Night-time trips to the toilet that disrupt sleep and a constant urge to urinate. These are typical symptoms of benign prostatic hyperplasia (BPH) — a non-cancerous enlargement of the prostate that affects more than half of men over the age of sixty. Although it affects most men with age, there is no need to simply accept these uncomfortable symptoms. The key is understanding the role of hormones, excess body weight, and diet. In this article, you will learn why early diagnosis is important and how prostate health can be actively supported through lifestyle changes as well as proven natural and nutritional substances.
What will you learn in this article?
- The role and location of the prostate
- Key functions of the prostate
- Benign Prostatic Hyperplasia (BPH)
- Hormones and the development of BPH
- Diagnosis of BPH
- Treatment of BPH
- Nutrients that support prostate health
- Natural support for prostate health
- Lifestyle adjustments for prostate health
- Key takeaways from the article
The role and location of the prostate
The prostate, also known as the prostate gland, is an exocrine gland approximately the size of a walnut in younger men. It is located deep in the pelvic cavity, strategically positioned beneath the bladder and in front of the rectum. Its most important anatomical relationship is that it completely surrounds the upper part of the urethra — the tube that carries urine from the bladder out of the body. This close encirclement of the urethra is the main cause of urinary difficulties that arise when the prostate enlarges. The anatomical proximity to the rectum, on the other hand, allows physicians to perform a key diagnostic rectal examination, during which the posterior part of the gland can be assessed by palpation.
Key functions of the prostate
Despite its small size, the prostate has several essential functions, primarily related to reproduction.
The main role of the prostate is the production of prostatic fluid — a slightly alkaline, milky-white fluid that makes up approximately 15–30% of the volume of ejaculate. This fluid is rich in enzymes, proteins, and zinc and is crucial for sperm survival and function. It contains proteolytic enzymes, the most well-known of which is prostate-specific antigen (PSA), which liquefy semen after ejaculation and allow sperm to move freely. The alkaline pH of the fluid helps neutralize the naturally acidic environment of the vagina, thereby prolonging sperm viability and increasing the likelihood of fertilization.
Mechanical function during ejaculation: The prostate also functions as a muscle-driven mechanical switch between urination and ejaculation. During sexual climax, the smooth muscle tissue within the prostate contracts and actively expels the accumulated fluid together with sperm into the urethra, contributing to the force of ejaculation.
Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate caused by the proliferation of prostate cells. As a result, the prostate can increase in size from that of a walnut to that of an orange.
The prevalence of benign prostatic hyperplasia increases significantly with age — it affects more than half of men aged 60 and up to 90% of men over the age of 80.
Symptoms of BPH include frequent urination during the day and sudden, strong urges to urinate at night (nocturia), which often disrupt sleep. It may also present as difficulty starting urination, a weak or intermittent urine stream, a feeling of incomplete bladder emptying, and post-void dribbling.
However, the symptoms mentioned above are non-specific, and although they are most commonly caused by BPH, they may also indicate prostatitis, prostate cancer, or conditions unrelated to the prostate at all (such as neurological disorders or diabetes). Therefore, if these symptoms occur, it is advisable to undergo a professional medical examination.
Hormones and the development of BPH
Prostate enlargement is a complex condition caused by a combination of several factors that emerge with increasing age. However, hormonal activity plays a key role.
The hormone dihydrotestosterone (DHT) , which stimulates the growth of prostate cells, is formed from testosterone through the action of the enzyme 5α-reductase. Excessive activity of this enzyme therefore promotes prostate enlargement. Many medications used in the treatment of BPH specifically target the inhibition of the 5α-reductase enzyme.
In addition to testosterone , the (predominantly female) sex hormone estrogen also plays an important role in benign prostate enlargement in men. With advancing age, the activity of an enzyme called aromatase increases in men. This enzyme converts the male hormone testosterone into estrogen. Studies show that higher levels of estrogen within prostate tissue are associated with prostate growth and the development of BPH.
Diagnosis of BPH
To establish a diagnosis of BPH and exclude other possible causes, a comprehensive urological examination is recommended. This includes a medical history, physical examination, and laboratory tests (urinalysis, assessment of kidney function, and measurement of PSA levels).
Additional examinations, such as uroflowmetry (measurement of urine flow rate) or ultrasound of the prostate and urinary bladder, help assess the degree of obstruction, measure prostate size, and determine the amount of residual urine after voiding.
Symptoms are commonly evaluated using the international questionnaire IPSS (International Prostate Symptom Score), which allows an objective assessment of disease severity.
Treatment of BPH
Conventional treatment includes so-called alpha-blockers (e.g. tamsulosin), which relax the smooth muscle of the prostate and bladder neck, thereby improving urine flow. 5-alpha-reductase inhibitors (e.g. finasteride) block hormonal influences and gradually reduce prostate volume.
Surgical treatment is reserved for patients with severe symptoms or for cases in which pharmacological therapy has failed. The goal is to remove the excess prostate tissue.
The gold standard is transurethral resection of the prostate (TURP); however, other endoscopic methods are also available, including modern laser procedures (vaporization, enucleation).
Nutrients that support prostate health
An appropriate selection of foods and nutrients can naturally support hormonal and inflammatory balance in the body, limit the growth of prostate tissue, and act preventively against its enlargement. Including foods rich in specific plant compounds, antioxidants, and healthy fats in the diet can therefore be a simple and effective step toward long-term prostate health and overall male vitality. In contrast, the so-called Western diet—high in processed meats, refined sugars, sweets, and industrially processed foods—is associated with inflammatory processes and hormonal imbalances that may contribute to BPH.
Soy isoflavones and flaxseed lignans are phytoestrogens that influence hormonal balance. By interacting with estrogen receptors, they can inhibit the enzyme 5α-reductase and thereby support prostate health. Research suggests that they contribute to lowering PSA levels, limiting the growth of prostate cells, and promoting apoptosis, while being very well tolerated. [4]
Pumpkin seeds have traditionally been used in folk medicine as a remedy for urinary problems caused by an enlarged prostate. Pumpkin seed oil also has the ability to attenuate the effects of dihydrotestosterone and thus reduce prostate volume. Studies confirm the beneficial effects of pumpkin seeds and pumpkin seed oil on urine flow, PSA reduction, and symptom improvement—especially when combined with phytosterols or saw palmetto. [5] [6]
Lycopene , a carotenoid found primarily in tomatoes , is an antioxidant that also supports prostate health. Studies show that higher lycopene intake is associated with a lower risk of prostate cancer and with reduced growth of prostate cells. [7]
In raw tomatoes, however, lycopene is present in a form that is less bioavailable to the human body. Cooking, stewing, or baking disrupts tomato cell walls and converts lycopene into a more biologically active form. Its absorption is further enhanced by the presence of fat, which is why it is ideal to combine heat-treated tomatoes (such as tomato sauces, soups, or stewed tomatoes) with healthy fats like olive oil.
Healthy fats are also important for prostate health. Fatty acids , such as eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and gamma-linolenic acid (GLA), exhibit a wide range of beneficial effects and may support prostate health. Flaxseed oil and fish oil, rich sources of essential fatty acids, have anti-inflammatory effects and may also reduce 5α-reductase activity. [8]
Among common foods, garlic also plays a role in BPH prevention, thanks to its anti-inflammatory, antioxidant, and anticancer properties—especially when combined with olive oil and tomatoes. [9]
A higher intake of beta-carotene and vitamin C (for example from red peppers, broccoli, and citrus fruits) is also associated with a lower risk of severe BPH requiring surgical treatment. [10] Foods rich in beta-carotene (such as carrots, pumpkin, and sweet potatoes), similarly to lycopene, are best heat-treated and consumed with fat to increase their bioavailability.
A deficiency of vitamin D has also been associated with prostate enlargement. Increasing vitamin D intake correlates with a reduced risk of BPH and may help decrease prostate size in men who already have BPH. [13]
Natural support for prostate health
A number of plant-based and natural substances with proven biological effects have traditionally been used in the management of benign prostatic hyperplasia (BPH). Their mechanisms of action primarily involve inhibition of the enzyme 5α-reductase, which promotes prostate growth, anti-inflammatory effects, and protection of cells from oxidative stress.
The most commonly used natural remedy is saw palmetto (Serenoa repens) , whose efficacy in some studies is comparable to commonly prescribed medications such as finasteride or tamsulosin. Saw palmetto inhibits 5α-reductase, has anti-inflammatory effects, and supports natural apoptosis of prostate cells. [1]
Another important compound is beta-sitosterol , a plant sterol found, among other sources, in saw palmetto extract. Clinical studies have confirmed its ability to improve urinary symptoms, urine flow, and quality of life in men with BPH. [2] Its effects are maintained with long-term use and complement other natural compounds, such as vitamin E.
Pygeum africanum , also known as African plum, is another plant extract with a long tradition of use, particularly in Europe. It acts against cellular proliferation and inflammation in the prostate.
Stinging nettle ( Urtica dioica ) is among the best-known medicinal plants in Central European tradition. Folk medicine has used it for centuries for “blood cleansing,” supporting red blood cell formation, and improving liver, kidney, and urinary tract function. It was valued for its ability to strengthen the body after winter and to support hair growth and skin health.
Stinging nettle has gained particular attention in relation to men’s health, especially benign prostatic hyperplasia (BPH). Extract from its root helps regulate the growth of prostate cells and reduces BPH symptoms; when combined with saw palmetto, it shows effects comparable to finasteride, but with better tolerability. [3]
Lifestyle adjustments for prostate health
Healthy body weight and regular physical activity
Maintaining a healthy body weight is absolutely crucial for prostate health. The amount of body fat is strongly associated with prostate size , and a similar relationship has been observed with body mass index (BMI). [11]
A sedentary lifestyle directly contributes to increased body fat and excess weight. How significant is this issue? One study found that obese men are 3.5 times more likely to develop prostate enlargement than men with normal body weight. [12]
This is because adipose tissue produces the enzyme aromatase, which converts testosterone into estrogen, thereby potentially contributing to prostate growth. In contrast, regular physical activity, including resistance training, supports testosterone production and helps maintain healthy body weight and metabolic health.
Limiting alcohol consumption
In the case of BPH, limiting alcohol intake is essential. Alcohol generally acts as a diuretic—it increases urine production, accelerates bladder filling, and worsens urinary frequency as well as nighttime urination. It may also irritate the bladder and intensify the feeling of urgency. Additionally, any alcohol places a burden on the liver, which is responsible for breaking down excess estrogen in the body.
Avoiding toxins
Xenoestrogens—synthetic chemical substances found, for example, in plastics (bisphenol A, BPA), cosmetics, cleaning products, herbicides, and pesticides used in agriculture—mimic the effects of estrogen and can disrupt the hormonal system, thereby contributing to the development of BPH. Choose glass containers for food storage, use natural cosmetics and cleaning products, and opt for organic-quality foods.
Supporting mental well-being and sleep
Lack of quality sleep disrupts overall recovery and hormonal balance. Chronic stress also increases levels of the stress hormone cortisol, which can lead to reduced testosterone production. Stress management and consistent, high-quality sleep lasting 7–9 hours per night can therefore help support prostate health.
Key takeaways from the article
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Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate, but its symptoms (frequent urination, weak urine stream, feeling of incomplete emptying) can significantly reduce quality of life.
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Medical diagnosis is essential: BPH symptoms are non-specific and may overlap with more serious conditions. A visit to a urologist and appropriate tests (including PSA levels) are crucial to rule out prostate cancer.
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The main drivers of prostate growth with age are two processes: the conversion of testosterone into the growth-stimulating hormone DHT (via the enzyme 5α-reductase) and the conversion of testosterone into estrogen (via the enzyme aromatase).
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The role of diet and nutrients: prostate health benefits from adequate intake of lycopene (from heat-treated tomatoes with fat), pumpkin seeds , phytoestrogens (flaxseed, soy), and healthy fats (fish oil). Adequate vitamin D intake is also essential.
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Nature offers effective support: compounds such as Saw Palmetto , beta-sitosterol , and stinging nettle root extract have been shown to help alleviate BPH symptoms, often by naturally inhibiting the enzyme 5α-reductase.
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Lifestyle matters: excess weight and a sedentary lifestyle contribute to BPH because adipose tissue produces the enzyme aromatase (which forms estrogen). Regular physical activity, limiting alcohol intake (especially beer), and avoiding toxins are fundamental pillars of prevention.
