Why is this happening?
Male anatomy includes a gland located between the bladder and penis that secretes prostatic fluid, meant to nourish sperm and provide protection for its journey out of the body. Running through the centre of this gland is the urethra, the tube whereby urine exits the body.
When prostate tissue starts to enlarge, it can put pressure on the urethra causing you to experience symptoms associated with a condition known as benign prostatic hyperplasia (BPH). The benign part is important to stress here as it indicates that BPH is a non-cancerous growth of tissue.
What are the symptoms of an enlarged prostate?
- Urinary frequency
- Weak urination
- Sense of leftover urine in the bladder
- Possible dribbling at end of stream
- Trouble initiating urination
- Nocturia – one study determined that needing to pee at night was prevalent in 85.4% of those with BPH, while another placed the prevalence at 80%.
How can alcohol affect an enlarged prostate?
- As a diuretic, alcohol further exacerbates urinary frequency, causing you to feel the need to go even more often. The toxin downregulates the production of the anti-diuretic hormone, more formally known as vasopressin. The function of vasopressin is to tell the body, specifically the kidneys, to reabsorb water. However, it now signals to the brain that you're ready to go
- Alcohol can potentially cause the neck of the urinary bladder to constrict, leading to urinary retention and a feeling of incomplete voiding as the bladder retains fluid, despite increasing the need to pee.
- When alcohol is broken down, it forms products such as acetaldehyde. This toxic byproduct then gets converted into acetate, which is further broken down into water and carbon dioxide so it can be expelled. Acetaldehyde is a known carcinogen and heavy consumption is associated with an increased risk of developing prostate cancer.
- Alcohol depletes many key minerals in the body. This includes minerals such as magnesium, zinc, and many of the B vitamins, especially thiamine or B1. These perform key functions in the body, and research has demonstrated that zinc can inhibit 5-alpha-reductase, the enzyme responsible for converting testosterone into dihydrotestosterone. Zinc also seems to show some ability to inhibit these androgens from binding to receptors in the prostate, which could explain its ability to reduce symptoms of BPH.
Can alcohol increase the risk of developing enlarged prostate?
Quite the opposite is true!
Current research indicates that consuming alcohol is negatively correlated with the risk of BPH. A meta-analysis from 2009 looked at 19 studies spanning a total of 120,091 male participants who consumed greater than 1.2oz of alcohol a day. This intake was associated with a 35% reduced risk of developing BPH. However, before you get excited about getting a hall pass to indulge, it's important to remember the myriad of risks associated with chronic alcohol intake. In the case of urinary concerns and this study, while the risk of BPH dropped, the risk of developing a lower urinary tract infection rose with alcohol consumption.
Are alcohol-free beer or wine an alternative option?
Absolutely! These options won't create the byproducts as a result of normal ethanol metabolism. As we saw though, these will mostly benefit your defense against lower urinary tract infections since ethanol seems to decrease the risk of BPH.
Are there any other beverages or foods I should steer clear of or add to my diet?
Any other diuretics can stimulate the tissues of an already overactive bladder, including coffee and tea. While increasing fluid intake can help against lower UTI's as it flushes the system out, it's important to strike a balance where it doesn't increase your urinary frequency too much when you're already suffering from BPH.
Green tea has been shown to have benefits that protects against BPH due to its anti-inflammatory properties. In a blend with black tea, it was shown to increase the flow rate of urine, improve one's sexual function and quality of life.
High-protein diets sourced mainly from animal proteins can also increase your risk of developing an enlarged prostate, so considering plant-based proteins may reduce your risk. Foods worth considering include those rich in lycopene, such as tomatoes, an antioxidant that helps with prostate health due to the high concentration of this substance in prostate tissues. Studies have shown it has the ability to slow the progression of BPH and improve symptoms as per the International Prostate Symptom Score (IPSS) questionnaire. A prospective cohort study demonstrated that those who consumed more tomato products, including sauce, experienced a 23% reduced risk of developing prostate cancer.
Is there anything that could benefit me now?
For symptomatic relief, a fruit known as Saw Palmetto (Serenoa repens) may be just the answer you were looking for, Long-term treatment of BPH with Serenoa repens saw research participants experience decreased urinary obstruction and increased flow, as well as an increase in sexual function. Products such as Prostate 1 come in tablets containing organic saw palmetto fruit extract and can be taken every day to manage symptoms. The berry works due to its ability to inhibit 5α-reductase which results in reduced levels of dihydrotestosterone and a decreased risk of developing BPH. It also has the ability to inhibit epidermal growth factor which contributes to the enlargement of the prostatic glandular tissue.
So, what are the key points you should take away from this?
- Alcohol plays a contributing role in worsening the symptoms associated with an enlarged prostate
- Follow Canadian Guidelines for alcohol consumption – no more than 15 drinks a week. This includes defining what a 'drink' actually is:
- 5oz (142mL) of wine (12%)
- 1.5oz (43mL) of liquor (40%)
- 12oz (341mL) or beer, ciders, or coolers (5%)
- If you struggle with ways to reduce your alcohol intake, consider having a discussion with your primary care provider or reaching out to local services.
- Consider swapping out some animal protein for plant proteins
- Add saw palmetto to your daily regiment
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