Prostate health might not be at the top of every guy’s health checklist but it’s important for men to get checked, especially if they have a family history of issues or cancer. And while it isn’t talked about very much, there is some promising research showing acupuncture and East Asian Medicine (EAM) can offer effective treatment options for prostate health issues.
The prostate, a walnut-sized gland located beneath the bladder, plays a crucial role in male reproductive health. As men age, the prostate may undergo changes, leading to conditions such as benign prostatic hyperplasia (BPH), prostatitis or even prostate cancer. Given the symptoms and implications of these conditions, prostate disorders can significantly impact the well-being of those affected, both physically and psychologically, profoundly influencing their overall quality of life.
The primary prostate conditions are prostatitis (acute bacterial, chronic bacterial and chronic non-bacterial prostatitis) also known as inflammation of the prostate gland or CPPS (chronic pelvic pain syndrome), benign prostatic hyperplasia (BPH) a non-cancerous enlargement of the prostate gland and prostate cancer.
Of these disorders, chronic non-bacterial prostatitis (CPPS) is the most common prostate condition in men under 50 and BPH the most common for those over 50 and the most common prostate disorder, overall. Of all the prostate diseases, they are also the least understood by allopathic medicine, where no exact causes are known. CPPS and BPH present challenges to modern medicine, where treatment is largely aimed at symptom control and recovery is often slow.
Here’s a breakdown of the symptoms for both BPH and CPPS:
Benign Prostatic Hyperplasia (BPH)
- frequent or urgent need to urinate
- increased frequency of urination at night (nocturia)
- difficulty starting urination
- weak urine stream or a stream that stops and starts
- dribbling at the end of urination
- inability to completely empty the bladder
- pain during or after urination or ejaculation
Chronic Pelvic Pain Syndrome (CPPS)
- Perineal and genital pain that can be unrelenting
- Possible pain in lower back and rectum
- Frequent or urgent need to urinate
- Increased nocturia
- Difficulty urinating
- Pain during or after urination
- Pain during ejaculation
- Blood in urine
- Sexual dysfunction
In EAM, we divide the internal organs into three regions (jiaos); the upper, middle and lower jiaos. While the prostate gland is not specifically recognized in classical Chinese medicine, the genitourinary system as a whole lies in the domain of the lower jiao, which is governed by the kidneys and liver. Because of this, prostate conditions are often understood in terms of an imbalance with one of these organ systems, especially the kidneys.
In EAM, the energies of opposing but mutually engendering yin and yang are central. EAM sees male conditions as typically, but not always, yang in nature. It holds that the kidneys belong to the water element and are fundamental to fluid physiology.
It is the warming, vitalizing energy of kidney yang that enables both the creation and excretion of urine. The ‘opening and closing’ of the lower ‘gates’ (urethra / spermatic duct and anus) is also overseen by the kidneys. Where kidney qi (energy) is weakened, the function is impaired, allowing leakage from the ‘gates’ (ie. incontinence, spermatorrhea, etc). There may also be insufficient yang energy to drive urination, resulting in difficult urination and a weak flow.
Stress, anger, frustration and repressed emotions disrupt the circulation of liver qi in EAM. The liver meridian passes through the lower jiao, very closely to the bladder and this can impact bladder qi causing disruptions that result in urinary dysfunction.
Qi moves blood and prolonged impairment of bladder qi can also lead to blood stagnation in the lower jiao. This is another common, potentially serious, clinical presentation in prostate disorders. Stones (bladder or kidney) and prostate cancer often present with patterns of disharmony involving blood stagnation.
In addition to chronic qi stagnation, blood stagnation in the prostate may also arise from trauma, surgery, infections, urinary tract stones or as the result of pathogenic factors known as the ‘six excesses’ in EAM – wind, cold, dampness, heat, dryness and fire. In cases of prostate disorders, we are typically looking at heat and damp heat.
Damp heat in the lower jiao can be externally contracted, as in the case of infections, or internally generated. Internal damp heat can come from numerous sources (ie. prolonged yin deficiency, heat or damp stagnation), but is often the result of diets high in spicy, fatty foods and alcohol. This creates damp heat in the middle jiao, which is governed by the the digestive organs of spleen and stomach. This dampness, which is heavy in nature, then sinks to the lower jiao where it may affect the prostate.
In EAM, we diagnose based on the patterns being presented. Here’s the breakdown of the different categories in EAM:
Damp Heat (BPS / CPPS):
- Pain: Occurs during urination, burning in nature, worse for pressure
- Frequency: Frequent, urgent
- Flow: Can feel incomplete
- Color: Dark, cloudy (greater opacity indicates more dampness), pink / red / purplish red and possible clots where blood is present
- Amount: Concentrated
- Other: Smelly
- Accompanying symptoms: Possible nausea, poor appetite, loose stools, low-grade fever (especially in the afternoon)
- Tongue: Greasy coat
- Pulse: Rapid
Heart Fire (CPPS): Similar to damp heat, but the urine is not typically cloudy and is accompanied by significant emotional upset (typically anxiety or worry), often with insomnia and heart palpitations. If there is blood present, the urine will be fresh red in color. The tongue will be red with a very red tip and may have ulcers. The patient may have a rapid radial pulse.
Liver Fire (CPPS): Similar to Heart Fire, but the predominating emotions here are anger, frustration and resentment, with angry outbursts. Symptoms are exacerbated by excessive consumption of alcohol and spicy foods. The eyes may also be red and sore and the tongue sides will be red, as these areas pertain to the liver. There may also be a predisposition to rashes in the groin region. Again, the radial pulse will be rapid, but it will also feel ‘wiry’, like a guitar string.
Liver Qi Stagnation (BPH / CPPS):
- Pain: Occurs during urination, worse for pressure and stress, better after urination, lower abdominal pain and distension
- Frequency: Frequent, urgent
- Flow: Difficult, incomplete
- Color: Normal
- Amount: Normal
- Accompanying symptoms: Chest oppression, frequent sighing, irritability, depression, fatigue (better with exercise)
- Tongue: Normal or slightly dark
- Pulse: Wiry
Blood Stagnation (BPH / CPPS):
- Pain: Occurs during urination, fixed, sharp, stabbing in nature, can be intense, worse for pressure
- Flow: Difficult, thin stream
- Color: Possibly dark, purple (if bleeding present)
- Amount: Normal
- Other: Possibly containing small dark blood clots
- Accompanying symptoms: Spider veins on abdomen/ inner ankle/ knees, dark complexion and lips, darkness under the eyes
- Tongue: Purple
- Pulse: Wiry
Kidney Yang Deficiency (BPH / CPPS):
- Flow: Difficult, weak, incomplete, broken, dribbling after, incontinence
- Frequency: Frequent desire to urinate but may be difficult to starting, nocturia
- Color: Clear
- Amount: Copious or scanty
- Other: Urge to urinate, can be worse when cold
- Accompanying symptoms: Propensity to feeling cold, edema, fatigue, weak low back and knees, possible impotence
- Tongue: Pale, wet, swollen
- Pulse: Deep, weak, slow
Kidney Yin Deficiency (BPS / CPPS):
- Pain: Burning
- Flow: Incontinence
- Frequency: Frequent
- Color: Yellow
- Amount: Scanty
- Accompanying symptoms: Thirst, insomnia, dizziness, night sweats, constipation, weak low back and knees, possible impotence
- Tongue: Red, dry
- Pulse: Rapid, thin
Lastly, here are some holistic solutions and tips on how to keep the prostate happy and healthy. Eating an organic, whole food diet and maintaining a healthy weight is very important in the prevention and management of prostate disorders. Limit caffeine, alcohol, fizzy drinks and artificial sweeteners as these can irritate the bladder and worsen urinary symptoms. Avoid spicy, rich, fatty foods in cases of damp heat. A fiber-rich diet can help ease prostate pain that may be exacerbated by constipation. Drink barley water or alfalfa tea, both can help reduce pain. Do some bladder training through the use of pelvic floor exercises and progressively extending the time between voiding. Limit fluid consumption at night. Consider counseling or hypnotherapy to learn how to handle your emotions more effectively. Stay active, but try to avoid activities like cycling that may put added pressure on the groin. Take up tai chi or qigong. Relax in a warm bath. Add in regular acupuncture treatments to help with inflammation, pain and urinary urgency or incontinence.
If you or someone you love is having prostate issues, don’t just write it off as a sign of getting older. Make sure you get yourself checked so an issue doesn’t lead to something more serious like prostate cancer. The body is connected and if one area isn’t functioning optimally, it will begin to impact other areas as well. So don’t wait to take steps to improve your health.