Prostate Power Rx and BPH - How to treat an enlarged prostate gland with natural herbs and prescription medications, are herbal remedies effective?

A man with an enlarged prostate gland has several choices. If the enlargement is mild or moderate, and causes no major urinary symptoms, he can either do nothing and wait, begin with an herb used for prostate health such as saw palmetto, take a prostate formulas such as Prostate Power Rx, or begin with a prescription medication. There are two major options for prescription medications as treatment for BPH,  5alpha-reductase inhibitors and alpha-receptor blockers.
   Many men whose symptoms of BPH are mild prefer to begin with a natural product in order to avoid the side effects of the prescription medications.  5alpha-reductase inhibitors can cause sexual problems including difficulty with erections and loss of libido. A prostate formula, such as Prostate Power Rx, does not have cause sexual dysfunction, but rather enhances sexuality and erectile function.
   This article discusses the causes of BPH and the several treatment options that men have in order to lessen their symptoms.

Testosterone and DHT
In the prostate gland the enzyme 5alpha-reductase converts testosterone into more active form--dihydrotestosterone (DHT). This hormone strongly influences prostate function and takes part in its pathology Since the connection between androgens and pathology of this gland has been proved, pharmacological inhibition of conversion became one of the therapy strategies both for benign prostate hyperplasia and prostate cancer. Last decade has brought numerous, long term clinical trials which involved numerous men being administered finasteride and other 5alpha-reductase inhibitors in benignprostate hypertrophy (BPH) treatment and prostate cancer prevention.

Cause of BPH
The epidemiology of benign prostatic hyperplasia is complex and not fully understood. The androgenic hormones testosterones and dihydrotestosterone play at least a permissive and important role. Growth factors and other hormones including estrogens may also play a role. BPH is a hyperplastic process resulting in growth of glandular-epithelial and stromal / muscle tissue in the prostate, leading to often measurable growth taking on different shapes and configurations which may impact symptoms and secondary outcomes. It is important to recognize that BPH is a histological conditions, which is one but not the only cause of lower urinary tract symptoms, and may or may not be associated with prostate enlargement and bladder outlet obstruction.

The histopathology of BPH strongly implicates local paracrine and autocrine growth factors and inflammatory cytokines. A complex milieu of growth-regulatory proteins includes members of the fibroblast, insulin-like, and transforming growth factor families. It appears that these proteins and downstream effector molecules, in addition to a variety of interleukins, are overexpressed in BPH and, working together, create a landscape of increased stromal and epithelial growth that leads to disease progression. Inflammation, commonly present in BPH, may contribute to tissue injury, and cytokines produced by inflammatory cells may serve to drive local growth factor production and angiogenesis in the tissues as a "wound healing" response.

Treatment options for BPH, watchful waiting,  the use of herbal supplements, drug therapy, combination drug therapy and surgery

Watchful waiting
This is a well known approach to the management of benign prostatic hyperplasia. Both longitudinal studies and randomized placebo-controlled trials have confirmed the progressive nature of BPH, with symptom progression being the most common manifestation. Variables such as baseline prostate-specific antigen, prostate volume, symptom score and bother score, decreased flow rate, and increased postvoid residual have all been linked to progression to acute urinary retention and need for surgery. Historically, not much has been known about the natural history of BPH and thus, who would be a good candidate for watchful waiting.

Herbal therapy
Treating benign prostatic hyperplasia with herbal extracts is recommended if symptoms are minor.

Should one take a prostate product such as saw palmetto or Prostate Power Rx if one does not have a prostate problem? I am 62 and make several trips to the bathroom at night but I have no other symptoms of a malfunctioning prostate gland. There is no pain or problem urinating.
    It's difficult to say. It boils down to being a personal choice and preference. It's difficult to predict whether taking saw palmetto or an herbal prostate formula for months and years will be of overall health benefit or a detriment. One option is to take such a product two months on, two months off, and then decide whether you wish to continue.

I was Diagnosed with BPH 16 years ago. My biopsies have been negative throughout the years. My PSA has been gradually increasing (4.2 to 9.5). My last ultrasound revealed the prostate at approx 100gr in size. Do herbal products such as beta sitosterol, saw palmetto, Prostate Power Rx, or research reveal any evidence of shrinking the prostate? I am trying to avoid a TURP.
    There are natural supplements such as the herbal extracts you mention that have been found in human studies to be helpful. However, it is not possible to know in any one individual which natural products, if any, will be helpful.

Single drug therapy with 5alpha-reductase inhibitors
In some men, prostate volume is decreased and mechanical component of dysuria is improved by treating for a long time (months, years) with 5-alpha-reductase finasteride. This drug is indicated when the volume of the prostate gland is over 40 g.

Single drug therapy with alpha-receptor blockers
Alpha-receptor blockers which act on the bladder neck. These medicines have effects earlier and are recommended for patients with benign prostatic hyperplasia independently of prostate volume. Low blood pressure is a side effect.

Combination drug therapy
Combination therapy can be beneficial in the treatment of BPH and associated LUTS. The greatest efficacy for the alpha(1)-ARA and 5alphaRI combination was shown in patients with larger prostate size and more severe symptoms. The combination of alpha(1)-adrenergic receptor antagonists and 5alpha-reductase inhibitors appears to prevent disease progression in these patients. The combination of alpha(1)-ARAs with anti-muscarinic agents is useful for relieving symptoms of bladder outlet obstruction and detrusor overactivity. Men with overactive bladder and BPH who are not receiving adequate alleviation of symptoms from the first-line alpha(1)-adrenergic receptor antagonists may benefit from the addition of an anti-muscarinic agent.
   Open or transurethral resection of the prostate was once the only option for men afflicted with symptomatic benign prostatic hyperplasia. In the past 10 to 15 years, however, medical management has become a common step in the treatment of BPH, often postponing or eliminating the need for surgical intervention. The two drug classes used in the medical management of BPH are alpha-blockers and 5-alpha-reductase inhibitors.

PSA testing
Several analyses have demonstrated a clinically useful relationship between serum prostate specific antigen and prostate volume in men with benign prostatic hyperplasia and lower urinary tract symptoms (LUTS). Both prostate volume and serum PSA predict certain aspects of the natural history of LUTS and BPH, and men with higher PSA and larger glands in general have a higher rate of progression measured by various parameters. Serum PSA also predicts the response to certain types of medical therapy in men with LUTS and BPH and is thus useful in the evaluation and management of these patients. Lastly, serum PSA does not loose its usefulness as a cancer marker for prostate cancer even if certain medications reduce serum PSA values predictably by 50%.

Does Prostate Power Rx do anything to PSA numbers or levels?
    We have not seen any studies with this natural herbal formula to know how or if it influences PSA levels.

Questions and comments, feedback and testimonials
My husband started taking Prostate Power Rx several years ago and really notices a difference when he doesn't. He's only taking one pill a day, I think the dose suggested is 2 pills a day. It really works for him.