What BPH is
Benign prostatic hyperplasia is an enlarged prostate that is not caused by cancer.1 It affects about 5–6% of men aged 40–64 and 29–33% of men 65 and older.2 Symptoms include trouble starting, a weak stream, dribbling and waking at night,3 but they do not always match the prostate's size.5
How an enlarged prostate affects urination
A simplified illustration based on NIDDK.
How common BPH is
What makes it worse, and what is urgent
Cold and cough medicines such as decongestants and antihistamines can make symptoms worse.4 The same symptoms can come from other problems, including prostate cancer.6 Not being able to urinate at all, or blood in the urine, needs help right away;7 acute urinary retention is a sudden inability to urinate.8
Treatment
BPH can be treated with watchful waiting, medicines or surgery.9 Simple habits help: less fluid before bed or going out, and less alcohol and caffeine.10 Alpha blockers relax the muscles; 5-alpha reductase inhibitors help shrink the prostate.11 Surgery is an option when medicines do not help.12
Treatment options
| Option | What it involves |
|---|---|
| Watchful waiting | Checkups plus habits: less fluid before bed, less alcohol and caffeine.10 |
| Alpha blockers | Relax muscles so urine flows more easily.11 |
| 5-alpha reductase inhibitors | Help stop growth or shrink the prostate.11 |
| Surgery | If medicines do not help or symptoms are severe.12 |
The choice depends on how much symptoms affect your life.
The PSA test
PSA can be high because of BPH or infection, not only cancer.13 Testing can find cancer early, but it is not clear that this lowers the risk of dying from prostate cancer,14 and some cancers never cause harm.15 Screening is a decision to make with your doctor.
The PSA test: what it can and cannot tell you
What it can do
- Find some cancers early.14
Supplements
A 2023 review found saw palmetto alone gives little or no benefit for BPH symptoms.16 Studies of lycopene for prostate cancer are mixed,17 there is not enough evidence for green tea or pomegranate,18 and men with prostate cancer should not take selenium.19 Too much zinc is harmful.20
Prostate supplements: what the evidence says
| Supplement | What the evidence says |
|---|---|
| Saw palmetto | Little or no benefit for BPH symptoms.16 |
| Lycopene | Mixed results for prostate cancer.17 |
| Green tea, pomegranate | Not enough evidence for prostate cancer.18 |
| Selenium | Not for men with prostate cancer.19 |
Tell your doctor about any supplement.
The clinic's approach
The clinic's handwritten formulary lists pumpkin seed, lycopene and zinc (reading uncertain) under "Prostate", with no doses or uses written.21
The clinic's prostate remedies, and what the evidence shows
Two entries from the clinic's formulary, each with the clinic's words first, then independent evidence.
Lycopene and zinc, listed under "Prostate" in the clinic's handwritten formulary
Listed in the clinic formularyNot proven- Where the clinic says this
- Handwritten formulary, page 1.21
- The clinic's stated rationale
- None written; they are listed under the heading "Prostate". The zinc reading is uncertain.21
- Evidence and limitations
- Studies of lycopene for prostate cancer are mixed,17 and ProperHealth found no NIH source showing it treats an enlarged prostate. Too much zinc is harmful and can lower copper; the adult upper limit is 40 mg a day from all sources.20
- What this means for you
- Count zinc from every product you take, and tell your doctor about any prostate supplement.
Pumpkin seed, listed under "Prostate" in the same formulary
Listed in the clinic formularyNot assessed here- Where the clinic says this
- Handwritten formulary, page 1.21
- The clinic's stated rationale
- None written.21
- Evidence and limitations
- ProperHealth has not yet saved an authoritative source on pumpkin seed for the prostate, so it makes no claim either way. The best-studied herb, saw palmetto, gave little or no benefit for BPH symptoms in a 2023 review.16
- What this means for you
- Do not let any supplement delay a check of new urinary symptoms.
A historical perspective: Dr. Majid Ali
“The prostate gland of a man is healthy when he does not even know he has the gland.”
— Dr. Majid Ali, 24 December 2015
His point that men first notice the prostate when urine is slow to start matches current descriptions of BPH.3
He also ranked green tea first for prostate health. The sources used here find not enough evidence for that.
What to do this week
Tell your doctor about symptoms
Other problems can look the same.6
Check your cold medicines
Some make urinating harder.4
Try the simple habits
Less fluid before bed; less alcohol and caffeine.10
Discuss PSA testing
When to get help now
Each warning sign cites the official guidance behind it. The wording still needs pharmacist sign-off.
- You cannot urinate at all, with a painful, swollen lower belly — go to the emergency department.2223
- Fever and chills with painful, urgent urination — get medical help right away.24
- Blood in the urine — contact your doctor right away.25
- Bone pain or weight loss you cannot explain, with urinary symptoms — see your doctor soon. New leg weakness, or loss of bladder or bowel control — call 911.262728
- Trouble urinating after starting a cold or allergy medicine — decongestants and antihistamines can cause it. Talk with your health care professional; if you cannot urinate, get care right away.293031
Every numbered marker links to the exact passage it rests on. Check the sources.