Help for Enlarged Prostates

Help for Enlarged Prostates

Julian Whitaker, MD

“Old guys” may, as the T-shirts proclaim, “rule.” But they also have to urinate a lot more often than younger men. That’s because the prostate gland, which sits like a donut around the urethra (the tube that carries urine from the bladder through the penis), experiences a growth spurt between the ages of 40 and 50. As it enlarges, it may impinge on the urethra and cause symptoms such as a weak stream, dribbling, hesitancy, and an inability to completely empty the bladder. This condition, called benign prostatic hyperplasia (BPH), is annoying at best, and may require surgical intervention at worst.

Two classes of drugs have been approved for the treatment of BPH, and conventional physicians often prescribe both for good measure. Alpha blockers such as Hytrin and Flomax relax muscles in the prostate and bladder neck and thus make urination easier. They work rapidly and are pretty effective, but because they’re also used to treat hypertension, they may cause low blood pressure, dizziness, and weakness.

The other class of meds reduces prostate volume by inhibiting the activity of an enzyme called 5-alpha reductase that converts testosterone into dihydrotestosterone (DHT), the hormone that ultimately drives prostate growth. These drugs, which include Proscar (finasteride), must be taken for weeks to months before benefits are noted, and they’re associated with decreased libido and erectile dysfunction.

Thankfully, there are several natural therapies for BPH that work as well as drugs and don’t threaten your health and sex life.

Herbs, Not Drugs

Saw palmetto (Serenoa repens) is nature’s 5-alpha reductase inhibitor. In fact, it was the inspiration for Proscar, the first prescription BPH medication approved in the US. It’s also the best-studied natural therapy for prostate enlargement. A meta-analysis of 14 placebo-controlled and three open-label trials involving more than 4,000 men demonstrated that saw palmetto significantly increased urinary flow and reduced nocturia (nighttime urination).

Unlike BPH drugs, saw palmetto is well tolerated. And, rather than impairing sexual function, it may actually improve it. Earlier this year, researchers gave older men 320 mg of saw palmetto per day and followed them for two years. In addition to reducing BPH symptoms and enhancing quality of life, the men reported improvements in erectile function.

We’ve had good success with saw palmetto at the Whitaker Wellness Institute. One of my patients, a quiet, dignified older gentleman, reported that he’d been getting up four times at night to urinate and could never fall right back to sleep. After he started taking saw palmetto, his nocturnal trips to the bathroom were reduced to one or two, and a good night’s sleep made a tremendous difference in his well-being. He also winked at me and said, “My wife likes it, too.”

Treatment and Prevention

Other botanicals with proven benefits for BPH include pygeum (a good source of beta-sitosterol), stinging nettles, and pumpkin seeds. Although they’re not backed by the same degree of scientific research as saw palmetto, all are time-honored treatments for BPH. Antioxidants are also important, especially selenium and zinc, which are particularly active in the prostate.

I want to mention one more promising natural ingredient. GoLess is a combination of soy isoflavones and pumpkin seed extract that not only targets 5-alpha reductase but also relaxes the bladder muscles. It’s fairly new but early research is compelling. In one six-week study, GoLess reduced nocturia by 40 percent!

Men, I suggest you start taking saw palmetto before you have symptoms. Prostate enlargement may be a normal part of aging, but you don’t have to let it get the best of you.


  • The suggested dose of saw palmetto for younger men (ages 40–50) is 160 mg per day; the full therapeutic dose for older men is 320 mg per day. Recommended daily doses of the other supplements are zinc 30–60 mg, selenium 200–400 mcg, stinging nettles 300 mg, pygeum (or beta-sitosterol) 100–200 mg, and GoLess 600 mg.
  • Look for these supplements individually or in combination products online or in your health food store. The product we use at the clinic, Prostate Health, is available at drwhitaker.com or by calling (800) 810-6655.


  • Boyle P, et al. Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU Int. 2004 Apr;93(6):751–756.
  • Sinescu I, et al. Long-term efficacy of Serenoa repens treatment in patients with mild and moderate symptomatic benign prostatic hyperplasia. Urol Int. 2011;86(3):284–289.

Modified from Health & Healing with permission from Healthy Directions, LLC. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.

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