MICROgenics^® Protech Advanced

The prostate gland

The prostate gland sits near the bladder surrounding the urethra. It produces fluid that nourishes sperm and is stimulated to grow by exposure to the male sex hormone testosterone. In males at puberty, it increases in size by about eight times and then continues to grow more slowly, doubling in size between the age of 21 and 50 years.¹ Between age 50 and 80 years, growth accelerates and it can double in size.

Benign prostatic hyperplasia (BPH)

BPH is a non-cancerous enlargement of the prostate gland that can interfere with bladder function and cause urination difficulties. About 80% of the prostate gland in BPH is stromal, half of which is smooth muscle, and 20% is epithelial tissue.² High levels of the testosterone derivative dihydrotestosterone (DHT), produced by the enzyme 5-alpha-reductase, appear to enhance prostate growth. It has been assumed that the urinary difficulties associated with BPH are due to physical obstruction of the urethra or bladder, but research has shown that smooth muscle constriction may be a factor.²

BPH is a very common problem that affects many men after the age of 40. Almost one in seven Australian men aged 40-49 years report being diagnosed with a prostate problem, increasing to about one in every four men aged 70 years and older.³

Urinary symptoms of BPH include:1

• decreased force and size of stream
• frequency during the day and especially at night
• urgency
• hesitancy, difficulty starting flow
• straining to urinate
• dribbling & difficulty stopping flow
• feeling that bladder has not been emptied fully
• involuntary passing of urine

Saw palmetto

Saw palmetto (Serenoa repens, also known as Sabal serrulata) is a dwarf palm tree from North America that has edible berries used by native Americans for food and medicine.

Traditional uses:⁴

• diuretic
• urination difficulties
• male sexual dysfunction
• stomach pain
• dysentery

Active constituents

Saw palmetto contains a variety of fatty acids that are believed to be the active principles in BPH.⁵

Mechanism of action

Animal and in vitro studies have shown that saw palmetto can inhibit binding of DHT and testosterone to receptors and inhibit activity of prolactin and the pro-inflammatory enzymes cyclooxygenase and lipooxygenase.⁵ It has antispasmodic properties, which may be helpful in preventing spasm of smooth muscle tissue in the enlarged prostate gland.⁵ Lipid-sterolic extracts of saw palmetto can inhibit 5-alpha reductase activity in vitro.⁶

Saw palmetto for BPH

A 2002 Cochrane review of 21 trials concluded that saw palmetto can improve urinary flow symptoms in BPH.⁷ A meta-analysis in 2004 also found similar improvements and a reduction in nocturia.⁸

The German Commission E, a European authority on herbal medicine, approves the use of saw palmetto for urination problems in early BPH (stages I and II) but claims that it does not decrease prostate size.⁴ However, a 5-year study found that saw palmetto significantly reduced urinary symptoms and also reduced the size of the prostate gland by an average of 30%.⁹

Resveratrol is an antioxidant phytochemical that suppresses inflammation by inhibiting synthesis and release of pro-inflammatory mediators, modifying eicosanoid synthesis, inhibiting activated immune cells, and inhibiting inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2).¹⁰

Selenium is part of the selenoprotein phospholipid hydroperoxide glutathione peroxidase (PHGPx) that is highly concentrated in male testes and sperm.¹¹ It is a unique antioxidant enzyme that can directly reduce phospholipid hydroperoxide that can damage cells.

Lycopene reduces DNA damage and improves oxidative stress defence by inhibiting prostatic IGF-I signalling, 1L-6 expression, and androgen signalling.¹²

Zinc content is high in the testes and especially the prostate gland, which has a higher concentration of zinc than any other body organ.¹³ Zinc is part of the important antioxidant enzyme superoxide dismutase.

Vitamin D in its active form has hormone-like activity that helps regulate cell replication and differentiation and inhibits cell proliferation and inflammation.¹⁴

References

1. Andrology Australia. Prostate Enlargement Fact Sheet. Monash Institute of Medical Research. Monash Medical Centre. Available at: http://www.andrologyaustralia.org/library/ProstateEnlargement_FactSheet.pdf
2. Lepor H. Alpha blockers for the treatment of benign prostatic hyperplasia. Rev Urol. 2007. 9(4):181-190.
3. Holden CA, McLachlan RI, Pitts M, Cumming R, Wittert G, Agius P, Handelsman DJ and de Kretser DM. Men in Australia Telephone Survey (MATeS): A national survey of the reproductive health and concerns of middle-aged and older Australian men. Lancet 2005; 366:218-24.
4. Commission E monograph. Saw palmetto berry. American Botanical Council. Available at: http://content.herbalgram.org/abc/herbalmedicine/default.asp?m=86
5. Braun L & Cohen M. Herbs and natural supplements: an evidence-based guide. 2007. 2nd ed. Elsevier. Sydney.
6. Scaglione F, Lucini V, Pannacci M, Caronno A, Leone C. Comparison of the potency of different brands of Serenoa repens extract on 5alpha-reductase types I and II in prostatic co-cultured epithelial and fibroblast cells. Pharmacology. 2008;82(4):270-5. Epub 2008 Oct 10.
7. Wilt T, Ishani A, Mac Donald R. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2002;(3):CD001423.
8. Boyle P, Robertson C, Lowe F, Roehrborn C. Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU Int. 2004 Apr;93(6):751-6.
9. Aliaev IG, Vinarov AZ, Lokshin KL, Spivak LG. 2002. Five-year experience in treating patients with prostatic hyperplasia patients with permixon (Serenoa repens, Pierre Fabre Medicament). Urologiia Jan-Feb(1):23-25.
10. de la Lastra CA, Villegas I. Resveratrol as an anti-inflammatory and anti-aging agent: mechanisms and clinical implications. Mol Nutr Food Res. 2005 May;49(5):405-30.
11. F Imai H, Nakagawa Y. Biological significance of phospholipid hydroperoxide glutathione peroxidase (PHGPx, GPx4) in mammalian cells. Free Radic Biol Med. 2003 Jan 15;34(2):145-69.
12. Wertz K, Siler U, Goralczyk R. Lycopene: modes of action to promote prostate health. Arch Biochem Biophys 2004:430:127-134.
13. Bedwal RS, Bahuguna A. Zinc, copper and selenium in reproduction. Experientia. 1994 Jul 15;50(7):626-40.
14. Lips P. Vitamin D physiology. Prog Biophys Mol Biol. 2006 Sep;92(1):4-8. Epub 2006 Feb 28.