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Men's health



Related terms
Background
Author information
Bibliography
Andropause
Benign prostatic hyperplasia (bph)
Erectile dysfunction
Male hypogonadism
Prostate cancer
Prostatitis

Related Terms
  • Acute prostatitis, andropause, benign prostatic hyperplasia, BPH, chronic prostatitis, decreased libido, decreased sex drive, ED, enlarged prostate, erectile dysfunction, impotence, incontinence, male menopause, metastatic prostate cancer, nocturia, prostate cancer, prostatectomy, prostatitis.

Background
  • Males may develop health conditions specific to their gender, such as infections or cancers that affect their reproductive organs. The male reproductive organs include the penis, testicles, scrotum, and prostate gland. Other common examples of male health issues include andropause, benign prostatic hyperplasia (BPH), erectile dysfunction, male hypogonadism, and prostatitis. Treatments and prognoses vary, depending on the specific condition.
  • Although some conditions cannot be prevented, adopting a healthy lifestyle that includes regular exercise and healthy eating habits, as well as undergoing regular health examinations and screenings, may help reduce the risk of developing some of these conditions.

Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. American Cancer Society (ACS). .
  2. American Urological Association (AUS). .
  3. Hoffman R, Monga M, Elliot S, et al. Microwave thermotherapy for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2007;(4):CD004135.
  4. Koh KA, Sesso HD, Paffenbarger RS Jr, et al. Dairy products, calcium and prostate cancer risk. Br J Cancer. 2006;95(11):1582-5.
  5. Kristal AR, Stanford JL. Cruciferous vegetables and prostate cancer risk: confounding by PSA screening. Cancer Epidemiol Biomarkers Prev. 2004;13(7):1265.
  6. National Institutes of Health (NIH). .
  7. Natural Standard: The Authority on Integrative Medicine. .
  8. Prostate Cancer Foundation. .

Andropause
  • Overview: As males age, they tend to experience a decrease in their sex hormone, which is called testosterone. This process is called andropause or sometimes male menopause. Most males go through andropause when they are between the ages of 40 and 55 years old.
  • Causes: Andropause is caused by decreased levels of the hormone testosterone and is considered a natural part of aging in males.
  • Symptoms: Common symptoms of andropause include fatigue, depression, hot flashes, night sweats, infertility, decreased sex drive, and erectile dysfunction. Erectile dysfunction (ED), also called impotence, occurs when a male is unable to achieve or maintain an erection. Men also have an increased risk of developing osteoporosis, or weak, brittle bones, after andropause.
  • Diagnosis: If it is suspected that a male patient is going through andropause, a blood sample may be taken to measure the amount of testosterone in the blood. Males who have undergone andropause may have low levels of testosterone in their blood. Patients may also have increased levels of globulin. This hormone binds to testosterone, resulting in lower levels of testosterone in the tissues.
  • Treatment: Although hormone replacement therapy has been used to treat andropause, there is little research on its safety or effectiveness.
  • Males who experience ED as a complication of andropause may receive treatment. Several drugs, including sildenafil (Viagra®), tadalafil (Cialis®), and vardenafil (Levitra®), have been used treat males who experience ED as a result of aging. These drugs are taken by mouth a few hours before sexual activity. These drugs should not be taken more than once every 24 hours. In general, side effects may include headache, upset stomach, diarrhea, dizziness, flushing, or stuffy nose. Serious side effects may include sudden severe loss of vision, blurred vision, changes in color vision, painful erection, priaprism (a prolonged erection lasting longer than four hours), fainting, chest pain, difficulty breathing, hoarseness, itching or burning during urination, and rash. Patients should seek immediate medical treatment if any of these serious side effects develop.
  • Prevention: Andropause is a normal part of aging. Strength training may be beneficial because the body produces testosterone when a person builds or maintains muscle mass.

Benign prostatic hyperplasia (bph)
  • Overview: Benign prostatic hyperplasia (BPH) is a normal, gradual enlargement of the prostate gland, which is located in front of the rectum and under the bladder. BPH usually beings during middle age. Hormonal changes in the prostate tissue are linked to BPH. For instance, decreases in testosterone and increases in dihydrotestosterone (DHT) and estrogen have been shown to cause BPH.
  • This condition is called "benign" because it does not lead to cancer. BPH does not generally cause pain, but discomfort (a feeling of pressure) in the groin area is generally found. An enlarged prostate may push against the urethra and interfere with urination. The bladder wall also thickens and becomes irritated. The bladder starts to contract even when it contains small amounts of urine, which results in frequent urination.
  • Causes: BPH affects about half of men who are 60 or older and 80 percent of men who are 80 or older. It is considered by clinicians to be related to aging because most men older than 45 have some prostate enlargement. However, symptoms are rarely felt before the age of 60.
  • Symptoms: Common symptoms of BPH include difficulty urinating, altered urinary flow (including variable flow rate), frequent urination, urinary urgency, dribbling of urine at the end of urination, and frequent urination at night (called nocturia). As the bladder weakens, it may not empty completely after urination. When the prostate blocks or narrows the urethra, it may lead to several problems, such as urinary tract infections (UTIs), bladder stones, or kidney or bladder damage.
  • Diagnosis: A digital rectal exam (DRE) is commonly performed during routine physical examinations. During a DRE, a doctor feels the prostategland by passing a gloved finger into the individual's rectum. If hard or lumpy areas of the gland are detected, it may indicate anabnormality. If the doctor suspects an abnormal prostate, a sample of urine and prostate fluid may be analyzed.
  • The doctor may also assess the degree of pain or discomfort the person feels when the muscles and ligaments of the pelvic floor and perineum are pressed. Patients with BPH generally do not feel pain.
  • A doctor may also take a sample of blood to analyze the patient's prostate-specific antigen (PSA) levels. PSA is an enzyme normally made by cells in the prostate gland that helps break down proteins in seminal fluid to aid with fertility. It is normal for the bloodstream to contain some PSA (about 4.0 nanograms per milliliter (ng/ml)). However, if the PSA level is elevated, it may indicate prostate infection, inflammation, enlargement (BPH), or cancer. If the PSA level is above 4.0, further tests, such as an ultrasound or prostate biopsy, are usually recommended. Even if the PSA is less than 4.0, further tests may be recommended if the PSA has risen a significant amount since a prior measurement. PSA values tend to be lower in younger men, and it has been suggested that the PSA level at which to consider a biopsy should be lower for younger men than for older men.Even if the PSA is elevated, it does not necessarily mean that cancer is present, since there are other causes of PSA elevation. This is why further evaluation with a biopsy is often recommended.
  • Treatment: The U.S. Food and Drug Administration (FDA) has approved several drugs for the treatment of BPH symptoms, although drug therapy is not effective in all patients. 5-alpha reductase inhibitors, including finasteride (Proscar®) and dutasteride (Avodart®), may help prevent the progression of prostate enlargement or help shrink the prostate gland. Other drugs, called alpha blockers, may also help reduce bladder obstruction. FDA-approved drugs include terazosin (Hytrin®), doxazosin (Cardura®), tamsulosin (Flomax®), and alfuzosin (Uroxatral®). Terazosin and doxazosin were first developed to treat high blood pressure. Tamsulosin and alfuzosin were developed specifically to treat BPH.
  • Some patients may require surgery. Transurethral resection of the prostate (TURP) is a surgical procedure that involves removing tissue from the prostate that may be blocking urine flow. This surgery is sometimes performed to relieve symptoms caused by benign (noncancerous) tumors. Transurethral resection of the prostate may also be done in men who cannot have a radical prostatectomy because of their age or overall health.
  • Several laser procedures are also available. They are performed to remove obstructing prostate tissue. Laser procedures generally require less anesthesia and are associated with a lower risk of bleeding and a quicker recovery time than TURP. However, laser procedures may not be as effective in the long term as TURP.
  • Microwave therapy may also be performed. During this procedure, microwave energy is delivered to the prostate in order to kill some of the cells and shrink the prostate. Although microwave therapy is not a cure, it may help reduce urinary frequency, urgency, and straining, as well as intermittent urine flow. It has not been shown to improve symptoms of incomplete bladder emptying.
  • The FDA has also approved the Transurethral Needle Ablation (TUNA) System for the treatment of BPH. The TUNA System is a minimally invasive procedure that involves placing interstitial radiofrequency (RF) needles through the urethra and into the prostate. The low-level radiofrequency energy burns away part of the prostate. The TUNA System has been shown to improve urine flow and relieve symptoms with fewer side effects than TURP. Neither incontinence nor impotence has been observed.
  • Prevention: It has been suggested that ejaculating on a regular basis may help prevent BPH. However, this has not been scientifically proven. Drinking eight glasses of water per day may help prevent UTIs in men with BPH. However, if the patient is experiencing increased urinary frequency as a symptom of BPH, drinking more water may worsen the symptom.

Erectile dysfunction
  • Overview: Erectile dysfunction (ED), sometimes called impotence, occurs when a man is unable to achieve or maintain an erection that is firm enough for sexual intercourse. The term impotence may also refer to other problems that interfere with sexual intercourse, such as decreased sexual desire or difficulty with ejaculation.
  • Although ED is more common in men older than 65, it can occur at any age. Occasional ED is considered normal and happens to most men. As men age, it is also normal to experience changes in erectile function. For instance, it may take longer to achieve erections or they may be less rigid. Some men may have less intense orgasms or produce less ejaculate. The recovery time between erections may also increase with age.
  • Causes: There are many causes of erectile dysfunction. In some instances, ED may be one of the first signs of an underlying medical problem. Physical diseases account for about 70 percent of ED cases. For instance, long-term diseases that affect the lungs, liver, kidneys, heart, nerves, arteries, or veins are risk factors for ED. The most common causes of ED include heart disease, high blood pressure, clogged arteries (called atherosclerosis), diabetes, obesity, and metabolic syndrome. This is because an erection is dependent on proper blood flow in the penis.
  • If the veins and muscles in the penis cannot prevent blood from leaving the penis during sexual arousal, an erection cannot be maintained. Venous leakage can be the result of injury, disease, or damage to the veins in the penis.
  • Prostate gland enlargement, such as with benign prostatic hyperplasia (BPH), can also cause symptoms of ED by placing pressure on the blood vessels that fill the penis to cause an erection.
  • Damage to the nerves that control erections can cause erectile dysfunction. It may result from an injury to the pelvic area or spinal cord. Surgery to treat bladder, rectal, or prostate cancer may also damage sensitive nerves and blood vessels and may cause ED.
  • Spinal cord and brain injuries can cause impotence if they interfere with nerve impulses transferred from the brain to the penis. Other nerve disorders, such as multiple sclerosis (MS), Parkinson's disease, and Alzheimer's disease, may also result in ED.
  • Hormonal disorders cause less than five percent of ED cases. Testosterone deficiency, although uncommon, may result in a decreased sex drive and ED. An excess of the hormone prolactin, caused by a pituitary gland tumor, can reduce levels of testosterone and cause ED. Hormone imbalances can also result from kidney or liver disease, causing ED.
  • Peyronie's disease is a rare inflammatory condition that causes scarring of erectile tissue. The normal skin cells are replaced by scar tissue. Scarring causes the penis to curve and may interfere with sexual function, cause painful erections, and even block some of the blood flow.
  • Psychological conditions, such as performance anxiety, stress, guilt, or depression, may also contribute to loss of sexual drive and may result in ED. If an individual experiences loss of erection during sexual intercourse, he may worry that it will happen again. This can produce anxiety associated with performance and may lead to ED during sex.
  • ED is also a common side effect of many medications. In fact, medications may cause as much as 25 percent of all ED cases. Several types of drugs can cause ED by interfering with nerve impulses or blood flow to the penis. Examples include antidepressants (e.g., Elavil®, Prozac®, Paxil®, or Zoloft®), stimulants (e.g., Adderall®), antihistamines (e.g., Benadryl® or Allegra®), medications to treat high blood pressure (e.g., Inderal® or Catapres®), heart medications (e.g., Lanoxin®), antiulcer drugs (e.g., Tagamet®), pain relievers (e.g., methadone, codeine, morphine, or oxycodone), prostate cancer drugs (e.g., Proscar®), tranquilizers (e.g., Valium® or Xanax®), and sleeping aids (e.g., Restoril® or Ambien®). Excessive or long-term use of alcohol, marijuana, heroin, cocaine, methamphetamine, or other drugs often cause ED and decreased sexual drive.
  • Low levels of iron may also lead to ED.
  • Symptoms: Symptoms associated with ED include the occasional inability to obtain a full erection, inability to maintain an erection throughout sexual activities, and complete inability to achieve an erection. Lack of morning erections is also seen along with a decrease in sex drive (libido).
  • Diagnosis: After a physical examination, several tests are available to determine the cause of erectile dysfunction.
  • A complete blood count may be taken to determine if the patient has low levels of iron in the blood. Low levels of iron may lead to erectile dysfunction.
  • A blood test may be performed to determine whether or not high levels of fat in the blood are causing the condition.
  • Low levels of sex hormones, including testosterone, may indicate erectile dysfunction.
  • A duplex ultrasound, which takes pictures of the penis, may also be performed. An ultrasound helps the healthcare provider evaluate blood flow to the penis. It can detect leaking arteries, hardened or blocked arties, or tissue scarring, which may be causing erectile dysfunction.
  • Treatment: Several drugs, including sildenafil (Viagra®), tadalafil (Cialis®) and vardenafil (Levitra®), have been used to treat males who experience ED as a result of aging. These drugs are taken by mouth a few hours before sexual activity. These drugs should not be taken more than once every 24 hours.
  • In general, side effects may include headache, upset stomach, diarrhea, dizziness, flushing, or stuffy nose. Serious side effects may include sudden severe loss of vision, blurred vision, changes in color vision, painful erection, prolonged erection lasting longer than four hours (called priaprism), fainting, chest pain, difficulty breathing, hoarseness, itching or burning during urination, and rash. Individuals should seek immediate medical treatment if any of these serious side effects develop.
  • Prevention: A simple way to help prevent ED is to introduce lifestyle changes. For some men, adopting a healthier lifestyle by quitting smoking, exercising regularly (at least 30 minutes daily), or reducing stress may be all that is needed to find relief. For others, adopting these lifestyle changes in addition to other treatments, such as medicines or surgery, can further help.
  • Some additional methods that may help prevent symptoms of ED include limiting or avoiding the use of alcohol and other recreational drugs (marijuana, cocaine), getting enough sleep (eight hours a night), dealing with anxiety or depression (through counseling and medication), and seeing a doctor for regular checkups and medical screening tests.

Male hypogonadism
  • Overview: Male hypogonadism is a hormonal disorder that occurs when the male gonads (testes) are underactive. The testes secrete testosterone, which is a hormone that is essential for reproductive function, development of secondary sexual characteristics, body composition, and mood. Some males may be born with hypogonadism, while others develop it later in life.
  • Causes: Primary hypogonadism occurs when the gonads are directly affected. Common causes of primary hypogonadism in males include a genetic disorder called Klinefelter's syndrome, undescended testicles, mumps orchitis, testicle injury, cancer treatment, or an inherited disorder called hemochromatosis, which causes the body to absorb too much iron.
  • Secondary hypogonadism occurs when other parts of the body, such as the hypothalamus or pituitary gland (both located in the brain), cause the gonads to be underactive. Common causes of secondary hypogonadism include Kallman syndrome, opiate medications, inflammatory diseases (such as sarcoidosis), and obesity.
  • Symptoms: If the body does not produce enough testosterone during fetal development, the growth of sex organs may be impaired. Male children born with hypogonadism may have female genitals, ambiguous genitals that are neither male nor female, or underdeveloped male genitals. If hypogonadism occurs during puberty, the male may experience decreased development of muscle mass, impaired growth of body hair, impaired growth of genitals, excessive growth of the arms and legs in proportion to the trunk of the body, development of breast tissue, and a lack of deepening of the voice. Males who develop hypogonadism during adulthood may experience erectile dysfunction, infertility, decreased body hair growth, increased body fat, decreased testicle size, decreased muscle mass, development of breast tissue, and osteoporosis (hollow, brittle bones).
  • Diagnosis: Hypogonadism is diagnosed when a patient experiences symptoms that are characteristic of the disorder and has low levels of sex hormones in the blood. Males will have low levels of testosterone. Additional tests may be performed to determine the underlying cause.
  • Treatment: Patients with hypogonadism typically receive hormone replacement therapy (HRT) with testosterone injections. This treatment has been shown to stimulate puberty and restore fertility in patients.
  • Prevention: Because obesity may lead to secondary hypogonadism, patients who maintain a normal body weight can reduce their risk of developing the condition. Reducing the risk of head trauma may also reduce the risk of hypogonadism. This is because some cases occur as a result of injury to parts of the brain, such as the hypothalamus.

Prostate cancer
  • Overview: Prostate cancer is the uncontrollable growth of cells in the prostate gland. After skin cancer, prostate cancer is the most common form of cancer in America, affecting about one in six men.
  • The prostate gland, which is located in front of the rectum and under the bladder, is part of a man's reproductive system. It surrounds the urethra, the tube that carries urine. A healthy prostate is about the size of a walnut.
  • Prostate tumors are masses of prostate cells. Prostate tumors can be noncancerous (benign) or cancerous (malignant). Benign tumors in the prostate are rarely life-threatening. Benign prostatic hyperplasia (BPH) is the abnormal growth of noncancerous prostate cells. The prostate grows larger and squeezes the urethra, preventing the normal flow of urine. BPH is common, affecting about 30 million men worldwide.
  • Malignant prostate tumors are generally more serious than benign tumors. In some cases, malignant prostate tumors may be life-threatening, especially if they spread to other areas of the body, such as the lymph nodes, liver, bones, colon, and other organs.
  • When diagnosed and treated early, prostate cancer can be successfully cured more than 90 percent of the time. It is important to be diagnosed early, which is why the American Cancer Society recommends that healthcare professionals offer screening tests annually, beginning at age 50. Men at high risk may be encouraged to undergo screening earlier.
  • Causes: As men get older (particularly after age 50), their risk of prostate cancer increases.
  • The incidence of prostate cancer varies among populations worldwide. Asian men typically have a very low incidence of prostate cancer, with age-adjusted incidence rates ranging from 2-10 per 100,000 men. Higher incidence rates are generally observed in northern European countries. African-American men, however, have the highest incidence of prostate cancer in the world. In the United States, African-American men have a 60 percent higher incidence rate compared with Caucasian men. If an immediate family member has prostate cancer, the risk of developing the disease is greater than that of the average American man.
  • A high-fat diet and obesity may increase the risk of prostate cancer. Researchers theorize that fat increases production of the hormone testosterone, which may promote the development of prostate cancer cells. Obese men who are diagnosed with prostate cancer are two-and-a-half times more likely to die from the disease than men of normal weight at the time of diagnosis. Scientists believe that obesity increases the risk of prostate cancer by increasing inflammation and steroid hormones, such as testosterone.
  • Because testosterone naturally stimulates the growth of the prostate gland, men who have high levels of testosterone are more likely to develop prostate cancer than men who have lower levels of testosterone. It has also been suggested that testosterone therapy might increase or speed up the growth of prostate cancer that is already present.
  • Symptoms: If the cancer is identified at its earliest stages, most men will not experience any symptoms. Some men, however, experience symptoms, such as a need to urinate frequently (especially at night); difficulty starting or stopping urination; weak or interrupted flow of urine; a painful or burning sensation during urination; difficulty having an erection; painful ejaculation; blood in urine or semen; or frequent pain or stiffness in the lower back, hips, or upper thighs. Because these symptoms can also indicate the presence of other conditions, such as urinary tract infections or bladder problems, men who experience any of these symptoms will undergo a thorough work-up to determine the underlying cause of the symptoms.
  • Diagnosis: Men with risk factors for developing prostate cancer, such as men older than 50 years of age, should undergo routine prostate cancer screenings.
  • The digital rectal exam (DRE) is commonly performed during routine physical examinations. During a DRE, a doctor feels the prostategland by passing a gloved finger into the patient's rectum. A hard or lumpy area may indicate anabnormality.
  • A doctor may also take a sample of blood to analyze the patient's prostate-specific antigen (PSA) levels. PSA is an enzyme normally made by cells in the prostate gland that helps break down proteins in seminal fluid to aid with fertility. It is normal for the bloodstream to contain some PSA. In the United States, a generally accepted standard PSA level is 4.0 nanograms per milliliter (ng/ml). However, if the PSA level is elevated, it may be an indication of prostate infection, inflammation, enlargement (BPH), or cancer. Using the PSA test to screen men for prostate cancer is controversial because it is not yet known if this test actually saves lives. It is also unclear if the benefits of PSA screening outweigh the risks of follow-up diagnostic tests and cancer treatments. For instance, the PSA test may detect small tumors that would never become life-threatening.
  • If the PSA level is elevated, or if the person has an abnormal digital rectal exam, a doctor may recommend a prostate biopsy. The patient will be prescribed antibiotics, usually a three-day course, before the surgery. Most individuals receive local anesthesia, such as lidocaine (Xylocaine®). To do a biopsy, a doctor inserts a small, lubricated probe (called a transrectal ultrasound) into the rectum. The probe uses sound waves, which are then converted to visual data in order to see a picture of the prostate gland, which is then analyzed for changes. If an abnormal area is seen on the transrectal ultrasound, the doctor will likely biopsy that area. During a biopsy, a fine, hollow needle is aimed at the abnormal area(s) of the prostate, and a small section of tissue is removed. Biopsies generally take about 15-45 minutes to complete, depending on the procedure. The procedure used to diagnose prostate cancer (prostate biopsy) may cause side effects, such as bleeding and infection. Fifty-five percent of men report discomfort during the biopsy. The same procedure can be performed through the perineum area (between the anus and the scrotum) and is called a transperineal biopsy, or through the urethra (the canal that the urine travels through for elimination), and is called a transurethral biopsy.
  • If a doctor thinks the cancer may have spread to other parts of the body, other tests may be used. These include procedures such as a bone scan, ultrasound, a computerized tomography (CT) scan, magnetic resonance imaging (MRI), and lymph node biopsies.
  • Treatment: When prostate cancer has not spread beyond the prostate, most practitioners will discuss options with patients that include the surgical removal of the prostate (called a prostatectomy), radiation treatment, or active surveillance (also called watchful waiting or observation). The goal of a prostatectomy and radiation treatment is to cure the patient by eradicating the cancer. There are other, less well-established approaches, including cryotherapy and high-intensity focused ultrasound (HIFU), for which there is less scientific evidence available compared to prostatectomy or radiation therapy.
  • When prostate cancer has spread beyond the prostate, it is said to be ''metastatic'' or to have metastasized. The most common areas of metastasis are the bones (especially the ribs, spine, skull, and pelvis) and lymph nodes, and less commonly the lungs and liver. Once the cancer spreads to the bones, liver, or lungs, it is not generally curable, and treatments are aimed at controlling the growth of the cancer for as long as possible. The standard initial treatment for metastatic prostate cancer is hormonal therapy. Chemotherapy is generally not given unless the cancer becomes resistant to the effects of hormonal therapy. Generally, the prostate area itself is not treated if the cancer has spread, although in some cases if there is a lot of cancer in the prostate area, radiation may be given for ''local control'' to avoid complications from the cancer growing too large in the pelvis area.
  • Prevention: A new vaccine, although not FDA-approved, has been developed to help extend survival for patients with deadly metastatic prostate cancer. The FDA has requested additional clinical data before the vaccine, called Provenge®, can be approved. The vaccine is targeted at individuals with prostate cancer who have ceased responding to hormone therapy and have cancer that has spread to other organs and tissues. Reported side effects include fever, chills, and fatigue (tiredness).
  • Because high-fat dairy products and the calcium contained in dairy may increase the risk of developing prostate cancer, these foods should be limited. Examples of high-fat dairy foods include cheese, sour cream, and ice cream.
  • Cruciferous vegetables (such as broccoli, cabbage, and cauliflower) have been reported to contain cancer-fighting phytochemicals that may decrease the chance of developing prostate cancer. Antioxidant-containing foods, including fruits (such as berries, grapes, and tomatoes) and vegetables (such as peppers and carrots) may help prevent the development of prostate cancer.
  • Eating large amounts of red meat or processed meats has been shown to increase the risk of colon cancer. It has also been suggested to increase the risk of developing prostate cancer, although this is an area of ongoing research.
  • Exercise (at least 30 minutes daily for five days a week), smoking cessation, and relaxation all may contribute to decreasing the risk of developing prostate cancer.

Prostatitis
  • Overview: Prostatitis is inflammation of the prostate gland. It often affects younger men. With treatment, prostatitis generally goes away within several days to two weeks. Treatment of chronic (long-term) bacterial prostatitis usually involves antibiotics for 4-12 weeks. This type of prostatitis is difficult to treat and recurrence is possible.
  • Causes: Prostatitis usually results from the blockage or irritation of some of the ducts within the prostate gland, and the cause may be mechanical (such as a narrowing of the urethra) or infectious. Infectious causes may be viral or bacterial, including E. coli or sexually transmitted infections such as chlamydia.
  • There are four types of prostatitis. Chronic nonbacterial prostatitis is the most common type. Prostadynia, also known as chronic pelvic pain syndrome, is a condition associated with similar symptoms as chronic nonbacterial prostatitis, but which has no evidence of prostate inflammation. Chronic bacterial prostatitis is not very common. It typically affects men who are 40-70 years old. Asymptomatic inflammatory prostatitis does not cause symptoms and generally occurs in men who are 60 years of age or older. Acute bacterial prostatitis is the least common form. It usually occurs in men who are younger than 35.
  • Symptoms: Symptoms of prostatitis may include painful, burning, or frequent urination; weak urine flow or incomplete emptying; fever and chills; lower abdominal pain or pressure; painful ejaculation; impotence; and low back pain.
  • Chronic prostatitis and chronic pelvic pain syndrome are the most common types of prostatitis, but are probably the most poorly understood. Symptoms may go away and then reappear without warning. The infection may be considered inflammatory. This occurs when the infecting organism is not present in the urine, semen, or other secretions but infection-fighting cells are present. In other cases, the infection may be considered noninflammatory, in which inflammation and infection-fighting cells are both absent.
  • Chronic bacterial prostatitis is a frequent infection of the prostate gland that is difficult to treat. Symptoms are often similar to acute bacterial prostatitis, but they are often less severe. Symptoms of chronic bacterial prostatitis generally last longer and do not cause a fever.
  • Asymptomatic inflammatory prostatitis may be diagnosed when infection-fighting cells are present, but common symptoms of prostatitis are not. A diagnosis is usually made incidentally during an examination for other conditions, such as infertility or prostate cancer.
  • Acute bacterial prostatitis can occur at any age. Symptoms are usually sudden and severe. Symptoms may include painful and/or difficult urination, fever, chills, lower back pain, pain in the genital area, frequent urination, burning during urination, urinary urgency at night, and aches and pains throughout the body.
  • Treatment: Acute bacterial prostatitis (infectious prostatitis) is usually treated with oral antibiotics for one to two weeks. The commonly used antibiotics include quinolones, such as norfloxacin (Noroxin®), ciprofloxacin (Cipro®), or levofloxacin (Levaquin®). In severe cases, treatment with intravenous (IV) antibiotics may be necessary. Chronic bacterial prostatitis is also treated with oral antibiotics for 4-12 weeks. Other medications used to treat infectious prostatitis include: stool softeners, such as docusate sodium (Colace®); anti-inflammatory medications, such as ibuprofen (Motrin®); analgesics or pain medications, such as hydrocodone (Vicodin®, Lortab®); alpha blockers such as tamsulosin (Flomax®); and 5-alpha reductase inhibitors, such as finasteride (Proscar®) or dutasteride (Avodart®).
  • If the individual has nonbacterial prostatitis, antimicrobial medication is not needed. Treatment depends on the symptoms. If the condition responds to muscle relaxation, the individual may be given an alpha blocker, a drug that can relax the muscle tissue in the prostate and reduce the difficulty in urination. Pain meditations, anti-inflammatories, and warm sitz baths may also be helpful.
  • Chronic prostatitis may respond to multidisciplinary approaches incorporating exercise, progressive relaxation, and counseling. Asymptomatic inflammatory prostatitis may respond to the same treatment measures, but this condition generally does not require treatment.
  • Prevention: Men are encouraged to practice good hygiene. Keeping the penis clean can help prevent some types of infections that can lead to prostatitis. Patients are encouraged to drink plenty of fluids, especially water, to cause regular urination.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.



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