Benign prostatic hyperplasia, also called BPH, benign prostatic hypertrophy, or benign prostatic obstruction, is a condition in men in which the prostate gland is enlarged and not cancerous. As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. In time, the bladder may deteriorate and lose the ability to empty fully, leaving some urine in the bladder. The narrowing of the urethra and urinary retention produce many of the problems associated with benign prostatic hyperplasia. The National Institute of Diabetes and Digestive and Kidney Diseases asserts BPH is, “the most common prostate problem for men older than age 50.”

Given its ubiquity, treatment of benign prostatic hyperplasia is an area of medicine that is consistently pursued. The most common treatments are lifestyle change, medication, minimally invasive procedures, and surgery. However, lately, a few alternative therapies have emerged and they are getting a lot of attention.

Saw Palmetto

The extracts from the berries of saw palmetto are the most popular herbal product used to treat symptomatic BPH. While the evidence is mixed, multiple studies have shown an improvement in symptoms. Studies have shown use of saw palmetto can reduce the need to urinate during the night and improve urinary flow and symptoms, including painful urination. In fact, a large analysis of multiple studiesconcluded that saw palmetto produced a benefit similar to finasteride, a drug for enlarged prostate, and was better tolerated. Saw palmetto may also boost the general quality of life for men with BPH.

For BPH, studies have used a daily intake of 320 milligrams of saw palmetto split into two doses. In other forms, like tinctures, the dosing will be different. Consult your doctor. It may take four to six weeks for saw palmetto to have effect.

Pumpkin Seeds

Another popular treatment with similar effects of saw palmetto is the use of pumpkin seeds. Pumpkin seeds contain protective compounds called phytosterols, which some believe contribute to a shrinking of the prostate. They also contain chemicals that may prevent some transformation of testosterone into dihydrotestosterone (DHT). High levels of DHT are associated with enlarged prostate.

Betasitosterol is one of the several phytosterols (plant sterols) with chemical structures similar to cholesterol. Betasitosterol is widely distributed in the plant kingdom and found in both the popular saw palmetto and in pumpkin seeds. A review of betasitosterol studiesshowed that Betasitosterol use for BPH produced improved symptoms, improved peak flow rate symptoms, improved peak flow rate, and reduced post-void residual volume. However, their long-term effectiveness, safety, and ability to prevent BPH complications are not known.

To help prevent BPH, Prevention’s clinical herbal advisor, Douglas Schar, DipPhyt, MCPP suggests eating a handful, about 1 ounce, of shelled pumpkin seeds three times per week.


Zinc supplements are often referenced as an alternative treatment to benign prostatic hyperplasia because zinc levels decrease in the presence of BPH. The human prostate gland contains a higher level of zinc than most other tissues. There is a decrease in zinc levels in the plasma and prostate tissue of men with BPH, as well as prostate cancer, when compared to those with normal prostate function.

Zinc has been demonstrated to relieve lower urinary tract symptoms, probably due to its ability to inhibit prolactin. Prolactin is an issue because it has been shown to increase the uptake of testosterone by the prostate, thereby leading to increased levels of dihydrotestosterone (DHT). It all seems to come back to alternative treatments that lower levels of DHT.

However, be very careful when using zinc supplementation. Studies show an excessive consumption of zinc supplement, more than 100mg per day, may significantly increase the risk of advanced prostate cancer and could actually cause the symptoms associated with BPH.

Cialis Prescription

Cialis belongs to a specific class of drugs, Phosphodiesterase-5 inhibitors, which urologists prescribe mainly for erectile dysfunction. Tadalafil (Cialis) belongs to this class of medications and is used regularly to manage BPH. It can reduce lower urinary tract symptoms by relaxing smooth muscles in the lower urinary tract, leading to fewer BPH symptoms. Researchers are working to determine the role of erectile dysfunction drugs in the long-term treatment of benign prostatic hyperplasia.

The drug was approved by the FDA as a BPH treatment in 2011. The press release noted, “The severity of symptoms of BPH can be measured using the International Prostate Symptom Score (IPSS). In two clinical trials, men with BPH who took 5 milligrams (mg) of Cialis once daily experienced a statistically significant improvement in their symptoms of BPH, compared to men who were treated with placebo. The trials based their findings on a reduction in total IPSS scores. In a third study, men who experienced both ED and BPH and who took 5 mg of Cialis once daily had improvement in both their symptoms of BPH and in their ED compared to men who were treated with placebo. The improvement in ED was measured using the Erectile Function domain score of the International Index of Erectile Function.”