Phytotherapy for Prostatitis
What Is Phytotherapy?
Phytotherapy for prostatitis is a natural treatment that combines two supplements for prostatitis, quercetin and pollen extracts, in specific formulations. Phytotherapy is helpful for men suffering from chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and other prostate disorders such as enlarged prostate. Pollen and quercetin work well in combination to help restore prostate health. Both supplements are anti-inflammatories that can be helpful in reducing prostate inflammation. In addition, quercetin is a bioflavonoid nutrient that you can find in apples, red grapes, red wine, onions, berries, and tea. It has antioxidant properties and plays a role in inhibiting the production and release of inflammation-causing substances in the body. Pollen extracts have a slightly different mechanism of action from quercetin, and that is why the two work well in combination. Pollen fights inflammation and causes the bladder to contract, making it helpful for relieving urinary symptoms associated with prostatitis. One of the more common pollen extracts, called Graminex, contains pollen from timothy, rye, and corn. You may also see it referred to as “Cernilton”.
Phytotherapy for Prostatitis—Does It Work?
Phytotherapy for prostatitis is a Tier 1 Supplement, meaning it has successful clinical studies and research supporting it effectiveness. More and more doctors and men are turning to natural and alternative treatments like phytotherapy for prostatitis because it works well, is easier on the body, supports the immune system, and does not produce the serious side effects for long-term problems associated with pharmaceutical drugs. The UPOINT system for prostatitis treatment also recommends phytotherapy and quercetin for the organ specific and pelvic floor spasms domains as does the NPAT Program used by Dr. Geo Espinosa at the Integrative Urology Center in NYC.
There are several studies on the effectiveness of phytotherapy for prostatitis:
- One study at the Cleveland Clinic found quercetin to be a very effective treatment for prostatitis. In the study, they treated 100 men according to the UPOINT model. They had an average of 3 positive UPOINT domains, with organ-specific being the most common (70%). The main goal of the study was to reach at least a 6-point decline in the Chronic Prostatitis Symptom Index (CPSI). Quercetin was chosen as the treatment for men who were in the organ-specific UPOINT category. Compared with other prostatitis treatments used in the study, quercetin was associated with a greater decline in the CPSI.
- Another study had 28 men with Chronic Prostatitis/CPPS take either 500 mg quercetin or a placebo for one month. This was a randomized, double-blind, placebo controlled study. An additional 17 men took a supplement containing quercetin, bromelain, cranberry, papain, and saw palmetto. After the month, the men who took quercetin saw their International Prostate Symptoms Score go down from 21.0 to 13.1, while the placebo group only went from 10.2 to 18.8. The authors compared the three groups to see which ones reported at least a 25% improvement in symptoms: 20% of the placebo group, 67% of the quercetin group, and 82% of the combination supplement that contained quercetin reported at least a 25% improvement in CPPS symptoms.
- That same author of the previous study also conducted a multimodal study that involved quercetin over 10 years later. This study involved 100 men with CP/CPPS. Quercetin was associated with a greater decline in CPPS symptoms than other approaches.
- In 1999, researchers reported that quercetin “provides significant symptomatic improvement” in men who have CP/CPPS. Two-thirds of the patients in the study reported that their quality of life had improved after treatment with quercetin. The authors attributed the positive results to quercetin’s anti-inflammatory and antioxidant properties.
- An early study of the pollen extract Cernilton/pollen involved 90 men with CPPS. The men were divided into two groups: those without complicating factors (72 men) and those with complicating factors (18 men). All the participants took Cernilton/pollen three times a day for six months and underwent testing (e.g., digital rectal examination, uroflowmetry, bacterial studies) after three and six months of intervention. Among the men who did not have complicating factors, 56 (78%) reported a favorable response to Cernilton: 26 men (36%) had their symptoms eliminated, and 30 (42%) experienced significant improvement, including an increase in urine flow rate. In the group of 18 men with complicating factors, only one patient reported a response. Overall, Cernilton/pollen was well tolerated by 97% of patients.
- A six-month study on pollen extract in 60 men with CP/CPPS found that pollen extracts are “superior to placebo in providing symptomatic relief in men with chronic nonbacterial prostatitis/chronic pelvic pain syndrome.” The men who took pollen extract had either no symptoms or had a significant improvement in symptoms at the end of the six months.
- A randomized, multicenter, double-blind, placebo-controlled study, lasting 12 weeks, was published in European Urology. It reported that the 70 men who took Cernilton/pollen pollen extract had significant improvements in pain, prostatitis symptoms, and quality of life compared to 60 men who took a placebo. The men who took Cernilton reported significant improvements in pain, quality of life, and their prostatitis symptoms (without any severe side effects).
- In 2006, the American Urological Association presented a study on Cernilton/pollen. They reported that men who took Cernilton/pollen had statistically significant improvements in their pelvic discomfort and quality of life.
- In January 2006, a double-blind study published in Urology reported that men with CPPS who took a pollen extract for six months were either symptom free or had experienced a significant improvement in their symptoms. In this study, 60 CPPS patients were assigned to take either a Prostat/Prolit (a pollen extract preparation that has similar ingredients to Cernilton) or a placebo. The authors concluded that that the pollen extract was “superior to placebo in providing symptomatic relief in men with chronic nonbacterial prostatitis/chronic pelvic pain syndrome.”
- Authors of a study published in the World Journal of Urology performed a systematic review of the articles published in PubMed up to 2012 that covered alternative therapies for treating CP/CPPS such as phyotherapy, acupuncture, myofascial physical therapy, diet and lifesyle midifications, and stress management/cognitive behavioral therapy. The authors concluded that CP/CPPS often requires a multimodal approach that and alternative therapies should be considered as adjuncts in the treatment of refractory CP/CPPS patients.
- A Spanish study looked at phytotherapy for CP/CPPS patients. They found phytotherapy useful in a field of multimodal treatment for CP/CPPS and phytotherapy useful for recurrent urinary tract infections.
Sometimes prostatitis symptoms can include urinary symptoms that are similar to another condition like enlarged prostate (benign prostatic hyperplasia—BPH). It can be helpful to read studies about how pollen extracts and quercetin can help those symptoms as well.
- A review of four different studies including 144 men with BPH was published in Cochrane Database Systemic Review. The reviewed trials used Cernilton/pollen and each lasted 12 to 24 weeks long. The pollen extract resulted in an improvement in urinary symptoms compared with use of placebo, however he pollen extract did not affect prostate size.
- A study published in the British Journal of Urology stated that of the men with BPH who took Cernilton every day for six months, 69% experienced an improvement in their symptoms. Only 30% of the men who took the placebo had an improvement.
- A Japanese study evaluated the use of cerniltin in 79 patients with BPH. Participants ranged in age from 62 to 89 years. They took Cernilton/pollen three times daily, 2 tablets of 63 mg each per dose, for over 12 weeks. At the study’s end, the urine maximum flow rate and average flow rate had increased significantly, while residual urine volume had decreased significantly. The men had improvements in the following factors: urgency or discomfort 76.9% improvement; dysuria, 71.4%; nocturia, 56.8%; incomplete emptying, 66.2%; prolonged voiding, 64.1%; delayed voiding, 62.2%; intermittency, 60.6%; and postvoid dribbling, 42.7%. Overall, 85% of participants experienced benefit: 11% reported “excellent” results, 39%, “good,” 35%, “satisfactory,” and 15%, “poor.” In conclusion, the authors noted that Cernitin “showed a mild beneficial effect on prostatic volume and urination variables in patients with symptomataic BPH.”
- In a study that was published in the Journal of Endocrinology, scientists reported on their evaluation of the effect of quercetin and the drug finasteride (Proscar) on the prostate gland in rats. The quercetin (at doses of 50, 100, or 150 mg of quercetin per kg of body weight) along with the drug finasteride resulted in a 31.8%, 40.0%, and 48.2% reduction, respectively, in prostate weight. The authors concluded that quercetin works with finasteride to reduce prostate weight through a cell cycle-related pathway that may function independent of androgens.
Uses and Side Effects of Phytotherapy for Prostatitis
Phytotherapy with pollen extracts and quercetin is tolerated well by most men at 500 mg per day, but there are a few precautions for men with allergies. You should not take bee pollen if you are allergic to pollen. An allergic reaction can include shortness of breath, hives, and throat, tongue, or facial swelling. Additionally, you should talk to you doctor if you are allergic to flowers, grass, or other plants before taking any product that has bee pollen in it.
Quercetin is usually effective at a dose of 500 mg per day. Talk to your doctor before taking more than 1 gram. Quercetin may cause some minor side effects. The most common side effects include headache and upset stomach.
References for Phyotherapy for Prostatitis:
Elist J. Effects of pollen extract preparation Prostat/Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a randomized, double-blind, placebo-controlled study. Urology- 2006 Jan; 67(1): 60-63
Herati, A.S. Alternative therapies in the management of chronic prostatitis/chronic pelvic pain syndrome World J Urol. Aug;31(4):761-6. Epub 2013 Jun 6.
Ma Z et al. Reduction of rat prostate weight by combined quercetin-finasteride treatment is associated with cell cycle deregulation. J Endocrinol 2004 Jun; 181(3): 493-507
Morán, E. Phytotherapy in urology. Current scientific evidence of its application in urolithiasis, chronic pelvic pain, erectile dysfunction and urinary tract infections phytotherapy for prostatitis Actas Urol Esp. 2013 Mar;37(3):174-80. doi: 10.1016/j.acuro.2012.07.004. Epub 2012 Oct 9.
Rugendorff EW et al. Results of treatment with pollen extract (Cernilton N) in chronic prostatitis and prostatodynia. Br J Urol 1993 Apr; 71(4): 433-38.
Shoskes DA et al. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology 1999; 54(6):960-63.
Shoskes DA et al. Phenotypically directed multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome: a prospective study using UPOINT. Urology 2010 Jun; 75(6): 1249-53 –phytotherapy for prostatitis
Wilt T et al. Cernilton for benign prostatic hyperplasia. Cochrane Database Syst Rev 2000; (2):CD001042.
Wagenlehner FM et al. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomized, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol 2009 Sep; 56(3): 544-51