Question

I am a male aged 44, and healthy. My concern is frequent urination, the urge to urinate, dribbling, and loss of sleep, though I am not sure if this is due to a need to urinate, or stress. This has been ongoing for two years. After a bladder test and ultrasound, the urologist says my prostate is probably enlarging, which is normal at my age. I am not satisfied that this is normal for my age - what do you recommend?

Answer

Probably 30-40% of men over the age of 40 begin to have an enlarged prostate. This does not mean that they will necessarily have symptoms, but by age 50 a large percentage will start to have some urinary complaints. The easiest way to determine if your symptoms are related to stress only is by trying to remove that stress, even if just for a short period of time (e.g. a weekend away). If you find that your habits are completely normal during that time, then most likely the symptoms are stress-induced. If, on the other hand, they are unchanged, here are a few tips to help improve matters (other than medication or surgery, which should be discussed with your urologist if these don't help):

1) Drink plenty of water (about 6-8 glasses a day) but don't drink any 2 hours before bed.

2) Avoid all caffeine, alcohol and spicy foods.

3) Empty your bladder regularly (every 4-6 hours at least and right before bed).

4) Nutritional supplements, including zinc and saw palmetto, have been shown to reduce some symptoms and keep the prostate "healthy".

5) Have a prostate exam and PSA check every year by your doctor to rule out infection or cancer.

6) Have an annual check-up to make sure you maintain your current state of good health.

I strongly urge you to see your urologist if your symptoms don't improve because there are several medicines especially for the prostate which work very well.