keen to know what treatments are available for this condition as it can really make their life something of a misery. There are a variety of treatments for this condition but I always talk about the fact that treatment is normally only necessary if the patient has symptoms that are bothersome or if complications are present.
I have found it interesting that in recent years I have increasingly had conversations around enlarged prostate that involve the role of natural or ‘alternative’ treatments that many men seem to like to explore before starting on the conventional drugs used in treating enlarged prostate.
One of the commonest enquiries concerns the role of saw palmetto – a herbal remedy that comes from a type of palm tree and which has been used in traditional medicine for centuries to relieve urinary symptoms, including those caused by an enlarged prostate.
Over the years, some research studies have suggested that saw palmetto may be effective in relieving enlarged prostate symptoms, whilst others have been less convincing. However, more recently, a systematic review combining the results from 218 concluded very favourable conclusions as can be seen below1.
Personally, I have lost count of the number of men with symptoms of mild enlarged prostate who say their lives have dramatically improved when taking this supplement. As backed by the research, t's also safe, and doesn’t cause any serious side effects – an important point for people to consider.
As a result, this is one of the half dozen or so natural treatments that I am more than to happy to recommend to my patients, for a variety of conditions.
Some other herbal remedies I am sometimes asked about with enlarged prostate include the compound beta-sitosterol – taken from different plants that contain cholesterol-like substances called sitosterols – , another called pygeum from the bark of the African plum tree that has been used in traditional medicine to treat urinary problems since ancient times, although it can cause stomach upset in some people who take it, and rye grass pollen extract which is said to help in preventing the need to get up during the night to use the bathroom, and help men urinate more completely.
However, I almost always stick with saw palmetto as my first line of natural treatment advice due to the benefits as mentioned above. There is always the option to move on to traditional medications if the symptoms don't start to improve.
1. Sebu et al. (2022). Systematic Review on Safety and Efficacy of Saw Palmetto as a Health Supplement for Prostate Health in Adult Males. 5. 1252-1270. 10.52845/CMRO/2022/5-6-3.
Meet our guest blogger
Dr Roger Henderson is a senior partner in a busy general practice in Shropshire and his medical responsibilities also include teaching both medical students and GP registrars.
He sits on a number of health advisory boards both in the UK and globally.
To find out more about Dr Henderson visit http://www.doctorhenderson.co.uk/
