This article will explore a couple uniquely male issues and the evidence for some herbal remedies.
Whether it’s difficult to get in to see a general practitioner or urologist (here you can have a four month wait), or local medical facilities are still being COVID bullies, or you simply prefer to try more natural remedies before visiting a professional MD, or you simply just want to put your health back in your hands, there are many reasons to consider herbal remedies. The hormones and organs that make you male deserve care and attention. We’ll survey some of the literature around herbal remedies for some prostate issues so that you can make your own judgments as to treatment.
Disclaimer: This author is not a licensed medical doctor. Any choice to prepare any remedy listed here is the responsibility of the user. That said, I will not write anything here that I would refuse to give to any man in my family.
Both issues we’ll discuss involve the prostate. I will presume the reader is familiar with the basic location and function of the prostate and its function. If not, here are a couple places to familiarize yourself with this important part of the male reproductive system.
What is it?
Prostatitis is defined as the inflammation of the prostate gland. The cause may be either infectious or non-infectious. There are several classifications of prostatitis:
- I: Acute Prostatitis: This is a serious bacterial infection of the prostate gland. Symptoms include those typical of severe infection, including bodyaches, fever, and chills. A patient with acute prostatitis often will have pain in the genitals, perineum, or even the lower back. Urination will be frequent, urgent, and painful. The prostate will likely be very tender to touch upon examination. This is a medical emergency, and you should see a professional as soon as possible if you are experiencing these symptoms. Do not use herbal remedies as a substitute here. Do not attempt prostatic massage either, as sepsis can be induced if the infection is severe enough. A doctor will look for the presence of bacteria and white blood cells in your urine to make this diagnosis and then give you appropriate antibiotics, typically tetracyclines. Full recovery is typical.
- II: Chronic Bacterial Prostatitis:: This is a semi-rare condition that presents as intermittent urinary tract infections. If you experience frequent UTIs, see a doctor to evaluate for this issue. Some of the infusions or teas described below may help manage this condition, but don’t substitute this for seeing a doctor and receiving any necessary antibiotics.
- III: Chronic Prostatitis: This is defined as long-term (lasting 3 months or more) pelvic pain and urinary tract issues without evidence of bacterial infection. Among typical symptoms of pain in the genital area, the distinguishing symptom here is post-ejaculatory pain. The cause is as yet unknown. Again, this one is fairly severe, so if you experience issues lasting at least 3 months, see a urologist.
- IV: Asymptomatic Inflammatory Prostatitis: This is a painless inflammation of the prostate with no evidence of bacterial infection. It’s considered benign, and no course of treatment is usually given.
Herbal Remedies and Actions
I’ve given the medical overview of prostatitis above. From Medical Herbalism: The Science and Practice of Herbal Medicine, the following herbal remedies are suggested:
- Demulcents: used to soothe and protect inflamed or irritated tissues. These will be mucus-y herbs. This will help alleviate pain and symptoms in the genital and urinary area.
- Diuretics: make you pee more. The goal here is to help your body cleanse itself of waste. You should be drinking plenty of water if you’re taking any diuretic, herbal or pharmaceutical.
- Tonics: nonspecific nurturing herbs. It sounds a bit “woo” or New-Age, but pharmacologically they provide an overall synergistic effect with other herbs or have a general benefit to either the whole body or specific organs. There usually aren’t “white coat approved” explanations of the mechanisms by which these work, but the results can’t be ignored.
- Antimicrobials: help the body destroy pathogenic microbes. This should be contrasted with antibiotics, which are directly active against microbes. For instance, antibiotics kill or inhibit growth of bacteria directly. Antimicrobials from an herbalist’s perspective help the body fight off and kill microbes. They don’t do it for you. For this reason, acute or very severe infections may require antibiotics, as the body may just not be able to keep up or have time to keep up any longer.
Recommended herbs include:
- Bearberry (Arctostaphylos uva-ursi), buchu (agathosma betulina), and couch grass (Elymus repens) as antimicrobials. These aren’t specific to the prostate, but are generally helpful nonetheless. See the evidence section below.
- Saw palmetto (Serenoa repens), hydrangea (Hydrangea arborescens), damiana (Turnera diffusa), and sarsparilla(Smilax) are prostatic tonics.
- Cornsilk (Zea mays) and dandelion are diuretics and (in the former) demulcents. Bearberry and buchu also act as diuretics.
An herbal prescription for prostatitis is given in i>Medical Herbalism: The Science and Practice of Herbal Medicine:
Mix equal parts
- echinacea purpurea (another potent antimicrobial and easy to find)
- saw palmetto
Dose up to 5 mL of tincture made from the herbs above three times daily. The text also recommends drinking of a tea made from equal parts yarrow and cornsilk throughout the day.
- Tinctures take weeks to make from dried or fresh herbs, since you’re soaking them in a mixture of alcohol and water (if using dried herbs). While I try to anticipate the needs of my household and have tinctures ready, sometimes it’s just not possible. Tinctures are not the only way to dose this. You can also use the recipe above to make a decoction for shorter term use. To make a decoction, place equal parts of the dried herbs above into a sufficiently sized pot (with lid) and add cold water. Typically you’ll use 1 cup of water for each teaspoon of herb (or herbal mixture in this case). Bring the mixture gently to a boil. Cover and reduce heat so the mixture is simmering for at least 15-30 minutes. Drink warm or cold and store the rest in the fridge for a day or two at most.
- If treating for mild prostate or urinary symptoms with these herbs, keep in mind that these can be pretty potent diuretics. From my experience using these to treat such issues, I recommend taking these tinctures or drinking these decoctions/teas during the day, stopping about an hour before bed. Otherwise you may find yourself losing sleep with frequent trips to the bathroom at night.
- Drink lots of water.
Benign Prostatic Hypertrophy
This is formally defined as “benign adenomatous hyperplasia of the periurethral prostate gland, commonly seen in men over 50 and causing variable degrees of bladder outlet obstruction”. It’s a noncancerous size increase of the prostate, typically beginning over age 40-50. You’re more likely to have this issue if you’re overweight, not exercising enough, have type 2 diabetes, or are on certain medications (pseudoephedrine, calcium channel blockers). The most commonly accepted cause is the accumulation of testosterone in the prostate, which is converted to dihydrotestosterone once in the prostate. DHT is more chemically potent than testosterone, and is chemically necessary for the development of the prostate. However, too much is believed to cause the over-enlargement of the prostate. Thus, one method of treatment for benign prostatic hypertrophy is the reduction of the formation of DHT. This is accomplished by blocking the enzyme responsible for this conversion of testosterone to DHT.
Pharmaceutically, finasteride (marketed as Proscar and Propecia) and also used to treat hair loss is prescribed for this. However, saw palmetto has been clinically shown to have the same effect on the DHT enzyme as finasteride without the unpleasant side effects (depression, breast enlargement, sexual dysfunction).
An herbal remedy for BPH is as follows:
- Saw palmetto – 2 parts
- hydrangea – 2 parts
- sarsparilla – 1 part
- cornsilk – 1 part
- bearberry – 1 part
Dose up to 5 mL of the tincture three times daily.
Since antihistamines and antidepressants are associated with reduction in bladder tone, men should avoid these drugs, especially if they find themselves with urinary symptoms of BPH. (Actually, everyone should avoid the latter if at all possible.)
You’ll notice that the same herbs show up for BPH as for prostatitis. In the next section, we’ll look at some of the evidence supporting the use of these herbs.
Saw palmetto has been clinically shown to inhibit the formation of DHT as well as inhibit binding of DHT to receptor sites. That said, the quality of saw palmetto matters. I purchase the berries directly from a reputable source (Starwest Botanicals) and make my infusions, decoctions, and tinctures myself.
The NIH decries studies that show its benefits, and its own studies do not show any benefit. In formal medicine, the powers that be either begrudgingly admit that it “may help”, or deny its effects outright. The herb has been used for hundreds of years for men’s health issues, there are no real side effects (except increased urination and rarely, digestive upset and some headache), and enough studies have demonstrated a benefit that I accept its use medicinally. Each person should judge for himself.
According to Medical Herbalism: The Science and Practice of Herbal Medicine, bearberry has a specific antiseptic and astringent effect on the membranes of the urinary system. An NIH review does grumpily admit its effectiveness in treating UTIs. They do rightly point out that bearberry can cause some side effects, is contraindicated in pregnant women (but this article is for men anyway, and men don’t get pregnant), and shouldn’t be used for a very long time. They are right to say that bearberry and other herbal medicines should be treated as medicines and not just haphazardly consumed as teas. Other discussions of the effectiveness of bearberry can be found here and here. There is less MD-approved literature on this herbal remedy than for saw palmetto, but the traditional uses date back hundreds of years for these specific issues. In my opinion, successful traditional use constitutes a longitudinal study.
Cornsilk has been used traditionally for a wide variety of purposes. Even the NIH had to admit its effectiveness for multiple pharmacological activities in a review (which is quite good). I could find no literature warning people away from its consumption (except excessive consumption.)
This herb has generations of traditional use in South Africa and has been introduced as a pharmaceutical in the UK as a diuretic. It is contraindicated in people with kidney disease because of its potent volatile oils. However, a German monograph from 1998 does not accept that sufficient evidence exists for the use of buchu to treat urinary issues.
Sarsparilla is another general purpose herb used to treat more issues than genital or urinary ones. Perhaps the most important function of sarsparilla is its ability to act synergistically, helping to increase absorption of active compounds of other herbs. In searching for contrary opinions/evidence, I only found a lack of clinical trials as a reason to reject the use of sarsparilla. It behooves me to point out that a lack of clinical trials or clinical studies only tells us that the question….hasn’t been studied. This isn’t the same as saying “we put this question to the test and the answer either was a definitive no, or we couldn’t find enough evidence to say yes”. Sarsparilla has been shown over and over again to be generally safe, so if you’re willing to take ibuprofen for a headache, you should be willing to at least give this a try.
Medical herbalism is both a formal practice and a “folk practice”. I highly recommend having a good general source if you plan to use herbal remedies for ailments. The text I find myself reaching for the most is Medical Herbalism: The Science and Practice of Herbal Medicine, by David Hoffman. It’s a bit deeper and more technical than the other famous authors (e.g. Rosemary Gladstar), but I think this is better. It is more complete and acts like a Merck manual for herbs and body functions. (That said, I also keep a Merck manual around as a general medical encyclopedia. Try to find an older version from the 1990s or before.)
There is room for modern medicine and herbal medicine. As I mentioned above, acute infections and severe or prolonged symptoms should be examined by a medical doctor. Herbal remedies generally help the body fix itself, but sometimes that help just isn’t strong enough. If you try any of these herbal remedies, and they’re just not helping, go see a physician.
Herbs are also medicine, so please follow the links to look at any contraindications for your particular situation. Herbs and pharmaceutical can interact, and only you know what you’re on. If you have never taken any of these herbs before, start with a tea infusion at small doses to monitor for any allergic reactions, then increase the dose to what is recommended.
Finally, the source of herbs is important. Avoid ordering from disreputable sites and locations. If a website won’t give you the source of the herb, don’t buy it. I also refuse to buy anything from China, given its history of pollution and poor quality. I purchase any herbs I don’t grow myself from either Starwest Botanicals or Mountain Rose Herbs. I have no affiliation, paid or otherwise, with any author, store, or organization discussed here. All of this is my personal and professional opinion.