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Benign enlarged prostate

Benign enlarged prostate

Prostate problems: What can I do myself?

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Many men know what it's like to feel the urge to urinate often and have to make regular trips to the toilet at night. These problems are usually caused by a benign enlarged prostate. If the problems caused by the prostate are only minor, it is often possible to manage them by simply changing a few everyday habits.

The gradual growth of the prostate gland is a normal part of aging in men. At some point it may cause urination problems, though. Men who have only mild symptoms can often cope quite well without treatment. There are a few strategies that can help in everyday life:

  • Drinking less if you can't or don't want to use the toilet for a longer time period – for example, before going to bed. The German Society of Urology recommends not drinking more than 1.5 liters spread evenly throughout the day. It's still important to get enough to drink generally, though – especially if you're thirsty.
  • Drinking diuretic drinks in moderation. These increase the amount of urine that comes out of your bladder, and include alcohol and drinks with caffeine in them (like green and black tea) in particular.
  • Using what is called a double-voiding technique when you urinate: Try to urinate again a few moments after you finish. This increases the chances of emptying your bladder properly. It can also help to squeeze any remaining urine out of the urethra with your hands.
  • Training your bladder's ability to hold urine by regularly delaying trips to the bathroom a little, and not going to the toilet immediately when you start feeling the urge.

It is also a good idea to review the medications you are taking with a doctor or pharmacist. Some medications can increase the production of urine or affect the bladder muscles, making the symptoms worse. These medications include:

Your doctor can advise you on possible alternatives that don't make the prostate problems worse.

Can herbal medicines offer relief from the symptoms?

Some men try out herbal medicines for the relief of prostate problems. More than 30 different herbal medicinal products are available for this purpose. Most of them can be bought over the counter in pharmacies. These are the most common ingredients:

  • Pumpkin seeds (cucurbita pepo L.)
  • Saw palmetto (S. repens), also called dwarf palm
  • African plum tree (P. africanum)
  • Rye pollen (S. cereale)
  • African potato (H. rooperi)
  • Nettle root (Urtica dioica radix)

Many of these products haven't yet been well studied. The best studied herbal products for prostate problems are made from saw palmetto extracts, sometimes combined with nettle root extracts. An analysis of 32 studies involving over 5,500 men found no difference between these products and a placebo (fake medication).

One of the largest and best-quality studies on saw palmetto extracts showed the following:

It didn't matter whether the participants took a placebo or a saw palmetto extract – the symptoms improved in about 44 out of 100 men in each of the groups. A more recent analysis has confirmed these results.

These herbal products also had no effect on urine flow or nighttime trips to the toilet.

Höfner K, Bach T, Berges R et al. S2e-Leitlinie der Deutschen Urologen: Konservative und medikamentöse Therapie des benignen Prostatasyndroms (in Überarbeitung). [S2e guideline of the German urologists: Conservative and pharmacologic treatment of benign prostatic hyperplasia]. Urologe A 2016; 55(2): 184-194.

Tacklind J, MacDonald R, Rutks I et al. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev 2012; (12): CD001423.

Trivisonno LF, Sgarbossa N, Alvez GA et al. Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement: A systematic review and meta-analysis. Investig Clin Urol 2021; 62(5): 520-534.

Wilt TJ, N'Dow J. Benign prostatic hyperplasia. Part 2: Management. BMJ 2008; 336(7637): 206-210.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Prostate problems: What can I do myself?

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Updated on July 22, 2022

Next planned update: 2025

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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