Meet Our New Doctor
Dr. Darisa Espinal is a licensed Naturopathic Physician practicing in the State of CT. Dr. Espinal graduated from the University of Hartford cum laude with her BS in Biology. She earned her Naturopathic Doctoral Degree from the University of Bridgeport summa cum laude and was awarded “The Clinical Excellence” honor at graduation. She is currently working on completing the Master’s of Science Degree in Human Nutrition form the University of Bridgeport.
Blog I | Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH) is an abnormal enlargement of the prostate that commonly affects middle-aged and older men. By the age of 60, 50% of men have BPH, and by the age of 80, over 90% of men develop this condition. The cause of BPH is not well understood. (1) BPH is not the same as prostate cancer, which is a malignant tumor that has the potential to spread to other organ systems. It is inconclusive if BPH can lead to prostate cancer; nonetheless, prostate cancer is always ruled out when making a diagnosis of BPH. (2)
The prostate is a walnut-shaped accessory organ located at the base of a male reproductive system. (3) When enlarged, urinary symptoms develop, such as a weak stream, delayed bladder emptying, dribbling, urinary frequency, and urgency. (4) Your doctor will ask questions that relate to BPH but also rule out other possibilities that may explain your symptoms.
The first step in diagnosing BPH is to perform a digital rectal exam, commonly known as a prostate exam. All men over the age of fifty are encouraged to get a yearly-routine prostate checkup to help diagnose and treat early. If the patient has a positive family history for prostate cancer or has early onset of symptoms that are suspicious for BPH, then a workup is warranted before the age of fifty. Prostate-specific antigen (PSA) is a standard blood test that may help detect prostate cancer, but it is not diagnostic and does not rule out BPH. A transrectal ultrasound with a possible biopsy can support the diagnosis of BPH. (4) The patient’s clinical presentation, demographics, and diagnostic testing are all applied to make a conclusive diagnosis of BPH.
BPH is a chronic condition with no known cure. What can be done, however, is the management of symptoms to increase the patient’s quality of life. (5) Utilizing Western medicine and naturopathic medicine, the patient can have a significant improvement in symptoms. From a naturopathic doctor standpoint, ruling out comorbid or life-threatening conditions is of top priority. Once accomplished, lifestyle modifications and botanical medicine can act as tools to manage and treat BPH.
Saw palmetto is a highly talked about herbal treatment for BPH. Also referred to as Serenoa repens, it has gained acceptance in the medical community as an effective herbal treatment. Saw palmetto is a weak inhibitor of type I and type II 5-alpha reductase. 5-alpha reductase is an enzyme that converts testosterone into dihydrotestosterone (DHT). When this enzyme is blocked, DHT levels drop. It’s hypothesized that DHT builds up inside the prostate tissue causing an enlargement of the prostate. (6)
A new theory, however, is currently under investigation. Estrogen, a vital steroidal hormone, may be the culprit in BPH and not testosterone as previously believed. Estradiol induces epithelial-to-mesenchymal transition at the estradiol alpha-receptor of the prostate. These mesenchymal cells have the ability to differentiate into prostate cells resulting in hyperplasia. (7) Urtica dioica, commonly referred to as stinging nettles, is an anti-inflammatory and anti-proliferative herb that is used as a complementary treatment to BPH. Research shows that the root of the nettles can decrease the number of secretory glands of the prostate gland and improve urinary outflow. (8) Nettle root also acts as an aromatase inhibitor, preventing the conversion of testosterone to estrogen. (9)
If you have any questions, feel free to schedule a consultation with Dr. Espinal at Carucci Chiropractic Center.
1. Lee CL, Kuo HC. Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts. Ci Ji Yi Xue Za Zhi. 2017;29(2):79–83. doi:10.4103/tcmj.tcmj_20_17
2. Dai X, Fang X, Ma Y, Xianyu J. Benign Prostatic Hyperplasia and the Risk of Prostate Cancer and Bladder Cancer: A Meta-Analysis of Observational Studies. Medicine (Baltimore). 2016;95(18):e3493. doi:10.1097/MD.0000000000003493
3. Kumar A, Sharma M. Basics of Human Andrology, A Textbook. Springer; 2017.
4. Papadakis M, McPhee SJ, Rabow MW. CURRENT Medical Diagnosis and Treatment 2014. McGraw Hill Professional; 2013.
Cunningham, G.R., Kadmon, D. (2018). Medical Treatment of Benign
5. Prostatic Hyperplasia. In M.P. O’Leary & J. Givens (ED), UpToDate. https://goo.gl/ZuCjLP. Accessed November 29, 2018.
6. Keehn A, Lowe FC. Complementary and alternative medications for benign prostatic hyperplasia. Can J Urol. 2015;22 Suppl 1:18-23.
7. Cunningham, G.R., Kadmon, D. (2018). Epidemiology and pathogenesis and benign prostatic hyperplasia. In M.P. O’Leary & J. Givens (ED), UpToDate. https://goo.gl/Jr6Z4j. Accessed November 29, 2018.
8. Moradi HR, Erfani Majd N, Esmaeilzadeh S, Fatemi Tabatabaei SR. The histological and histometrical effects of Urtica dioica extract on rat’s prostate hyperplasia. Vet Res Forum. 2015;6(1):23-9.
Urtica dioica; Urtica urens (nettle). Monograph. Altern Med Rev. 2007;12(3):280-4.