Enlarged prostate — which herbs and remedies do herbalists and doctors recommend?

Aim of the study: Aim: Benign prostatic hyperplasia (BPH) is an important public health problem. Roughly half of all men will suffer from BPH-related symptoms later in life. The prostate gland, a hormone-dependent part of the male reproductive system, is susceptible to internal and external disruptions of regulatory systems.

Results: Moderate exercise and the type and amount of protein intake have a considerable influence on BPH symptoms. Zinc and vitamin D intake also positively influence BPH symptoms, as do certain supplements, such as saw palmetto, Cernilton and pygeum extracts. Lifestyle changes, dietary modifications and certain nutritional supplements can favorably influence BPH symptoms.

Aim of the study: To systematically review the existing evidence regarding the efficacy and safety of phytotherapeutic compounds used to treat men with symptomatic benign prostatic hyperplasia (BPH).

Results: A total of 44 studies of six phytotherapeutic agents (Serenoa repens, Hypoxis rooperi, Secale cereale, Pygeum africanum, Urtica dioica, Curcubita pepo) met the inclusion criteria and were reviewed. Many studies did not report results in a form that allowed meta-analysis. Serenoa repens, extracted from saw palmetto, is the most widely used phytotherapeutic agent for BPH. A total of 18 trials involving 2939 men were reviewed. Compared with men receiving placebo, men taking Serenoa repens reported greater improvement in urinary tract symptoms and measures of urine flow. Serenoa repens reduced nocturia (weighted mean difference (WMD) = -0.76 times per evening; 95% CI = -1.22 to -0.32; n = 10 studies) and improved peak urine flow (WMD = 1.93 ml s(-1); 95% CI = 0.72 to 3.14, n = 8 studies). Men treated with Serenoa repens reported greater improvement in urinary tract symptoms than men taking placebo (risk ratio of improvement = 1.72; 95% CI = 1.21 to 2.44, n = 8 studies).

Aim of the study: Benign prostatic hyperplasia is a common condition affecting older men. Typical symptoms include difficulty starting urination, a weak stream, nocturia, incontinence and recurrent urinary tract infections.

Results: Limited evidence shows that the herbal agents saw palmetto extract, rye grass pollen extract and pygeum relieve symptoms. Transurethral resection of the prostate often provides permanent relief. Newer laser-based surgical techniques have comparable effectiveness to transurethral resection up to two years after surgery, with lower perioperative morbidity. Various outpatient surgical techniques are associated with reduced morbidity, but symptom relief may be less durable.

Aim of the study: Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men. Its incidence gradually increases with age and leads to lower urinary tract symptoms (LUTS), which seriously affect patients’ quality of life. Chinese herbal medicines (CHMs) are widely used to treat BPH in China and some other countries.

Results: The results suggest that the mechanisms of action of CHMs in treating BPH may involve regulation of sex hormones, downregulation of cell growth factors, anti-inflammatory and antioxidative effects, inhibition of cell proliferation and promotion of apoptosis. CHMs also have α-blocker-like effects, with the potential to relax urethral smooth muscle and alleviate LUTS. In addition, we reviewed 4 clinical trials and meta-analyses of CHMs for treating patients with BPH, which provided initial evidence of the safety and effectiveness of CHM treatment. CHM treatment for BPH has advantages as a multi-component, multi-target and multi-pathway therapy. It can reduce disease severity, improve LUTS and may become a reliable treatment option in the future.

Aim of the study: Benign prostatic hyperplasia (BPH) can affect quality of life and cause various complications. Previous studies have suggested that Chinese herbal medicine can alleviate symptoms in patients with BPH. This study aimed to investigate whether the Chinese herbal medicine prescription VGH-BPH1 can alleviate BPH symptoms when used as an add-on treatment.

Results: VGH-BPH1 treatment significantly decreased the total International Prostate Symptom Score (p = 0.027); however, no significant difference was observed between the treatment and placebo groups. The Aging Male Symptoms Score for “joint pain and muscular ache” in the VGH-BPH1 group was significantly lower than that of the placebo group (p = 0.022). The “physical exhaustion” score also showed a decreasing trend when the two groups were compared (p = 0.057). Although VGH-BPH1 treatment did not outperform placebo in improving BPH symptoms, it improved several quality-of-life indicators compared with placebo. Further research with a larger sample and appropriate amendments to the protocol should be conducted to investigate the effects of VGH-BPH1.

Aim of the study: Anti-inflammatory and antioxidant effects play crucial roles in recovery from benign prostatic hyperplasia (BPH). Wenshenqianlie (WSQL) capsules, a typical traditional Chinese medicine formulation combining 14 Chinese herbs, have been reported to have tonic effects on the kidneys and improve clinical symptoms of BPH.

Results: We investigated the anti-inflammatory and antioxidant effects and mechanisms of WSQL in BPH using histopathological examination, immunohistochemistry, enzyme-linked immunosorbent assay and western blotting, combined with in vivo serum metabolomics and gut microbiomics analysis. WSQL alleviated prostate hyperplasia and reduced prostate-specific antigen, dihydrotestosterone, testosterone and inflammation levels. Gut microbiomics and untargeted serum metabolomics indicated that the protective effect of WSQL against BPH may be related to improvements in inflammation- and testosterone-related gut microbiota and serum metabolites. Further studies showed that WSQL improved nuclear factor-kappa B, its downstream inflammatory factors and the nuclear factor E2-related factor 2 pathway.

Aim of the study: Background/Objectives: Benign prostatic hyperplasia (BPH) is a common age-related disorder in elderly men and a major cause of lower urinary tract symptoms. Lycopus lucidus Turcz.

Results: Expression of 5α-reductase type 2 and aromatase in the ventral prostate tissue was significantly downregulated, while Bax and Bcl-2 expression and the Bax/Bcl-2 ratio remained unchanged. Conclusions: LLE attenuated TP-induced prostatic hyperplasia in rats, suggesting that modulation of androgen metabolism may contribute to its anti-hyperplastic effects. These findings support further investigation of L. lucidus extract in BPH.

Aim of the study: Used clinically to manage benign prostatic hyperplasia, Qianlong Shutong Formula (QLSTF) is an empirical therapeutic preparation with properties described as clearing heat, promoting urination, activating blood circulation and resolving nodules. However, its molecular mechanisms in regulating inflammation and fibrosis remain unclear.

Results: The findings indicated that QLSTF markedly reduced the extent of prostatic hyperplasia, promoted the death of hyperplastic cells and lowered the expression of fibrosis markers in BPH model rats. At the same time, it inhibited YAP/TAZ migration into the nucleus and balanced Th17/Treg expression, thereby producing therapeutic effects against BPH. QLSTF can inhibit inflammatory responses and interstitial fibrosis by regulating the imbalance of the Th17/Treg-mediated immune-inflammatory microenvironment and the Hippo-YAP/TAZ pathway. Notably, the observed effects are associated with modulation of the Hippo-YAP/TAZ pathway, although direct causal mechanistic links require further functional validation.

Aim of the study: To investigate the molecular mechanism of Qianlong Shutong Formula (QLSTF) in treating benign prostatic hyperplasia (BPH) through the regulation of metabolism and protein function. An integrated metabolomics and proteomics analysis was conducted using a BPH animal model.

Results: Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and Clusters of Orthologous Groups (COG) enrichment analyses revealed that these proteins are involved in biological processes such as cell proliferation, apoptosis and inflammatory responses. Correlation analysis demonstrated a synergistic relationship between metabolite levels and protein expression. Integrated analyses revealed metabolic disorders and differential protein expression, providing multiomics evidence for QLSTF’s mechanism. QLSTF alleviates BPH by modulating metabolic pathways and protein networks, providing a molecular basis for traditional Chinese medicine (TCM) in BPH treatment and suggesting directions for future research.