Benign prostatic hyperplasia (BPH)
A benign prostate enlargement, also known as benign prostatic hyperplasia (BPH), is common in men from about 50 years of age. The prostate lies around the first part of the urethra. If the prostate tissue increases, this can hinder the passage of urine.
This may make it more difficult to start peeing, the urinary stream may become weaker and may cause a feeling that the bladder is not completely empty. On the other hand, other men suffer from frequent urination, strong pressure or need to go to the toilet several times a night.
Within Chinese medicine, not only the prostate enlargement itself is considered. The overall grievance picture determines which TCM pattern is at the forefront. Acupuncture and Chinese herbal medicine can be used in addition to the related urinary tract complaints.
Common symptoms
An enlarged prostate does not always have to cause symptoms. If this happens, problems with the urine flow as well as problems with the storage of urine can arise.
Common complaints are:
- difficulty starting to urinate;
- pressing to activate the urine flow;
- a weak, slow or interrupted urinary stream;
- drips;
- the feeling that the bladder is not completely empty;
- should urinate more frequently;
- udden strong urge;
- need to pee several times at night;
- sometimes urinary loss due to strong urges.
The size of the prostate and the severity of the complaints do not always have to be equal.
Possible causes
BPH is caused by a benign increase in prostate tissue. It is more common as men age. Hormonal changes probably play an important role, although the precise mechanisms are complex.
Because the prostate lies around the urethra, enlargement can make it difficult to drain urine from the bladder. In addition, changes in the function of the bladder may occur. This can cause obstructive complaints such as a weak urinary stream, as well as symptoms such as frequent urination and strong urges.
A benign prostate enlargement is not prostate cancer. However, the conditions can occur at the same time and some symptoms may resemble each other. New or increasing problems of urine therefore deserve conventional medical assessment.
How can acupuncture help with benign prostatic hyperplasia?
In acupuncture, the treatment is tailored to the urinary problems and the underlying TCM-pattern. It looks, among other things, at the strength of the urinary stream, how often you pee, how many times you need to urinate at night and whether there is pain, heat, cold or a feeling of pressure in the lower abdomen.
Other symptoms may also give direction to the treatment. One man, for example, has stress and tension in the foreground, while the other are mainly tiredness, coldness or signs of Dampness.
Depending on the pattern, acupuncture can be aimed at:
- support the urine discharge and function of the Bladder;
- Improve Qi flow in the lower abdomen;
- Reduce stagnation of Qi and Blood;
- Reduce Dampness, Heat or Phlegm when playing a role;
- Support Spleen-Qi in general Qi deficiency;
- Kidney-Yang strengthens in cold and weak urine flow;
- Kidney-Yin support when dryness and relative heat are present.
Acupuncture is an additional treatment. A physical obstruction by the prostate is not replaced or explained by a TCM pattern.
How can Chinese herbal medicine help with benign prostatic hyperplasia?
Chinese herbs are also tuned to the overall grievance picture. As a result, treatment in two men with the same diagnosis may be different BPH.
With clear Dampness-Heat, for example, the focus can be on reducing Dampness and Heat and supporting urinary discharge. With a more chronic image with Phlegm or Blood stasis, TCM focuses more on reducing accumulation and stagnation. When a deficiency of Spleen or Kidney is at the forefront, the emphasis is on strengthening.
Depending on the pattern, Chinese herbal medicine can be aimed at:
- support urine discharge;
- Regulate Liver-Qi;
- improve Qi and Blood flow;
- Reduce Dampness and Heat;
- Reduce Phlegm;
- Enhance Spleen-Qi;
- Heat and strengthen kidney-Yang;
- Feeding kidney-yin.
Chinese herbs can be used daily between acupuncture treatments. Possible interactions and regular treatment are taken into account when taking medicines for prostate problems or other conditions.
How does Chinese medicine view benign prostatic hyperplasia?
The prostate is not described as a separate TCM organ system in classical Chinese medicine. In the modern TCM, the prostate is mainly placed within the functions of the kidney and the lower body region.
The Kidney and Bladder are important for the processing, storage and excretion of liquids. According to TCM, the Liver influences the free movement of Qi through the abdomen. Also the Spleen plays a role, because it is involved in the processing and displacement of moisture and in supporting Qi.
In TCM, BPH is often approached by distinguishing between excess and deficiency patterns. In excess patterns, Qi stagnation, Blood stasis, Dampness-Heat or Phlegm may obstruct normal movement and urination. Obstructive symptoms are often more prominent in these cases.
In deficiency patterns there is precisely insufficient Qi, Yin or Yang to support normal urine function. Frequent urination, nocturnal urination, postdrip and weak urine flow may then be associated with general signs of weakness.
In practice, combinations are common. For example, a long-term kidney deficiency can be associated with Blood stasis, Dampness or Phlegm.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns
Liver-Qi-stagnation
Brief explanation
The Liver ensures free movement of Qi within TCM. When this movement stagnates, the circulation of Qi and fluids in the abdomen may also be hindered. In case of prostate complaints, it is particularly striking that urine discharge can change and is clearly influenced by stress and tension.
Common symptoms
- difficulty starting to urinate;
- Interrupting or weak urinary stream;
- feeling that the bladder is not completely empty;
- symptoms aggravated by stress;
- pressure or nagging discomfort over the pubic bone, around the perineum or scrotum;
- chest tightness or sighing;
- tension around the ribs;
- irritability or frustration;
- fatigue that can improve by moving;
- Bloated belly and varying bowel movements.
Blood stasis
Brief explanation
In case of prolonged stagnation, TCM also says that blood flow can decrease. Blood stasis is mainly associated with a longer and more obstructive sign of complaints. It may be present alongside other patterns.
Common symptoms
- clear difficulty in peeing;
- thin or interrupted urinary stream;
- urinate droplets;
- feeling of obstruction;
- frequent nocturnal urination;
- local discomfort or pain in the abdomen or perineum;
- sometimes pain in ejaculation;
- complaints that have existed for a long time;
- dark or purple tongue may be present.
This pattern may also be associated with structural changes, which is why regular investigations remain important for obvious obstructive complaints.
Damp-Heat
Brief explanation
At Dampness-Heat, according to TCM, he fought in the lower body region. This may irritate both the prostate region and the urinary tract.
The relationship between Dampness and Heat can be different. When Heat dominates, burning and irritation are more obvious. In case of long-term complaints, Dampness can come to the fore.
Common symptoms
- difficulty in urination;
- small amounts of concentrated urine;
- drip urine;
- feeling hot or burning when passing urine;
- pressure or full feeling in the abdomen and perineum;
- sometimes turbid urine;
- bitter taste;
- low appetite or nausea;
- thirst without much need to drink;
- constipation or alternating stool.
Phlegm
Brief explanation
Phlegm is a thickened form of fluid accumulation within TCM. This pattern gradually creates a more persistent accumulation in the lower body region. The image is usually chronic and clear signs of Heat do not need to be present.
Phlegm often does not occur on its own, but may coexist with Liver Qi stagnation, Spleen Qi deficiency, Blood stasis or Kidney deficiency.
Common symptoms
- difficulty starting to urinate;
- weak or interrupted urinary stream;
- feeling that the bladder is not completely empty;
- prolonged obstructive urination problems;
- pressure or heavy feeling in the lower abdomen;
- little or no pain when passing urine;
- feeling heavy in the body;
- a possible overweight tendency;
- sometimes other benign nodules or thickening in the body;
- often a swollen tongue with thick batter.
Spleen-Qi-deficiency with sinking Qi
Brief explanation
The Spleen is involved within TCM in processing moisture and supporting Qi. If this function weakens, moisture can accumulate more easily and there is less force behind the urine discharge.
As a result, the complaints can clearly change with the energy level: when someone is equipped, it is easier to urinate than when he is tired.
Common symptoms
- difficulty in triggering the urine flow;
- have to push to urinate;
- weak or slow urinary stream;
- drips;
- frequent urges with small amounts each time;
- symptoms that get worse in case of fatigue;
- feeling heavy or depressed in the lower abdomen;
- fatigue and listlessness;
- fast out of breath;
- low appetite;
- bloated abdomen;
- loose stools;
- Sometimes stick to fluid.
Kidney-Yang-deficiency
Brief explanation
Kidney-Yang deficiency is described in the used TCM source as an important pattern at BPH. Kidney-Yang stands among other things for the heating and activating force behind the processing of moisture and urinary discharge.
When this function weakens, sufficient force is lacking to separate the urine properly. At the same time, control over the Bladder can be reduced.
Common symptoms
- difficulty starting to urinate;
- weak, powerless or interrupted urinary stream;
- drips;
- frequent urination;
- often have to pee at night;
- sometimes severe urge or loss of urine;
- fatigue and listlessness;
- Curvature;
- cold hands and feet;
- cold, weak or painful lower back and knees;
- decreased libido or erectile dysfunction.
Kidney-Yin-deficiency
Brief explanation
Within TCM, kidney-Yin represents the nourishing and cooling aspects of the kidney system. In case of a shortage, liquid processing may be disturbed and relative Heat may occur at the same time.
This pattern is mainly described in older men and in long-term complaints involving previous Dampness-Heat.
Common symptoms
- difficulty in triggering the urine flow;
- thin, weak or drip urinary stream;
- frequent urge with low urine levels;
- small amounts of concentrated urine;
- dry mouth and throat;
- heat from palms and soles of the feet;
- hot or night sweats;
- weak or painful lower back and knees;
- dizziness or ringing in the ears;
- dry stools or constipation.
What can you do for yourself?
Regular movement can help to support the general condition and function of the urinary tract. Walking in particular is an easily accessible form of movement.
If you notice that long sitting makes the complaints worse, it can help to get up and move regularly. The TCM source also advises restraint with long-term cycling in case of obvious prostate problems. However, this is not a general medical rule for every man with BPH; the most important thing is whether cycling actually causes pressure or complaints.
Alcohol and caffeine may worsen the urge and frequent urination in some men. Especially in the evening it may be useful to take this into account. The same applies to large amounts of drinking just before sleep. However, do not reduce total fluid intake unnecessarily.
Constipation can also exacerbate urine problems, which is why regular bowel movements are important.
When to contact your doctor?
Plastic complaints that fit with BPH can also have other causes. Therefore, have new or increasing complaints assessed.
Please contact the GP when:
- you are getting more and more trouble to urinate;
- the urinary stream is clearly weaker;
- you regularly feel that the bladder is not emptying;
- you see blood in your urine;
- urine becomes painful or burning;
- you get fever or chills;
- you have recurrent urinary tract infections;
- complaints are clearly changing or increasing rapidly.
If you cannot urinate at all despite feeling that your bladder is full, prompt medical assessment is essential. This may indicate acute urinary retention.
Outlook
BPH is usually a long-term condition and the course of treatment depends on the severity of the prostate enlargement, the degree of obstruction, the duration of the complaints and the underlying TCM pattern.
Within the TCM source used, mostly deficiency patterns are described as gradually treatable images, but it is also stressed that usually several months of treatment are required. At Kidney-Yin deficiency, a slower course is described than in some other patterns.
For a client it is more important to assess the treatment by means of concrete changes, such as a more powerful urinary stream, less drips, easier to start peeing and less often wake up at night.
In the initial phase, one acupuncture treatment per week is a common guideline. Depending on severity, temporary treatment can be more frequent. If complaints improve and remain stable, the frequency can be reduced. Chinese herbs can be used daily between treatments where appropriate.
In case of apparent mechanical obstruction or complications, the prognosis is significantly determined by the prostate and its regular treatment.
Contact
Do you suffer from a weak urinalysis, difficulty peeing, after dripping or need to go to the toilet regularly at night and do you want to know if acupuncture and/or Chinese herbal medicine can fit in with your prostate problems? During a first consultation we will discuss your pee pattern and other relevant symptoms and symptoms. Based on the overall complaint picture, we will examine which TCM pattern is likely to be at the forefront and what treatment will suit it.
In case of new or increasing prostate and puddle problems, it is important to have the cause assessed regularly.