For men, waking up multiple times in the middle of the night to go to the bathroom is one of the most common symptoms of an inflamed prostate. Getting up two or more times a night to urinate is a sign of a potential problem, and it also disrupts healthy sleep. While disrupted sleep is a serious concern, resolving the need to urinate frequently may be much more important.
Prostatitis is the inflammation of the prostate, which is a tiny fluid-producing organ that smoothes the way for sperm to leave the body during ejaculation. The prostate lives below the bladder, wrapping around the multipurpose tube called the urethra, which allows fluids such as urine and sperm to leave the body through the penis. When the prostate gets inflamed, it can press on the urethra, restricting the flow of urine and sperm. This pressure can result in the bladder not emptying as much as it usually would, so the urge to go to the bathroom quickly returns. Unfortunately, the pressure of an inflamed prostate can also cause pain upon ejaculation, affecting sexual function.
The doctors and practitioners of Temecula Center for Integrative Medicine (TCIM) are big advocates of early diagnosis. We heartily suggest seeking out medical attention when aspects of reproduction or elimination change suddenly. Early intervention with appropriate treatments can significantly reduce pain and suffering from many health issues (such as prostate cancer and pelvic floor disorder). Catching and treating prostatitis early can preserve sexual function, prevent chronic infection, and help keep your reproductive organs healthy.
Different Types of Prostatitis
Inflammation of the prostate can be broken down into different types, and each type can affect how it is treated. This article focuses on chronic prostatitis. However, other types of prostatitis will also be described. Doctors can help distinguish between the types of prostatitis, as well as rule out other health conditions with similar symptoms.
Here is a brief explanation of the different types of prostatitis (1):
Chronic prostatitis is prostatitis that lasts over three months. The chronic prostatitis category is often merged with a diagnosis called chronic pelvic pain syndrome (CPPS). CPPS is not very well understood, yet shares many symptoms with chronic prostatitis, so it is often mentioned side-by-side.
Bacterial prostatitis is caused by bacterial overgrowth lodging in the prostate (usually from an untreated urinary tract infection). Acute bacterial prostatitis begins suddenly and usually only lasts a short time. Bacterial prostatitis becomes chronic if it persists past three months.
Asymptomatic inflammatory prostatitis has no symptoms, so this type may only be found during a physical exam.
Can Prostatitis Resolve On Its Own?
Sometimes, prostatitis will resolve on its own without any action taken to address it. However, there are times when the condition continues rather than being a temporary state of inflammation. When prostatitis does not resolve within three months, it's called chronic prostatitis. If left untreated, chronic prostatitis can increase the risk of other health issues, depending on what type of prostatitis is present. For this reason alone, it is imperative to get a physical evaluation as soon as it becomes apparent that something is wrong.
For example, untreated chronic bacterial prostatitis can lead to sepsis, an over-response to infection leading to dangerous, system-wide uncontrolled inflammation (2). With bacteria, the blood can also become infected, called bacteremia, or infection can spread to bones of the pelvis or spine (1). Lastly, prostate glands can form abscesses (1).
Non-bacterial chronic prostatitis can lead to a variety of unwanted symptoms, such as pain, urinary urgency, difficulties in sexual function, and even reduced fertility (2).
While there are many treatments for chronic prostatitis, and it can be resolved, there is no consistently effective "cure" that is agreed upon by the medical establishment (3).
Do I Have Prostatitis?
Sometimes, prostatitis has no symptoms! The only way asymptomatic prostatitis is caught is through a physical examination or perhaps a urine or blood test. While each man may have a unique set of symptoms, the following are commonly associated with prostatitis (1, 3, 4):
Frequent urination (often with decreased volume of urine)
Inability to hold back urination
A urine stream that is feeble or unexpectedly stops
Change in quality of urine (cloudy, bloody)
Different types of pain, including burning or stinging during urination
Back, pelvis, or rectal pain (sometimes a "throbbing" sensation)
Inability to achieve or maintain an erection; decreased libido
Pain associated with ejaculation
Possible fever and chills
Causes
Some causes of chronic prostatitis are not known, but some have been identified:
Bacterial prostatitis is caused by the growth of bacteria into the prostate, typically originating from the bladder or urethra (1). If the bladder cannot completely empty for some reason (for example, pelvic floor disorder), this can provide an environment where bacteria can overgrow.
Prostatitis is not a sexually transmitted disease (STD), so it cannot be given or caught by sexual activity. However, having an STD could put one more at risk for developing prostatitis (3), especially if it involves an overgrowth of bacteria.
Non-bacterial chronic prostatitis/CPPS has no one clear cause and is still being studied (1). Research hints that the cause (or causes) may include lingering infections and disorders of the nervous system, immune system, or hormones (1).
Spasms in the muscles of the pelvic floor can be a cause of CPPS (2).
Risk Factors
Chronic prostatitis is a fairly common health condition; it is estimated that five out of one hundred men will experience it in their lives (5). Urologists (doctors who specialize in disorders of the urinary tract) will often have up to 25% of their total patient visits being driven by symptoms of chronic prostatitis. Certain conditions increase the risk of developing chronic prostatitis (2, 3):
Urinary tract or bladder infections
An enlarged prostate (Benign Prostatic Hyperplasia)
Anatomy that lends itself to bacterial overgrowth or blockage
Tissue damage in the area directly below the anus (the perineum)
Bladder or prostate stones
Insertion of instruments into the urethra, such as a scope or catheter
Preventing Chronic Prostatitis
While many online sources do not list any suggestions for prevention, Functional Medicine offers plenty!
1. Screenings are an excellent way to prevent chronic prostatitis. If you see the doctor at the first sign of something wrong, the health of your reproductive organs can be preserved, and a whole cycle of unpleasantness can be completely avoided. You can be screened for prostate issues during the two-step Executive Physical. Please do not waive this vital screening.
2. Stay hydrated. Dehydration is a driver of bladder infections because bacteria can overgrow if high volumes of urine do not regularly flush microorganisms out of the urinary tract.
3. Treat any urinary tract infections quickly. Antibiotics can target bacteria in the bladder and urinary tract, ending the infection instead of allowing it to spread (2).
4. Reduce substances that irritate the bladder or cause stinging urination. There may be a food, drink, or supplement that causes urine to sting or causes cramps in the bladder. It may be a worthwhile experiment to withhold common bladder irritants: alcohol, coffee, caffeinated drinks, ibuprofen, or certain vitamin supplements. If removing those substances relieves the symptoms, keep them out of your diet, but quickly get an appointment with your doctor to rule out a urinary tract infection!
5. Do not consistently deny the urge to urinate or pass stool. Consistently holding back urine or stool for long periods can lead to a variety of complications. Take time to go to the bathroom.
6. Use mild, unscented soaps for washing genitals. Scented soaps can be very irritating to the opening of the penis and disturb the natural immunity there.
7. Avoid contracting sexually transmitted diseases (STDs). A properly situated, good-quality condom can protect foreign bacteria from entering the opening of the penis.
Potential Treatments
The treatment for prostatitis depends on the type, duration, frequency, and severity of symptoms. As mentioned before, antibiotics prescribed for bacterial prostatitis (chronic or acute) can help eliminate the infection and return the system to normal. If the situation is severe, intravenous (IV) antibiotics may be necessary to prevent sepsis.
Pain relief may require pain medications, with "alpha blockers" aiding a more significant amount of urine to flow out of the bladder. Combining the medications provides a substantial reduction of pain. Caution must be exercised with over-the-counter (OTC) pain medications, as ibuprofen can be irritating to the bladder for a small number of people.
Pelvic floor therapists can assist in cases where specific muscles would benefit from conscious exercise. TCIM doctors can refer patients to pelvic floor therapists and urologists to expand opportunities for effective chronic prostatitis treatments.
Integrative Medicine Treatments for Chronic Prostatitis
Integrative doctors at TCIM have access to additional healing modalities that can ease pain and potentially resolve prostate-related issues:
Pulsed electromagnetic field (PEMF) devices can address pain by reducing inflammation and repairing damaged tissues, muscles, and bones below the skin. While there are too few studies of PEMF for prostatitis, it can be aimed at the pelvic area to relieve the pain of CPPS. Non-invasive and effective, PEMF therapy is also used to heal damaged spinal disks, sports injuries, and bone fractures.
Massage is very effective for chronic prostatitis/CPPS, especially in cases of lower back pain and pain that radiates from the pelvis into the legs.
Acupuncture can relieve the pain of CPPS, as well as aid healing by bringing increased circulation to the area. The power of this ancient art to speed healing is deeply appreciated by patients and doctors alike.
Nutritional approaches can bring relief from pain as well as help resolve inflammation. Saw palmetto, quercitin, vitamin C, and other supplements fight inflammation. We can provide customized suggestions for an anti-inflammatory diet and supplements.
IV therapy delivers anti-inflammatory substances (vitamin C, Myers’ cocktail, or glutathione) directly to the bloodstream, bypassing potential digestion issues. Relieving inflammation in the prostate can reduce its size - and symptoms!
Executive Physicals & Complementary Healing
Please take us up on the offer of a prostate screening during our Executive Physicals. This one step can save years of pain and expenses. Other tests may be run during the Executive Physical (such as blood and urine tests) so we can verify both your overall health and the health of your prostate.
If you've already been diagnosed with chronic prostatitis by another care provider, you can still benefit from complementary treatments listed above. We are privileged to partner with you through any health issue and guide you step by step to your greatest possible well-being.
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
info@tcimedicine.com
951-383-4333
Sources:
1. Prostatitis - Symptoms and causes - Mayo Clinic [Internet]. Mayo Clinic. 2022. Available from: https://www.mayoclinic.org/diseases-conditions/prostatitis/symptoms-causes/syc-20355766
2. Professional CCM. Prostatitis [Internet]. Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/diseases/15319-prostatitis
3. Prostatitis [Internet]. Johns Hopkins Medicine. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostatitis
4. Prostatitis: inflammation of the prostate [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2022. Available from: https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate
5. Chronic prostatitis Guide: Causes, Symptoms and Treatment Options [Internet]. Drugs.com. Available from: https://www.drugs.com/health-guide/chronic-prostatitis.html
6. Professional CCM. Digital Rectal Exam [Internet]. Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/diagnostics/24212-digital-rectal-exam