To Treat Prostatitis Naturally, First Understand What It Is
by Dr. Geo Espinosa
If prostatitis symptoms are not top of the mind recall for you, cut yourself some slack; the definition of prostatitis is a kerfuffle for many of us. Here’s the silver lining: natural prostatitis treatment is within your reach, and antibiotics need not be your only recourse.
What is prostatitis and how do you treat it with natural medicine?
Prostatitis can be a doozy to treat; patients and physicians alike are frustrated from lack of medical efficacy in the treatment of prostatitis. If you are a patient, often your quality of life is significantly compromised and your gut may be wrecked from over-consumption of antibiotics.
Prostatitis definition: do you know what it means?
The National Institutes of Health (NIH) has defined prostatitis as one of four syndromes (1):
I – Acute bacterial prostatitis – typically, the patient experiences a fever and positive urine analysis for bacteria. About 80% of the times, the bacteria responsible is Escherichia coli (E.coli). Approximately, 5% of patients with acute bacterial prostatitis develop chronic bacterial prostatitis, which accounts for approximately 5–10% of all cases.
II – Chronic bacterial prostatitis – here, despite there being an infection shown from a urine analysis the person may or may not have symptoms.
III – Chronic prostatitis and chronic pelvic pain syndrome (CPPS; further classified as inflammatory or noninflammatory) – This is observed in 90–95% of cases. The urine analysis is negative but the patient has associated symptoms.
IV – Asymptomatic inflammatory prostatitis – this is from an incidental finding, it could be that a prostate biopsy shows inflammation but the person has no symptoms.
How do you identify prostatitis symptoms?
A patient with prostatitis often has two things going on:
- Pain, discomfort, ache in the perineum area (between the scrotum and anus), around the testicles, lower abdominal area, and/or on the penis. Pain is often worse after urinating or ejaculating.
- Urinary problems, typically in urgency and in frequency.
To reiterate, both symptoms, pain around the pelvic area and urinary problems have to be present for it to be prostatitis. If there’s only one out of the two, it is something else.
The type of prostatitis you will clinically see most is category III.
Most patients experiencing prostatitis are very young – typically in their mid-twenties or thirties.
Other facts about prostatitis
- Prostatitis is one of the most common diseases seen in urology practices in the United States, accounting for nearly 2 million outpatient visits per year.
- Most patients are very young – typically in their mid-twenties or thirties. The youngest I’ve seen clinically is fifteen.
- Across the globe, areas with higher rates of widespread sexually transmitted disease (STD) and prostitution have a higher incidence of acute bacterial prostatitis. STD though, is often not the cause, at least not in my clinical experience.
- The first line of therapy is antibiotics, even when urinary cultures show no bacteria. E.coli is the most common type of bacteria when urine culture is positive.
Dr. Geo’s take on a prostatitis treatment method
The first thing to know is that prostatitis does NOT improve by treating the prostate, the person with the prostate must be treated.
Secondly, category III prostatitis, CP/CPPS, is not likely to be an organ-specific problem, but a prostate/bladder/pelvic problem. The symptoms are very similar to Interstitial Cystitis and overactive bladder.
The cause may begin with an infection or autoimmune reaction causing inflammation or neurological damage in and around the prostate (pelvic floor, bladder, perineum, etc.). If not adequately treated in the early stage, peripheral and then central sensitization could occur. Once the central nervous system is “pissed off” (pun unintended), the nerves continue to persistently fire away at the pelvic region causing pain and discomfort around the pelvic area. As a result, depression, anxiety, and frustration set in thereby worsening the symptoms.
You should also know that antibiotic therapy by far a WORSE approach for prostatitis, particularly the non-bacterial type.
That’s right! This prostatitis treatment method, while life-saving for some infections, is horrific for prostatitis even though post-treatment, some people feel better initially. I’ve even seen patients get prostatitis symptoms shortly after the end of the antibiotic course.
And that is frustrating for patients!
The primary form of antibiotics used for prostatitis are fluoroquinolones, i.e., Ciprofloxacin (Cipro, Cipro XR, Proquin XR), and Levofloxacin (Levaquin) typically for 4 to 6 weeks. Not only can fluoroquinolones cause achilles tendon rupture or tendonitis, fluoroquinolones can also cause mitochondrial dysfunction of the pancreas. This is when insulin (beta cells) is made, which leads to low blood sugar (hypoglycemia). Yikes!
But that’s not all.
Misuse or overuse of antibiotics in patients with CP/CPPS can have a direct effect on the gut microbiome, killing off good bacterial flora that are important for health. The prolonged overuse of antibiotics also contributes to Irritable Bowel Syndrome (IBS), caused likely by the killing of healthy flora.
Here is the kicker: IBS is common among prostatitis sufferers and treating IBS is a major component for treating prostatitis. So, antibiotics cause not just all sorts of undesirable side effects but likely make the disease worse by causing IBS. (Seriously!)
There are many ways to calm the nervous system and one of which is meditating.
Prostatitis treatment that isn’t just a diagnosis of exclusion
I’m privileged to see many prostatitis cases at my clinic, likely more than any functional/naturopathic doctor in the nation. While still imperfect, the treatment approach I deliver has worked for many patients. I believe prostatitis is a neuropathic dysfunction of the urogenital system.
In other words, prostatitis is caused by the excess firing of the nerves through the urological system that includes your bladder, prostate, scrotum, and penis. That’s why the burning and achy sensation is felt in those areas after peeing, ejaculating or even from doing nothing.
The term “prostatitis” is often a diagnosis of exclusion and just a diagnosis to connect an ICD-10 code number to it for billing purposes. But the real problem is hyperactivity and hypersensitivity of the nerves innervating the urological and digestive system. That is why treating gut related issues help with prostatitis as well – the two are connected via the nervous system.
OK, so how do we do treat the cause?
1. Listen to the patient with empathy
Prostatitis patients have been through the mill with their social life and by seeing many urologists, some of whom are likely as frustrated as the patient from seeing these cases with very few results. Listening to prostatitis patients not only offers some therapeutic solutions but also shows that you care. Listening with care is therapeutic in and of itself.
2. Calm the nervous system
There are many ways of achieving this. Meditating is one of them (2). There are numerous books that teach Mindful Based Stress Reduction (MBSR) and have a calming effect on the parasympathetic system that is stimulated from the practice. I recommend these books to my patients. I also teach patients how to breathe diaphragmatically to calm their senses.
3. Acupuncture
A systemic review study in looking at over 470 subjects shows efficacy in acupuncture treatment for prostatitis. I attest that it works, as I have seen it do wonders for some patients clinically.
4. Botanicals
I use many herbs, too many to mention here as every case I see requires a different protocol – it’s never a “one size fits all” approach. Some supplement ingredients I use include immune stimulant – mushrooms, beta 1, 3 glucans, arabinogalactan, diindolylmethane (DIM), astragalus, elderberry, andrographis, allspice, garlic, basil, sage, acerola, echinacea,
anti-inflammatory – curcumin, quercetin, anti-microbial– astragalus, garlic, goldenseal, clove, and allspice.
The reason these botanicals help is that they stimulate the immune system against hidden bacteria often not found in the urinary testing currently available to physicians. There are antimicrobials that are strong but work gently in the body. Herbs help to reduce inflammation. In studies, rye pollen extract, not included in APS, has shown to help men with prostatitis.
5. Heal the gut
This is done by eliminating foods like gluten and dairy. There may be others that a functional medicine or naturopathic doctor can detect but eliminating gluten and dairy is a good start. Also, typical “prostatitis inducing culprits” like coffee and spicy food may or may not cause prostatitis symptoms; each case is different.
6. See a physical therapist specializing in pelvic dysfunction
They can help by relaxing tight muscles in the pelvis that contribute to pain and discomfort.
Lastly, If you have prostatitis, I assure you that you are not crazy! Prostatitis symptoms are real. However, after suffering for a long time with an achy pelvis and the urge and frequency to pee, the mind becomes hypersensitive to the pelvic area even when under normal circumstances, the feeling is a mild itch or twitch down there.
In other words, every guy feels strange things around their scrotum, penis or perineal area at some point. This is common. But the person who has never had prostatitis ignores it. The guy with a history of prostatitis often agonizes over familiar sensations. Prostatitis symptoms worsen due to anxiety.
If you do not know where to start, meditate. Know that you are already on the first step to recovery.
Excellent article about the hows and whys of prostate pain and what to do about it. So many men, especially young men, have their lives ruined by lengthy courses of antibiotics with the fluoroquinolone (FQ) Cipro being top of the list.
I’d just like to point out the Cipro and its siblings (named in the article) cause mitochondrial dysfunction everywhere there are mitochondria, not just in the pancreas. The FDA issued an alert about hypoglycemic disturbance (and mental health problems) from FQs in July last year but the bottom line is that ALL mitochondria are affected – and we have hundreds or thousands in every cell apart from red blood cells. Tendon ruptures are the most well known of FQ adverse reactions (the tendon cells have thousands of mitochondria to produce all that energy) but every system in the body is affected leading to muscle and joint pains, peripheral neuropathy, central nervous system disturbances (insomnia through to hallucinations), cardiac problems – you name it. And the gut suffers too, of course.
The effects are cumulative meaning some people can take many courses while others only need to take one tablet before their life is ruined. It’s all to do with our genes and whether we were born with specific deficiencies (e.g. G6PD), or our lifestyle and environment can make a difference as chemical, pharmaceutical and environmental toxins all take their toll. One day there will be genetic testing so that our drugs can be specifically tailored for our genes but until then be careful of what you put into your body.
Thank you. It all rings true.