Options for Chronic Prostatitis – Alternative and Complementary Therapies February 2012

Posted on Nov 5, 2012 | 3 comments

Options for Chronic Prostatitis – Alternative and Complementary Therapies February 2012

Reprinted from Alternative and Complementary Therapies

Clinical Roundup: Selected Treatment Options for Chronic Prostatitis
February 2012

Multidisciplinary Approach—I

Prostatitis is a condition in which the prostate gland becomes inflamed, either as a result of a bacterial infection, decreased immune function, or a reduction in muscle-related function that affects 9% of males. Prostatitis represents a mix of conditions, including acute prostatitis, chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which accounts for the majority of the cases. CP/CPPS is a diagnosis of exclusion after eliminating
active urethritis, urogenital cancer, urinary-tract disease, urethral stricture, or neurologic disease affecting the bladder as a possible diagnosis.

Common symptoms include urologic pain, or discomfort in the pelvic region, associated with urinary symptoms and/or sexual dysfunction, lasting for at least 3 of the previous 6 months. Symptoms of CP/CPPS can diminish quality of life (QoL) and impair physical and psychologic function.1 The sections below describe how I treat patients with prostatitis.

Elimination of Good Intolerances and Exclusion of Irritants

Problem foods are identified by either an elimination/challenge diet or a food intolerance laboratory test such as the ALCAT test (Cell Science Systems, Deerfield Beach, Florida). Once the food culprits are identified, the patient is asked to eliminate them. In addition, coffee and spicy food can irritate the prostate of this patient population, so I ask these patients to limit consumption of these foods.

Prostate Massage

Prostate massage is a technique that is used to treat prostatitis, benign prostatic hyperplasia, male infertility, and other prostate disorders, as well as sexual problems. When the prostate is inflamed, infected or congested, the small sacs inside the gland become blocked and accumulate prostatic fluids. These fluids are a breeding ground for microbes that can cause more inflammation and prostatitis. The fluids cause the prostate to become enlarged, and the nerves
are irritated, causing pain and tightness.

Therapeutic prostate massage may extrude the accumulated fluids, open up the passages in the prostate and allow the gland to shrink back to normal size. Prostate massage also improves blood flow to the prostate, which delivers more essential nutrients, oxygen and white blood cells to fight infections.

Acupuncture

A recent meta-analysis concluded that acupuncture could be a safe and effective treatment for CP/CPPS pain symptoms more so than urinary symptoms that occur with this condition.2

Based on Traditional Chinese Medicine (TCM) disease patterns, scientific data on CP/CPPS, and numerous courses taken with Peter Deadman, LAc, and Bob Damone, LAc, prominent TCM practitioners in the United Kingdom and the United States, respectively, I use these main points for treatment: BL 32, BL 33, BL 35, CV 3, CV 4, Sp 6 and Sp 9. The secondary points I use for treatment will depend on symptomology as follows:

  • Pain in the urethra—LV 4, PC 5, and RN 3
  • Urinary frequency—LV 2, LV 4, LV 8, RN 2, BL 54, LU 5, BL 23, BL 26, KI 6, LV 1, RN 3, and RN 4
  • Severe pain and burning on urination—KI 5
  • Perineal pain—KI 5
  • Pain in external genitalia—LV 8, LU 7, St 29, Sp 6, KI 12, LV 2, and LV 12
  • Necessity to calm the mind—DU 20, PC 6, and Sp 4
  • Head of penis pain—LV 1 and Ren 1

Biofeedback

Use of biofeedback to treat chronic nonbacterial prostatitis or CPPS is based on the idea that these forms of prostatitis may result from, or be associated with, pelvic-floor muscle dysfunction. Biofeedback enables a person to become more aware of his body’s signals. It is very useful for pelvic-floor muscles because they are not visible. With increased awareness, patients can learn to correctly contract, relax and coordinate these muscles so they work more effectively. There are scientific data supporting the use of biofeedback for this condition.3

I use a biofeedback unit with two “channels,” so that the patient can see what is happening in two different muscle groups: the pelvic-floor muscles and the abdominal muscles. Ultimately, we want to coordinate the activity of these two muscle groups.

I start by taking a 30-second baseline reading to see what the muscles look like during rest. Then I look at the patient’s ability to contract and relax those muscles. I will ask him to contract 10 times, with each contraction lasting for 2 seconds, followed by 4 seconds of relaxation. Then I will ask him to contract for 5 seconds and relax for 10 seconds. Based on the feedback, it will become evident what the treatment plan needs to concentrate on. The patient will need to link what is happening on the screen to what he feels in his muscles in order to receive the most benefit from biofeedback.

Supplements

Phytotherapy can be essential for treating CP/CPPS. Along with commonly used natural agents for the prostate — saw palmetto (Serenoa repens), b-sitosterol, pygeum (Pygeum africanum) — the two best-used phytochemicals are quercetin and rye (Secale cereale) pollen.

Quercetin

This is a phytonutrient that reportedly “provides significant symptomatic improvement” in men who have chronic nonbacterial prostatitis/CPP syndrome.4 Other studies have also revealed quercetin’s anti-inflammatory and antioxidant properties.

Pollen extracts

Also known as cernilton, pollen extracts have anti-inflammatory properties, and this feature has proven beneficial for relieving prostatitis symptoms.5 In a more-recent study, 70 men who had CP/CPPS were given cernilton while 69 men with the same condition received placebo. After 12 weeks, the men who took cernilton reported significant reductions of their symptoms and improved QoL, with no severe side-effects.6

A combination of at least 3 treatments may be necessary at any one time. These may include physical medicine; either acupuncture or pelvic-floor muscle training with biofeedback; diet with eliminating problem foods; and proper supplementation with natural anti-inflammatories such as quercetin and rye pollen extract.

References

  1. Anothaisintawee T, Attia J, Nickel JC, et al. Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Systematic Review and Network Metaanalysis. JAMA 2011;305:78–86.
  2. Lee SH, Lee BC. Use of Acupuncture as a Treatment Method for Chronic Prostatitis/Chronic Pelvic Pain Syndromes. Curr Urol Rep 2011;12:288–296.
  3. Cornel EB, van Haarst EP, Schaarsberg RW, Geels J. The Effect of Biofeedback Physical Therapy in Men with Chronic Pelvic Pain Syndrome Type III. Eur Urol 2005;47:607–611.
  4. Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in Men with Category III Chronic Prostatitis: A Preliminary Prospective, Double-Blind, Placebo-Controlled Trial. Urology 1999;54:960–963.
  5. Elist J. Effects of Pollen Extract Preparation Prostat/Poltit on Lower Urinary Tract Symptoms in Patients with Chronic Nonbacterial Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized, Double-Blind, Placebo-Controlled Study. Urology 2006;67:60–63.
  6. Wagenlehner FM, Schneider H, Ludwig M, et al. A Pollen Extract (Cernilton) in Patients with Inflammatory Chronic Prostatitis–Chronic Pelvic Pain Syndrome. Eur Urol 2009;56:544–551.

Geo Espinosa, ND, LAc
Integrative Urology Center, Department of Urology, New York
Langone Medical Center
New York, NY

Multidisciplinary Approach—II

Chronic prostatitis has been thought to be infectious in origin and has been treated as such by both allopathic and alternative medicine. In many cases, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) can be the result of ongoing inflammation in the urothelium of the prostate, bladder, and urethra but rarely results from infection. It has been reported that 95% of patients who are diagnosed with CP/CPPS have musculoskeletal injuries to the sacrum, lumbar spine, hips and lower extremities, resulting in pelvic-floor dysfunction (PFD).1 It is believed that PFD is responsible for symptoms of perineal and pelvic pain, urinary frequency, urgency, nocturia, dysuria and restricted urinary flow.

The most successful treatments address both musculoskeletal and urothelial dysfunctions and combine musculoskeletal modalities, such as physical therapy, osteopathic manipulation, acupuncture, trigger–point injections and home exercise programs specific to each patient, 2–6 together with dietary restrictions of urothelial irritants (caffeine, carbonation, alcohol and spicy and acidic foods), urinary alkalinization with baking soda pills, and avoidance of allergens and chemicals. Mucinous herbs such as aloe (Aloe vera), marshmallow root (Althaea officinalis), slippery elm (Ulmus fulva) and corn silk (Zea mays), will help soothe
and heal the urothelium. Chinese herbs that disperse Liver Heat can be an excellent complement to the Western herbs mentioned above.

Adding natural anti-inflammatories and other well-known prostate aids can increase success in reducing symptoms. Supplements that I have found to be extremely helpful are quercetin, N-acetylcysteine, zinc citrate, a-lipoic acid, taurine, turmeric, resveratrol, melatonin, vitamin D3 and bromelain. Among the German biologic products, Proscenat, Upelva, Notatum and Quentans have been the most successful.

If this protocol seems broad, it is because CP/CPPS is multifactorial and, despite patients sharing similar symptoms, the causes of this condition vary dramatically from one patient to another. Our role as health care providers is to find the right combination of treatments for our patients.

References

  1. Anderson R, Wise D, Sawyer T, Nathanson BH. Safety and Effectiveness of an Internal Pelvic Myofascial Trigger Point wand for Urologic Chronic Pelvic Pain Syndrome. Clin J Pain 2011;27:764–768.
  2. Anderson RU, Wise D, Sawyer T, et al. 6-Day Intensive Treatment Protocol for Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome Using Myofascial Release and Paradoxical Relaxation Training. J Urol 2011;185:1294–1299.
  3. Duclos A, Shoskes D. Chronic prostatitis/Chronic Pelvic Pain Syndrome. In: Potts JM. Genitourinary Pain and Inflammation: Diagnosis and Management. Cleveland: Humana Press, 2008:175–200.
  4. Ripoll E, Mahowald D. Hatha Yoga Therapy Management of Urologic Disorders. World J Urol 2002;20:306–309.
  5. Ripoll E, Bunn T. The Role of Acupuncture in the Treatment of Urologic Conditions. World J Urol 2002;20:315–318.18.1ACT_pages.indd 52 2/1/12 4:10:39 PM53 ALTERNATIVE AND COMPLEMENTARY THERAPIES • FEBRUARY 2012 MARY ANN LIEBERT, INC. • VOL. 18 NO. 1
  6. Mahowald DR, Ripoll EA. Cystitis: A Time to Heal with Yoga & Acupressure, An Eight Week Exercise Program with Special Information on Interstitial Cystitis & Urethral Syndrome. Bloomington, IN: AuthorHouse, 2003.

Emilia Ripoll, MD
Choices in Health, PC, Boulder CO

Integrative Medicine

In integrative medicine, we work to build the health of the patient while simultaneously fighting the patient’s illness. To treat prostatitis, I use targeted botanicals, nutrients, mind–body practices, acupuncture, heat therapies, detoxification, nutritional intravenous (I.V.s) injections, and other modalities. These treatments work together to fight infections, reduce inflammation, improve immunity, reduce oxidative stress, remove heavy metals/toxins safely, and strengthen prostate and overall health.

Prostatitis can be caused by local infection, imbalances in the immune and neuroendocrine systems, heavy metal toxicity, and other factors. Therefore, a thorough baseline that focuses on both the health and disease aspects of the patient must be established before treatment, using tests such as complete blood count, prostate-specific antigen, immune and hormonal profiles, heavy metal body burden, oxidative stress assessment, and inflammatory and hyperviscosity markers.

Once a baseline is established, we can create a comprehensive prostatitis treatment plan specific to the patient. Key therapeutic strategies include:

  • Support/modulate immune responses — Prostatitis can be caused by a bacterial infection, abnormal cell function or inappropriate immune/inflammatory responses. Therefore, modulating and strengthening immune function is important.
  • Reduce inflammation — Prostatitis involves inflammation of the prostate gland, which, if left untreated, can damage the prostate further and increase risk factors for prostate cancer. The inflammation can also fuel the aggressiveness of existing prostate cancer.
  • Fight infections — The use of antimicrobial therapies is important for combating any possible infectious causes of prostatitis.
  • Improve circulation—Increased circulation helps reduce inflammation, improve immunity and increase healing.
  • Detoxify — Safe and gentle detoxification is important for reducing oxidative stress, fighting inflammation, supporting immunity and improving overall health.
  • Modulate hormones — Prostatitis can be related to, or aggravated by, hormone imbalances, so natural hormone modulation can be beneficial.
  • Provide prostate-specific support — Herbs and nutrients that have been shown in studies to improve prostate function are important adjuncts to any prostatitis treatment program.
  • Modify diet — Emphasize fresh cruciferous vegetables, high fiber, a nonprocessed food diet and adequate hydration. Instruct the patient to avoid alcohol, caffeine, red meat and refined sugars.

The following research-based natural therapies work to treat prostatitis by exerting multiple mechanisms that are useful for the key therapeutic strategies outlined above: nutritional I.V.s (such as high-dose vitamin C and glutathione); medicinal mushrooms; modified citrus pectin; curcumin; quercetin; saw palmetto (Serenoa repens); stinging nettle (Urtica dioica) root; pygeum (Pygeum africanum) bark extract; pomegranate (Punica granatum) extract; green tea (Camellia sinensis) extract; lycopene; broccoli extract; zinc; selenium; vitamin D3, diindolylmethane (DIM); and others.1–7

Mindful meditation, yoga, and qigong, acupuncture, bodywork and other modalities are also important. An individualized, integrative approach to treating prostatitis enhances a patient’s well-being and fights this condition from multiple angles, offering a significant opportunity for a positive clinical outcome.

References

  1. Eliaz I, Weil E, Wilk B. Integrative Medicine and the Role of Modified Citrus Pectin/Alginates in Heavy Metal Chelation and Detoxification—Five Case Reports. Forsch Komplementmed 2007;14:358–364.
  2. Jiang J, Eliaz I, Sliva D. Synergistic and Additive Effects of Modified Citrus Pectin with Two Novel Poly Botanical Compounds, in the Suppression of Invasive Behavior of Human Breast and Prostate Cancer Cells. Integr Cancer Ther 2012:in press.
  3. Kuang NZ, He Y, Xu ZZ, et al. Effect of Pomegranate Peel Extracts on Experimental Prostatitis Rats [in Chinese]. Zhong Yao Cai 2009;32:235–239.
  4. Ruan L, Zhong WD, Li ZM, Hua X. Relationship Between Vitamin D Receptor Gene Fok I Polymorphisms and Benign Prostatic Hyperplasia Complicated by Histological Prostatitis [in Chinese]. Zhonghua Nan Ke Xue 2011;17:880–883.
  5. Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in Men with Category III Chronic Prostatitis: A Preliminary Prospective, Double-Blind, Placebo-Controlled Trial. Urology 1999;54:960–963.
  6. Yan J, Katz A. PectaSol-C Modified Citrus Pectin Induces Apoptosis and Inhibition of Proliferation in Human and Mouse Androgen-Dependent and -Independent Prostate Cancer Cells. Integr Cancer Ther 2010;9:197–203.
  7. Wertz K. Lycopene Effects Contributing to Prostate Health. Nutr Cancer 2009;6:775–783

Isaac Eliaz, MD, MS, LAc
Amitabha Medical Clinic and Healing Center, Sebastopol, CA

Evidence-Based Systematic Review Results

The Natural Standard Research Collaboration systematically reviews data on complementary and alternative medicine (CAM). Natural Standard does not practice or recommend specific therapies, but uses comprehensive and reproducible methodologies to create objective and reliable information for patients and health care professionals. Based on an evaluation of the literature, CAM modalities that may be beneficial for chronic prostatitis include (but are not limited to) acupuncture, physical therapy, quercetin, saw palmetto and zinc.1,2

Acupuncture

Acupuncture, which is used for a variety of pain conditions, has been shown to decrease pain and reduce voiding symptoms in men with prostatitis who underwent 6 weeks of treatment.3

Physical therapy

Pelvic-floor physical therapy has been suggested as a possible treatment for symptoms of chronic prostatitis.4–7 In men with category 3 chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) who participated in a pelvic-floor biofeedback reeducation program, the National Institutes of Health (NIH)–Chronic Prostatitis Symptom Index score was significantly improved.7

Quercetin

Quercetin, a flavonoid found in onions and green tea, has been studied in men with CP/CPPS.8,9 Treatment with 500 mg of quercetin, twice daily, for 1 month reduced symptoms and was well-tolerated.8

Saw palmetto

Saw palmetto (Serenoa repens) is an herb used for urologic conditions. Most studies have focused on symptoms related to benign prostatic hyperplasia; however, there are a few studies evaluating its use for prostatitis, specifically.10,11 When comparing its efficacy to the pharmaceutical drug finasteride in men with category 3 CP/CPPS, statistical significance was only noted in the finasteride treatment group.11 However, it is notable that, at the end of the study, more patients opted to continue treatment with saw palmetto rather than with finasteride.

Zinc

In patients with chronic bacterial prostatitis, organic zinc supplementation after antibiotic treatment was found to reduce their scores on the NIH-Chronic Prostatitis Symptom Index and maximum urethra closure pressure.12

References

  1. Natural Standard: The Authority on Integrative Medicine. 2011. Online document at: www.naturalstandard.com Accessed December 5, 2011.
  2. Capodice JL, Bemis DL, Buttyan R, et al. Complementary and Alternative Medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Evid Based Complement Alternat Med 2005;2:495–501.
  3. Chen C, Gao Z, Liu Y, Shen L. Treatment of Chronic Prostatitis with Laser Acupuncture. J Tradit Chin Med 1995;15:38–41.
  4. Potts JM, O’Dougherty E. Pelvic Floor Physical Therapy for Patients with Prostatitis. Curr Urol Rep 2000;1:155–158.
  5. Suh LK, Lowe FC. Alternative Therapies for the Treatment of Chronic Prostatitis. Curr Urol Rep 2011;12:284–287.
  6. Van Alstyne LS, Harrington KL, Haskvitz EM. Physical Therapist Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Phys Ther 2010;90:1795–1806.
  7. Cornel EB, van Haarst EP, Schaarsberg RW, Geels J.The Effect of Biofeedback Physical Therapy in Men with Chronic Pelvic Pain Syndrome Type III. Eur Urol 2005;47:607–611.
  8. Shoskes DA, Zeitlin, SI, Shahed A, Rajfer J. Quercetin in Men with Category III Chronic Prostatitis: A Preliminary Prospective, Double-Blind, Placebocontrolled Trial. Urology 1999;54:960–963.
  9. Dhar NB, Shoskes DA. New Therapies in Chronic Prostatitis. Curr Urol Rep 2007;8:313–318.
  10. Aliaev IuG, Vinarov AZ, Lokshin KL, Spivak LG. Efficiency and Safety of Prostamol-Uno in Patients with Chronic Abacterial Prostatitis [in Russian]. Urologiia 2006;1:47–50.
  11. Kaplan SA, Volpe MA, Te AE. A Prospective, 1-Year Trial Using Saw Palmetto Versus Finasteride in the Treatment of Category III Prostatitis/Chronic Pelvic Pain Syndrome. J Urol 2004;171:284–288.
  12. Deng C, Zheng B, She S. Clinical Study of Zinc for the Treatment of Chronic Bacterial Prostatitis [in Chinese]. Zhonghua Nan Ke Xue 2004;10:368–370.

Catherine Ulbricht, PharmD, and Erica Rusie, PharmD
Natural Standard Research Collaboration, Somerville, MA

Yoga Therapy

Chronic prostatitis (CP), characterized by pelvic or perineal pain lasting longer than 3 months,1 affects 6.3% of the world’s population2 with symptoms such as dysuria and postejaculatory pain mediated by nerves and muscle. The symptoms of CP appear to be the result of interplay between psychologic factors and
dysfunction in the immune, neurologic, and endocrine systems. Studies show stress as an etiology leading to hypothalamic–pituitary – adrenal (HPA) axis dysfunction3 and adrenocortical hormone abnormalities.4 Stress-induced genitourinary inflammation experiments on mammals have shown that the inflammation in the prostate can result from the action of the chronically activated pelvic nerves on the mast cells at the end of nerve pathways.5

Research on complementary and alternative medicine (CAM) for CP reveals that certain herbal supplements, as well as manipulative therapies, such as acupuncture,6 are quite effective. Biofeedback therapy for relaxing the pelvic-floor muscles,7 physical therapies and relaxation therapies have been found to be helpful for relieving the pain.3,8

Studies in our research department have shown that yoga reduces stress levels9 and has a positive effect on the HPA axis.10 Yoga can help reduce negative emotions and offers a better quality of life with better relaxation of the mind-body complex and improved immunity. Relaxation techniques of yoga can also help reduce inflammation9 and pain.

The Integrated Approach of Yoga Therapy (IAYT), which is useful for both women and men,11 consists of certain asanas, mudras and relaxation techniques. Practices12 such as Ashwini mudra (Horse gesture), Vayu nishkasana (Wind Releasing pose), Vajrasana (Thunderbolt pose), and AA-kara and UU-kara chanting have to be performed with mindfulness to achieve deep local internal rest for the sick part of the body (i.e., the prostate gland.)

As a holistic therapy for CP, IAYT corrects the problem at physical, prana, mind, emotional and spiritual levels; this therapy has produced beneficial results in our 200-bed inpatient health home. Although this approach needs to be validated in the research literature, we recommend that all physicians include these yoga practices in the routine treatment of CP as an adjunctive therapy to achieve positive and faster results through the reduced use of pharmacotherapies.

References

  1. Luzzi GA. Chronic Prostatitis and Chronic Pelvic Pain in Men: Aetiology, Diagnosis and Management. J Eur Acad Dermatol Venereol 2002;16:253–256.
  2. Daniels NA, Link CL, Barry MJ, McKinlay JB. Association Between Past Urinary Tract Infections and Current Symptoms Suggestive of Chronic Prostatitis/Chronic Pelvic Pain Syndrome. J Natl Med Assoc 2007;99:509–516.
  3. Anderson RU, Orenberg EK, Chan CA, et al. Psychometric Profiles and Hypothalamic–Pituitary–Adrenal Axis Function in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. J Urol 2008;179:956–960.
  4. Dimitrakov J, Joffe HV, Soldin SJ, et al. Adrenocortical Hormone Abnormalities in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Urology 2008;71:261–266.
  5. Alexacos N, Pang X, Boucher W, et al. Neurotensin Mediates Rat Bladder Mast Cell Degranulation Triggered by Acute Psychological Stress. Urology 1999;53:1035–1040.
  6. Rosted P. Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Acupuncture: A Case Report. Acupunct Med 2007;25:198–199.
  7. Cornel EB, van Haarst EP, Schaarsberg RW, Geels J.The Effect of Biofeedback Physical Therapy in Men with Chronic Pelvic Pain Syndrome Type III. Eur Urol 2005;47:607–611.
  8. Anderson RU, Wise D, Sawyer T, Chan CA. Sexual Dysfunction in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Improvement After Trigger Point Release and Paradoxical Relaxation Training. J Urol 2006;176(4[pt1]): 1534–1538;discussion 1538–1539.
  9.  Telles S, Naveen KV. Yoga for Rehabilitation: An Overview. Indian J Med Sci 1997;51:123–127.
  10. Vera FM, Manzaneque JM, Maldonado EF, et al. Subjective Sleep Quality and Hormonal Modulation in Long-Term Yoga Practitioners. Biol Psychol 2009;81:164–168.
  11. Chattha R, Raghuram N, Venkatram P, Hongasandra NR. Treating the Climacteric Symptoms in Indian Women with an Integrated Approach to Yoga Therapy: A Randomized Control Study. Menopause 2008;15:862–870.
  12. Satyananda S. Asana Pranayama Mudra Bandha. Postures, Breathing Practices, Gestures, Locks [in Sanskrit-Devnagari]. Munger, India: Yoga Publication Trust, 2009.

Amit Rathi, BAMS, MD(Cand),
Satyam Tripathi, BAMS, MD,
and Nagarathna Raghuram, MBBS, MD, FRCP (UK)
Swami Vivekananda Yoga Anusandhana Samsthana
University, Bangalore, India

Traditional Chinese Medicine

Chronic prostatitis (CP) is a complex condition and some men do not respond well to modern medical treatment. This is when Traditional Chinese Medicine (TCM) can emerge as a potential treatment. TCM treats the root of the condition by resolving imbalances that are causing the symptoms and improving overall health. While research has demonstrated the effectiveness of acupuncture for treating CP,1,2 in my practice, I also use nutrition and Chinese herbal prescriptions. According to TCM, stagnated qi causes symptoms, including inflammation and pain. My treatment plan for CP has several aspects.

First, there are foods that should be avoided (spicy foods, alcohol, refined sugars), while there are other foods that I recommend, such as pumpkin (Curcurbita spp.) seeds. Pumpkin seeds have been used for centuries to reduce symptoms caused by what we call Damp Heat Stagnation in the lower belly that may cause conditions such as CP.

The second aspect of treatment is acupuncture. In TCM, proper diagnosis is imperative for determining the proper selection of acupuncture points and herbal prescriptions. I use pulse diagnosis to find energetic imbalances and design the acupuncture point prescription for each patient based on his pulse. Even if 5 patients have the same condition, TCM treatment should address each patient’s unique patterns rather than treating the condition per se. Therefore, the acupuncture point selection is likely to differ from patient to patient and treatment to treatment as the patient gets well.

References

  1. Lee SW, Liong ML, Yuen KH, et al. Acupuncture Versus Sham Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain. Am J Med 2008;121:79.e1–e7.
  2. Chen R, Nickel JC. Acupuncture Ameliorates Symptoms in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Urology 2003;61:1156–1159.

Martha Lucas, PhD, LAc
The Colorado Center of Traditional Medicine, Denver, CO

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For this interactive feature column, Clinical Roundup, a new question is posed and then answered by experts in the field. For an upcoming issue, we are seeking your contributions on how you treat female infertility in your practice for possible publication in a future issue of the Journal.

Reprinted from Alternative and Complementary Therapies

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3 Comments

  1. Marshmallow probably came first into being as a medicinal substance, since the mucilaginous extracts comes from the root of the marshmallow plant, Althaea officinalis, which were used as a remedy for sore throats. Concoctions of other parts of the marshmallow plant had medical purposes as well.::”:

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  2. Some studies show that saw palmetto is as effective in treating symptoms as finasteride (Proscar) without side effects, such as loss of libido. Other studies suggest that saw palmetto may actually shrink the size of the prostate gland. Due to the short duration (usually less than 3 months) of these studies, it is not possible to say for sure whether saw palmetto is truly effective for preventing complications of BPH. In fact, a well-conducted study published in the New England Journal of Medicine found that saw palmetto was no better than placebo in relieving the signs and symptoms of BPH.,..-^

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