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I was 61 years old, and I was being held hostage. By my prostate.
I couldn’t travel anywhere unless I knew where the nearest restroom was. Must-go-now emergencies came out of nowhere, and my nights were a series of strolls between bedroom and bathroom. I talked with a urologist who said that, at my age, I was probably dealing with an enlarged prostate — in medical terms, benign prostatic hyperplasia, or BPH.
The prostate is the walnut-sized gland in men that produces semen. As we age, it often increases in size and, because it surrounds the urethra (the tube that carries urine out of the body), it can obstruct its flow. BPH can leave a man feeling as though his bladder is always full, even after he’s just gone, and make it difficult for him to get the flow of urine started.
My urologist offered me a prescription drug to address my symptoms. But I wasn’t eager to add another medication to my growing daily regimen, so I opted first to experiment with herbal supplements long used in traditional cultures for men’s urinary health — plant extracts such as saw palmetto and milk thistle. I experienced fewer symptoms after a couple of weeks, but the problem slowly worsened until it was clear I needed a different solution.
“We don’t have good data to support supplements,” says Naren Nimmagadda, M.D., assistant professor of urology at Johns Hopkins University School of Medicine in Baltimore. He adds, though, “If people are on them and they tell me they have benefit, I don’t tell them to stop them.”
There’s a lot that science doesn’t understand about BPH — including what causes it, why it’s more common in the West than in Asian countries such as China and Japan, and why it may be more common among Black men. “Genetics, lifestyle and environmental factors may play a role,” says Thomas Chi, M.D., a urology professor at the University of California San Francisco.
What is known is that a man’s decade of life corresponds almost exactly with the likelihood that he’ll suffer an enlarged prostate. “Fifty percent of 50-year-olds, 60 percent of 60-year-olds, 70 percent of 70-year-olds and so on will have prostatic enlargement,” says Mayo Clinic urologist Tobias S. Kohler, M.D. But Kohler notes that only about half of those men will experience symptoms, because it’s not just the prostate’s size that causes obstruction but also its architecture (that is, how it’s configured around the urethra).
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