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How Does Prostatitis Affect a Man’s Sexual Function?
Men who have prostatitis (inflammation of the prostate) who are also experiencing erectile dysfunction or other sexual difficulties are not imagining things; the two are related. Although there is not a lot of research on the topic, a few previous studies have examined the relationship between prostatitis and sexual function. Now, a new analysis has taken it a step further.
What do we know about prostatitis and sexual function?
In prior research on the subject, such as that from investigators at Memorial Sloan Kettering Cancer Center, it’s been noted that “most of the data linking the two [prostatitis and sexual function] suggest that CP/CPPS [chronic pain/chronic pelvic pain syndrome] impairs the overall quality of life and it is this that contributes to or causes erectile dysfunction.” While this may be true, the authors of a recent study published in International Brazilian Journal of Urology evaluated the effect of histological prostatitis (prostatitis based on prostate biopsy findings) on lower urinary tract symptoms (LUTS) and sexual function.
More specifically, the investigators compared the effect of histological prostatitis on LUTS and sexual function in men with the prostate condition as well as those with symptoms but without histological prostatitis. Here’s what they discovered:
- Mean international prostate symptom scores (IPSS) in men with prostatitis were similar to those in men without prostatitis. This means that LUTS associated with prostatitis were similar among men with and without the disease.
- Mean international index of erectile function-5 (IIEF5) scores among men with prostatitis were significantly lower than those in men without prostatitis.
From these findings, the authors concluded that the presence of histological prostatitis “notably affected sexual function of patients and may serve as a major risk factor for sexual dysfunction while having little effect on lower urinary tract symptoms.” Men who had been diagnosed with histological prostatitis experienced more serious erectile dysfunction than their peers without prostatitis.
Sexual function can be impacted by prostatitis even in men who are not experiencing significant lower urinary tract symptoms. Men and their healthcare providers should be aware of this possibility and make treatment plans based on this knowledge.
What men with prostatitis can do for better sexual health
Men have a variety of treatment options for dealing with inflammation of the prostate gland. Certainly a number of pharmaceuticals are available, including nonsteroidal anti-inflammatories, antimicrobial therapy, 5a-reductase inhibitors, and alpha-blockers, but their use can be associated with some significant side effects. Natural lifestyle and alternative methods are suggested as the first line of defense to manage prostatitis and thus help with sexual function issues. Men are encouraged to consider one or more of these methods and to discuss them with a knowledgeable health professional to ensure they choose the ones that fit their lifestyle and needs.
- Acupuncture. Several studies have shown that acupuncture can be effective for symptom relief in men with CP/CPPS. Full body, ear, and electroacupuncture all have shown some success.
- Biofeedback. Use of biofeedback for CP/CPPS is based on the idea that men with this most common form of prostatitis have pain associated with pelvic floor muscle tension. Biofeedback can be used to manage this pain.
- Diet. A new study published in Prostate Cancer and Prostatic Diseases noted that an imbalanced diet, insufficient water intake, and consumption of caffeinated beverages are risk factors for or are associated with more severe pain in CP/CPPS. Men are encouraged to try a wheat-free diet (which has been shown anecdotally to help with symptoms), focus on fresh fruits and vegetables, include healthy fats in their diet, choose plant protein over animal protein, and drink green tea to promote a healthy prostate and help ward off prostatitis.
- Prostatic massage. This is a therapeutic method men can learn to do themselves or have a partner or medical professional do for them. Use of prostatic massage can help release accumulated fluids (and thus relieve pressure on the urethra), improve blood flow, and help the prostate return to normal size.
- Reflexology. This hands-on therapy is one men can easily learn to do on their own or have a partner do it for them. Reflexology for prostatitis is best for helping with pain relief.
- Stress management. Stress is both a risk factor and a factor that exacerbates prostatitis symptoms. Men are encouraged to make stress management techniques a part of their daily routine, whether it be deep breathing, tai chi, yoga, progressive relaxation, guided visualization, meditation, aerobic exercise, or other ways of relaxing.
- Supplements: Among the natural supplements scientifically shown to be beneficial for better prostate health are beta-sitosterol, cranberry, curcumin, green tea extract, indole3-carbinol (DIM), Pygeum africanum, quercetin, rye grass pollen, saw palmetto, stinging nettle root, vitamin D, and zinc. Rather than take these remedies individually, they are available in one high-quality supplement for prostate health.
- Trigger point release therapy. This is a hands-on therapy that involves applying pressure to specific points in the pelvic floor and related muscles. The trigger points are accessed both internally and externally, usually by a trained therapist.
Professions With The Highest Risk of Prostatitis
The work you do can have an impact on your risk of developing prostatitis. Based on information from the Urology Specialists of the Carolinas, the professions with the highest risk of prostatitis tend to be blue-collar and involve manual labor.
What are risk factors for prostatitis?
Prostatitis is a benign inflammatory condition of the prostate gland that most commonly develops in men younger than 50. Risk factors include history of bladder or urethral infection, use of a catheter, pelvic trauma (e.g., sports injury), dehydration, HIV/AIDS, stress, presence of benign prostatic hyperplasia, unprotected sexual intercourse, and genetics. Under the category of pelvic trauma, there are some professions that involve or are characterized by repetitive pressure or trauma to the pelvic region and/or genitals that could contribute to the development of this prostate disorder.
Which professions are at highest risk of prostatitis?
Professions associated with a greater risk of developing prostatitis include:
- Those that involve heavy lifting, such as package delivery personnel, warehouse workers, construction workers, dock workers, furniture and appliance movers, lumber yard workers, trash handlers, and airport luggage handlers
- Those that cause vibration of the pelvic region, such as long-distance truck drivers, heavy equipment construction workers (e.g., hydraulic jack workers), farmers (riding tractors and combines), forklift drivers
- Those that involve prolonged pressure or stress on the prostate gland, such as men who ride bicycles, motorcycles, riding lawnmowers, or horses for a living
How can men help prevent prostatitis?
Men who work in any of these or similar professions can take precautions against developing prostatitis.
Pee often. Empty your bladder regularly, especially if you are involved in heavy lifting. If your bladder is full and you are lifting heavy objects, the urine can cause pressure against the prostate, which may trigger a bacterial infection.
See a physiotherapist. A physiotherapist who is experienced and trained in myofascial release of the pelvic floor muscles can help with both prevention and treatment of prostatitis. Note that myofascial release is not the same as Kegel exercises, which can actually make prostatitis worse.
Get a pro-prostate seat. If your job involves sitting for long periods of time, then you might want to check out prostate cushions, which can be used in cars, trucks, and other vehicles. Such cushions are ergonomically designed to relieve pressure on the prostate. Similarly, there are bicycle and motorcycle seats specially designed to relieve pressure on the prostate.
Eat a prostate-friendly diet. A healthy prostate is less likely to become inflamed. Choose organic foods whenever possible, focus on fresh fruits and vegetables, whole grains, plant-sourced protein, omega-3 fatty acids (cold water fish), wheat-free, and green tea.
Exercise regularly. Daily physical activity helps prevent inflammation, promotes optimal blood flow, and stimulates lymph circulation, which reduces risk of developing infections.
Hydrate often. Dehydration can result in urinary tract infections, which is a risk factor for prostatitis. Be especially aware of getting sufficient fluids if you exercise vigorously and/or in high temperatures.
Manage stress. Chronic stress can weaken the immune system and make you more susceptible to disease. Make it a habit to practice stress management techniques (e.g., deep breathing, yoga, progressive relaxation, meditation) daily.
Practice safe sex. Several sexually transmitted diseases are associated with bacterial prostatitis, so be sure to practice safe sex.
Maintain good hygiene. Keeping the penis and pelvic area clean helps prevent infection.
Notice urinary infections. See a physician immediately if you experience symptoms of urinary tract infection, such as burning when urinating, urinary frequency and urgency, cloudy or strong smelling urine.
Supplement your prostate. Enhance your other efforts to maintain a healthy prostate by taking Prost-10X, a supplement specially formulated to promote and support better prostate health.
What’s the Risk of Prostatic Abscess in Prostatitis
Men who have been experiencing symptoms of prostatitis for an extended period of time are at increased risk of having a prostatic abscess and should undergo imaging to make that determination, according to new research published in BMC Urology. It’s important to identify a prostatic abscess early because it can be treated effectively more easily.
What is a prostatic abscess?
Prostatic abscesses smaller than 20 millimeters are usually easy to treat while larger ones may require surgical intervention. Before treatment can be initiated, physicians usually take a fluid sample from the abscess utilizing ultrasound to help them locate the formation. Once the type of bacteria is identified, the appropriate antibiotics can be prescribed.
In some men, the abscess needs to be drained, in which case an instrument is passed through the penis to the abscess. A minute cut is made, the abscess is allowed to drain, and antibiotics are then usually prescribed. Catheterization also may be required because of swelling associated with the procedure.
What did the new study reveal about prostatic abscess and prostatitis?
An expert team from The Catholic University of Korea retrospectively reviewed 31 prostatic abscesses that were identified in 142 men who had acute prostatitis. Overall, the investigators found that having urinary voiding problems and symptoms of prostatitis for an extended period of time were associated with a significantly greater risk of developing a prostatic abscess. In addition:
- Men with diabetes had an increased risk of prostatic abscess
- The length of antibiotic treatment was generally longer among men with an abscess than those without one
- Men who had an abscess smaller than 20 mm did not need to undergo surgery and were cured without complications
- Men with an abscess larger than 20 mm who underwent transurethral resection required antibiotics for a shorter time than did men who did not have surgery
- Prostatic abscesses were often discovered in men who did not improve after undergoing initial treatment
Overall, the authors concluded that “Routine imaging studies such as CT [computed tomography] or TRUS [transrectal ultrasonography] should be considered in cases of acute prostatitis…especially in patients with long-term symptom duration and voiding disturbances.” Imaging will allow doctors to be prepared for the presence of an abscess, which should be treated immediately and may need to be drained.
Aggressive Prostate Cancer Rates Up Nearly 100%
First, the good news: the number of cases of prostate cancer overall does not appear to be increasing. However, new research from Northwestern University indicates that new cases of metastatic prostate cancer (the type that has spread beyond the prostate) has risen 72 percent between 2004 and 2013. Men between the ages of 55 and 69 showed the largest rise, at 92 percent. This finding is especially disturbing because men in this age range are generally believed to be the ones most likely to benefit from prostate cancer screening and early treatment.
What does the metastatic prostate cancer study say?
According to the study, which appears in Prostate Cancer and Prostatic Diseases, the researchers evaluated data from 767,550 men from 1,089 facilities. They noted that beginning in 2007, the incidence of metastatic prostate cancer increased, especially in the age group mentioned. In addition, the average prostate-specific antigen (PSA) values of men diagnosed with metastatic prostate cancer in 2013 was 49, which was nearly twofold higher than the average of 25 seen in men diagnosed in 2004.
The study’s senior author, Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine, noted there could be two reasons for this dramatic rise in metastatic prostate cancer cases. “One hypothesis is the disease has become more aggressive, regardless of the change in screening.” In recent years, there has been a decline in the number of men seeking prostate cancer screening because of uncertainty about the accuracy and reliability of the PSA test as well as conflicting recommendations from the American Cancer Society and the US Preventive Services Task Force. (Note that the USPSTF guidelines are currently being updated.) Concurrently, there has been a decline in the overall number of new cases of prostate cancer reported.
Schaeffer also noted that “The other idea is since screening guidelines have become more lax, when men do get diagnosed, it’s at a more advanced stage of disease. Probably both [reasons] are true.” However, he also pointed out that the number of metastatic prostate cancer cases began rising in 2008, which was before the USPSTF loosened their screening recommendations, which suggests the investigators can’t definitively link the rise in cases to reduced screening alone.
The study’s lead author, Dr. Adam Weiner, a Feinberg urology resident, said that their findings “indicate the screening guidelines and treatment need to be refined based on individual patient risk factors and genetics.” Since prostate cancer is “100 percent treatable if detected early,” explained Dr. Jonathan W. Simons, president and CEO of the Prostate Cancer Foundation, better screening techniques could help prevent the rising occurrence of this form of prostate cancer.
What are the takeaways from this study?
- Until better tests for prostate cancer are available, men should become familiar with the risks and benefits of the current PSA testing procedures and discuss this information and their personal risk factors with a qualified healthcare professional. Just because the tests are not optimal does not mean men should completely avoid them.
- Studies have shown that participation in regular exercise is associated with a reduced risk of aggressive prostate cancer. Exercise also helps men maintain a healthy weight, which is also important since overweight and obesity are associated with an increased risk of prostate cancer.
- Men should have their vitamin D levels checked, given that low levels of this nutrients are associated with more aggressive prostate cancer. Your doctor may recommend a vitamin D supplement and/or more exposure to sunlight.
- Enjoy a totally or mostly plant-based diet. Consuming lots of meat, dairy, and other animal foods has been associated with prostate cancer.
- Get an abundance of omega-3 fatty acids, which fight inflammation and can reduce the risk of developing prostate cancer. Foods rich in omega-3 include salmon, sardines, and tuna, but you also can take omega-3 fish oil supplements.
- Avoid exposure to toxins as much as possible. Carcinogenic ingredients can be found in pesticides (on food and in your home and garden products), personal health products, dry cleaning, building supplies, plastics, and other common items. Read labels, ask questions, and use all-natural and/or organic products whenever possible.
- Manage stress on a daily basis. Researchers have noted that stress can trigger an immune system response that can result in uncontrollable cellular mutation, which can lead to cancer.
Treating Prostatitis with a Pelvic Wand
Use of a pelvic wand for prostatitis treatment (specifically chronic prostatitis/chronic pelvic pain syndrome) can provide significant relief for men who are living with this form of prostatitis. The personal wand allows men to self-treat internal myofascial trigger points in the pelvic floor, which in turn reduces pelvic muscle tenderness and pain.
The pelvic wand is curved and acts as an extension of a man’s finger to locate the internal trigger points. Once men are trained and supervised on how to use the device, they can treat themselves at home several times a week.
To demonstrate the effectiveness of the pelvic wand for chronic pelvic pain syndrome, one study evaluated its use for six months among 106 men. Nearly all of them reported that self-treatment was very or moderately effective in reducing pain. Similar findings were reported in a subsequent six-month study that involved 314 men.
How did use of the pelvic wand for prostatitis affect how much medication men took for pain? Yet another six-month study involving 298 men and 67 women took on this challenge. After six months of using the pelvic wand, medication use dropped by 36.9 percent, and cessation was significantly associated with relief in all symptoms.
Men who have chronic pelvic pain syndrome may want to talk to their doctor about using a pelvic wand for myofascial trigger point self-treatment.
PCA3 Test to Diagnose Cancer in Men with Prostatitis
A new study indicates that despite previous findings, high levels of PCA3 may be present in men who have prostatitis. The Prostate CAncer gene 3 (PCA3) is produced only by prostate cancer cells and has been believed not to be affected by prostate size (e.g., inflammation associated with prostatitis). This characteristic has led some experts to suggest using PCA3 testing in the general male population to help with early diagnosis of prostate cancer.
Based on new discoveries, however, PCA3 testing may not always help diagnose prostate cancer in men with prostatitis (prostate inflammation). The team that arrived at that conclusion evaluated 260 urine samples (PCA3 is a urine test) from men with suspected prostate cancer. They then analyzed the fate of 16 men who had a PCA3 ratio greater than 100 and a prostate biopsy.
Sixty-five percent of the men had prostate cancer, and 65 percent of them were high grade. Among the men who did not have prostate cancer as shown by the biopsy, 83 percent had acute prostatitis at biopsy. Therefore, doctors should not assume that inflammation does not elevate PCA3 and also aware that some men who have extremely high PCA3 levels can have prostatitis.
MRI Identifies Chronic Prostatitis From Cancer
High levels of prostate-specific antigen (PSA) present a challenge for physicians, since high PSA can occur in men who have prostate cancer or chronic prostatitis, or both. A high PSA typically causes doctors to suspect prostate cancer, which can prompt them to order potentially unnecessary tests such as prostate biopsy.
Although conventional MRIs are not adequate for distinguishing between prostate cancer and prostatitis, some experts believe a specific type of MRI —high spatial resolution dynamic contrast-enhanced MRI, or HR-CE-MRI—is superior to the conventional approach. If true, this new technique could reduce unneeded procedures and stress associated with the uncertainty of knowing whether one has prostate cancer.
Fifty-four men with prostate cancer who were scheduled for prostatectomy underwent HR-CE-MRI of the prostate, and features of the MRIs suggestive of chronic prostatitis were compared to specimens obtained during surgery. Clinicians observed specific features suggestive of chronic prostatitis which contrasted with those of prostate cancer.
Based on their preliminary results, the authors reported that the HR-CE-MRI method was accurate for differentiating between prostate cancer and chronic prostatitis and “can lead to more accurate MRI staging or prostate cancer which can affect treatment choice and clinical outcome.” If this MRI may help distinguish chronic prostatitis from prostate cancer, it also could offer more peace of mind to men who find themselves in this position.
Effect of Pollen on BPH and Prostatitis Symptoms
Pollen extract (Cernilton) can have a beneficial effect on symptoms associated with benign prostatic hyperplasia (BPH) and prostatitis following transurethral resection of the prostate (TURP), according to a new study appearing in the International Journal of Clinical and Experimental Medicine.
One hundred men with BPH and histological prostatitis (evident at a cellular or tissue level) after undergoing TURP were grouped according to the severity of their symptoms: A=mild, B=moderate, and C=severe. The men then were randomly assigned to take Cernilton for three months following TURP or to take a placebo (control group).
The men were evaluated for three factors: quality of life, storage symptoms score (storage symptoms of BPH include frequent urination, a sudden uncontrollable urge to urinate, and waking at night to urinate), and score on the International Index of Erectile Function-5 (IIEF-5).
Six months following TURP:
- Factors in the men in group A remained stable
- Significant differences were seen in the IIEF-5 in the men in group B
- Significant differences were observed in IEFF-5, storage symptoms score, and quality of life in group C
- Significant differences existed in all three factors between the men who took the pollen extract and those who took placebo
The authors concluded that in men with BPH and histological prostatitis who have undergone TURP, use of the pollen extract Cernilton can result in an improvement in lower urinary tract symptoms and sexual function, and that the degree of improvement depends on the grade of prostatitis.
Using Green Tea and Red Wine for Prostatitis
If you have prostatitis, there are two beverages that may not immediately come to mind. But both green tea and red wine harbor some great benefits for helping with prostatitis symptoms.
Green tea for prostatitis
Green tea leaves contain powerful polyphenols called catechins, which have an ability to fight bacteria. In fact, these catechins can work along with antibiotics in the treatment of bacterial prostatitis. If you have bacterial prostatitis, use of green tea may enhance the healing powers of the antibiotics you are taking.
Men who experience benign prostatic hyperplasia, also known as an enlarged prostate, can also find relief from their lower urinary tract symptoms when using green tea. Since these symptoms also affect men who have prostatitis, it is well worth trying green tea for prostatitis as well.
Tips on using green tea for prostatitis
What type of green tea should you use for prostatitis and how much?
- Caffeine-free products—whether you are using green tea for brewing or green tea extracts in supplement form–are your best choice, since caffeine can irritate the urinary tract and contribute to urinary tract symptoms.
- When shopping for green tea, look for the level of epigallocatechin-3-gallate (EGCG), the most potent of the catechins. You want a product in which the amount of EGCG is at least 50 percent of the amount of green tea extract. For example, if a supplement delivers 500 mg of concentrated green tea extract, choose a supplement that gives you at least 250 mg of EGCG.
- For prostatitis, a suggested dosage is 500 to 600 mg of a highly concentrated green tea extract. A number of studies indicate that the bioavailability of EGCG is boosted when taken along with vitamin C and/or omega-3 fatty acids.
- Generally, Japanese green tea (e.g., Matcha, Sencha) provides higher levels of EGCG than does Chinese tea.
- Green tea is more than a beverage; you can also cook with it. See suggestions below.
Using red wine for prostatitis treatment
The suggestion to use red wine for prostatitis is a bit misleading. Red wine is actually one of several vehicles for a potent antioxidant called quercetin, which has been shown to be helpful in treating prostatitis in a number of studies because of its anti-inflammatory qualities.
However, although red wine is a source of this beneficial phytonutrient, you would need to drink a lot of vino to get a beneficial amount. Therefore, downing red wine is not the way to reap the rewards. If you want results, a quercetin supplement, or a supplement that contains this antioxidant, is the way to go. Sure, you can have one glass of red wine with dinner, but for prostate and overall health, that should be your limit.
Quercetin has demonstrated benefits for men with prostatitis in so many studies, it is a standard part of the UPOINT system for treatment of prostatitis (used by Urologists) as well as Dr. Geo’s NPAT CPPS Treatment approach. The typical recommended dose for men who suffer with chronic prostatitis is 500 mg daily.
Bottom line on red wine and green tea for prostatitis
- Talk to your healthcare provider about using green tea and/or quercetin for prostatitis
- The best way to get quercetin is not red wine, but supplements. Do not take more than 1 gram daily without first consulting your doctor.
- If you take quercetin, it can reduce the effectiveness of the quinolones antibiotics, such as Avelox, Cipro, Floxin, and Levaquin.
- Green tea extracts and tea can be included in your lifestyle in several ways. In addition to green tea beverages and green tea extract supplements, try cooking with green tea. Did you know you can make delicious green tea soups, rice dishes, entrees, and desserts? You can use green tea as the basis for a soup stock, cook your oatmeal, rice, or other grains or cereals in green tea, and include it in a variety of other dishes.
What you drink and eat can have a significant impact on your prostatitis symptoms. Many foods have been shown to inflame symptoms and should be avoided. The best foods and drinks are those that can boost your immune system to help reduce the inflammation and pelvic stress.
Using Pollen for Prostatitis – Updated Studies
Men who want to venture outside of the conventional medicine box may want to consider pollen for prostatitis. Are you ready to hear the buzz about pollen?
If you have the most common form of prostatitis, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and you are not satisfied with your current treatment program (or you want to try something different), research and experience are on your side. In fact, for about four decades, men in Europe have been using pollen (pollen extracts) to treat symptoms of prostatitis (e.g., dribbling, frequent urination during the night, pain and/or burning during urination, pelvic or genital pain, blood in the urine, painful ejaculation, strong urge to urinate immediately).
What is Pollen?
Pollen, or pollen extract, for medicinal uses is derived from a specific group of flowering plants. These are not varieties you would normally find in your garden, but a select group that has been shown to be helpful in the management of inflammation associated with prostatitis as well as an enlarged prostate (benign prostatic hyperplasia, BPH).
The majority of studies of pollen for prostatitis have included a combination gathered and standardized from corn, rye, and timothy. Collectively this pollen extract is referred to as cernilton or Graminex. Remember these terms when you are looking for pollen extract supplements or studies on the topic.
What’s so special about pollen for prostatitis? Pollen extract has the ability to fight inflammation, which in turn helps the bladder to contract and the urethra to relax. The result is better urinary flow and relief from prostatitis symptoms.
Studies of Pollen for Prostatitis
The results of the following studies can give you a better idea of what you might expect if you take pollen for prostatitis.
- A new study (October 2014) evaluated the effect of pollen extract in association with B vitamins (B1, B2, B3, B6, B12, and folic acid in a formulation called DEPROX 500) in 87 men with CP/CPPS. The 41 men in the treatment group took 2 DEPROX 500 capsules twice daily for four weeks while the 46 men in the control group took ibuprofen daily for the same period. Three quarters of the men in the pollen and vitamin group reported an improvement in overall symptoms, pain, and quality of life at the end of the study compared with only 41 percent in the control group.
- Seventy men enrolled in a randomized, double-blind, placebo-controlled study were given either cernilton or placebo daily for 12 weeks. The men who took the pollen extract reported significant improvements in pain, total symptoms and quality of life when compared with those in the placebo group. No severe side effects were experienced by the men in the pollen group.
- A six-month double-blind study involved 60 men who were given either pollen extract or placebo daily. At the end of the study, the men in the pollen group said they had experienced either a significant improvement or elimination of their prostatitis symptoms.
How To Use Pollen For Prostatitis
If you are ready to consider pollen for prostatitis symptoms, be sure to talk to your doctor first about any allergies you may have to grasses, flowers, or other plants. If you get the all-clear, look for standardized pollen extract products derived from corn, rye, and timothy or a prostate health formulation that contains this pollen extract.
Before taking pollen extract, consult your healthcare provider and discuss any allergies you may have to flowers, grass, or other plants. He or she can help you determine if this extract is safe to use and at which dose.