Self-Conscious or Self-Care
There’s nothing embarrassing about prostate health
A number of years ago, a patient came to me who was in intense physical and emotional pain.
This man, who was in his 30s at the time, suffered from chronic prostatitis — an infection of the prostate.
The pain from this was such that he couldn’t sit down.
He couldn’t exercise.
He could hardly walk.
Naturally, the physical pain was affecting the rest of his life, too. His marriage was deteriorating, and his sexuality was suffering.
This patient came to me having tried every medical intervention his doctors could offer him. He had tried multiple medications, which often are effective in treating prostatitis — but none had worked.
When I met him, he was flying across the country weekly to get antibiotic injections directly into his prostate — a drastic measure that also was producing no results.
Having gotten nowhere with traditional treatments, he was ready to try alternative medicine, which is what I practice.
Upon our initial evaluation, I discovered that his prostate was very congested, very boggy.
What does this mean? Briefly — I’ll explain more about how the prostate functions below — the prostate is like a sponge. It’s full of tiny nodules that take in several different fluids, and if these fluids are not fully expressed, they build up and crystallize.
This results in a hardening of the prostate.
Think of what happens if you wash your dishes with the same sponge over and over. If you don’t wring it out, the sponge will become hard and heavy.
The cause of his problem, then, was very clear to me. I explained this to the young man, who understood and was eager to follow whatever treatment I thought would be beneficial.
Now I had to figure out what to do!
This was one of the most extreme cases of prostatitis I’d ever seen. I knew that prostate massage, which has been used for decades, would be part of the treatment, but I also began to wonder whether use of a particular osteopathic instrument, the Fulford Percussion instrument, might be helpful.
This instrument, which was invented by the osteopath Dr. Robert Fulford, is generally used to treat imbalances or tightnesses in the fascia, or connecting tissues of the body. It vibrates and oscillates at the same time, making it very useful for breaking up and loosening blockages.
By making some slight adaptations, I was able to make the instrument appropriate for prostate massage, and after explaining fully and exactly what the treatment would entail and receiving the patient’s informed consent, we began the treatment plan.
What this involved was prostate massage both with the Fulford Percussion instrument, and manually.
First, the instrument is covered with a prophylactic and lubricated. The instrument is then inserted into the rectum and placed against the prostate, where it vibrates — this breaks up the calcified deposits that have built up in the organ, which were causing the patient’s chronic, painful condition.
Once the instrument has broken up those deposits, we do what is referred to as milking the prostate — manual massage, which allows the deposits and built-up fluids to exit the body through the penis.
This patient underwent this treatment three times, and his results were almost unbelievable.
The pain dissipated entirely — and he has remained pain-free for 12 years.
His relationship with his wife improved. To this day, he and his family, which now includes a beautiful baby, visit me in my office.
If these types of dramatic results are possible, then why are so few doctors performing these treatments? And why are so few men aware of them?
Easy Embarrassment
Most men know, at least on some level, that prostate health becomes a priority at or around age 50 (unless something unusual happens, as was the case with my younger patient). But often, they’re not exactly sure what “prostate health” means.
Perhaps that’s because talking about the prostate — not only its function and location in the body, but also the nature of the prostate exam and prostate care — is uncomfortable for most men.
This is understandable, but avoidance only leads to health problems down the line.
After all, our bodies are not mere collections of organs, each operating independently. What is occurring in one part of our bodies affects our whole-body health — not to mention our emotional, mental, and spiritual health. In the case of the prostate, which plays such an important role in a man’s sexual well-being, this is especially true.
Fortunately, with a bit of awareness and the right preventative health choices, men can give themselves the best possible chance of avoiding problematic physical conditions, from painful prostatitis to prostate cancer, while also enjoying optimal sexual function and performance well into later life.
Limited Release
The first question we must answer in more detail is how, exactly, does the prostate function?
The prostate gland is about the size of a walnut and is located on the underside of the bladder, between it and the penis, just in front of the rectum. It’s a complex, spongy structure made up of tiny acini, or sacs, from which fluid that protects sperm is secreted.
During ejaculation, the prostate squeezes this fluid into the urethra, and it’s expelled with sperm as semen. The vas deferens bring sperm from the testes to the seminal vesicles, which connect to the prostate from behind, and also contribute fluid to the ejaculate. In addition, the urethra runs from the bladder through the center of the prostate and into the penis to allow urine to flow out of the body.
So by its nature and location, the prostate is the repository for several fluids.
As men age, the prostate can lose some of its suppleness, limiting its ability to vigorously contract and fully expel all its fluids.
This can result in conditions like retrograde ejaculation, where men do not release completely and/or experience a muted orgasm. When the prostate cannot fully empty, residual fluid can build up and, like the deposits in the bottom of a drinking glass, crystallize and calcify over time.
It’s this calcification that causes the prostate to become progressively more rigid over time, limiting its ability to fully contract.
If not addressed, this limited release not only leads to problems with sexual function, but the stagnant fluid and its resultant deposits invite infection. This leads to prostatitis — the most common prostate illness in men — which occurs when the prostate becomes infected by bacteria, viruses, mycoplasma or other nonbacterial agents. This is precisely what had occurred in the case of my patient with extreme, chronic prostatitis.
Mounting Maladies
If prostatitis is untreated and becomes chronic, the inflammation from the infection will cause the prostate to enlarge, creating great discomfort — particularly, burning sensations during urination.
As the prostate continues to swell, it increasingly constricts the urethra, narrowing the pathway through which urine can pass out of the body and making urination slow and difficult.
This condition is known as benign prostatic hypertrophy (BPH), or an enlarged prostate.
The chronic inflammation from BPH often leads to an eventual diagnosis of prostate cancer, particularly because inflammation is a primary factor in the development of all cancers.
Although prostate cancer is typically a slow-growing cancer that is rarely fatal — particularly when diagnosed late in life — a swollen, rigid, and inflamed prostate negatively impacts a man’s quality of life in so many ways that prostate health should be his number one priority moving into middle age.
It’s not only physical health that can be negatively affected by an inflamed prostate.
BPH can have serious effects on a man’s emotional health, leading to what I call pelvic armoring.
In this situation, the area of the pelvis can become metaphorically “armored” — libido lowers, tenderness decreases, and irritability increases. This can have drastic effects on a man’s ability to connect sexually with a partner.
Diagnostics & Disasters
The standard test for prostate health is the digital rectal exam (DRE).
The physician inserts a lubricated, gloved finger into the rectum to feel the prostate in order to detect enlargement, potentially cancerous lumps or nodules, or tenderness that might suggest prostatitis.
Some massaging of the prostate may occur to help it release some fluid through the penis in order to be tested, along with a urine sample, for white blood cells and pathogens that would signify an infection.
Blood tests for prostate-specific antigen (PSA), the protein thought to be associated with prostate cancer, may also be performed. It’s very important NOT to get preoccupied with PSA or frightened by a high number, which often has no bearing on whether a patient has cancer or not. Dr. Richard J. Albin, who discovered PSA, found that it was present in both the benign (normal) and malignant prostate.
His original research clearly showed there was no way to tell if a man had prostate cancer using the PSA, but with some additional analysis, it was found to be helpful for tracking the prostate for a recurrence of cancer — but only after it had already been diagnosed and treatment was administered.
As an initial diagnostic tool for cancer, the PSA was useless.
In 1986, the FDA approved the PSA test as a tool to track the recurrence of prostate cancer, but by 1994, lobbyists for profit-seeking biotech companies got their way, and the FDA officially approved the PSA test for the detection of prostate cancer in men through regular testing beginning at age 50.
As a result, millions of men who were told they had prostate cancer based on this one faulty test, but actually did not have cancer, had their prostates removed and their quality of life ruined.
Now, many doctors are de-emphasizing the PSA or not performing it at all for otherwise healthy men.
In a 2010 op-ed article in the New York Times, The Great Prostate Mistake, Dr. Albin poured out his regret about how his discovery got intentionally misrepresented for profit and why millions of men suffered for greed.
For more information about the dangers of PSA testing, read Dr. Albin’s book, The Great Prostate Hoax: How big medicine hijacked the PSA test and caused a public health disaster and the MegaZEN 2015 article, “Early Detection Disaster: How the rush to diagnose and treat prostate cancer devastated the lives of millions of men.”
If cancer is actually present, a prostate (transrectal) ultrasound can be performed. An ultrasound probe is inserted into the rectum, allowing it to get close to the prostate, and is usually performed in conjunction with a biopsy.
Treatments: Drug Interventions
If an infection is present, antibiotics may be prescribed.
The challenge, however, with treating a prostate infection this way is that there are few antibiotics to which the pathogens are sensitive that are able to pass through the plasma-prostate barrier and into the prostatic fluid. Because of this, antibiotic-only therapy works in just 1 out of 3 cases.
Other drug treatments can help treat the symptoms of a prostate infection.
\Alpha-blockers can relax the muscles around the urethra in men with an enlarged prostate, allowing urine to flow more freely. 5-alpha-reductase inhibitors can reduce levels of dihydrotestosterone (DHT), which run high when the prostate is enlarged. DHT is the hormone linked to hair loss, and its levels increase as men age.
Lowering DHT levels can help shrink the prostate.
Prostate Massage
Once prostatitis reaches the chronic stage, it’s extremely difficult to eradicate, as relapses are common.
Therefore, the best approach for prostatitis is a preventative prostate massage 2 to 4 times per year after age 50.
The primary goal of a prostate massage is to drain the residual fluid to prevent hardened deposits from forming, preventing the development of an environment that’s hospitable to microbes.
Prostate massage can also help release the tension around nerve endings behind the prostate in the levator ani muscle — the broad muscle that stretches across the pelvis. The massage can result in a form of myofascial release, relieving pain.
A prostate massage is conducted similarly to the DRE.
A physician inserts a lubricated, gloved, finger into the rectum and gently massages the prostate.
Once the prostate is properly relaxed and primed, the Fulford Percussion instrument is inserted to make contact with it.
The physician guides the patient through a pattern of deep breathing, holding and muscle contractions, as the instrument lightly oscillates and vibrates against the prostate in order to break up calcified deposits.
After a few minutes, an additional massage of the prostate is performed, known as “milking” the prostate, in order to encourage fluid and particles to be expelled through the penis.
Prostate massage is not new, and up until the 1960s, when certain drugs became available, it was the primary treatment for prostatitis.
At present, existing studies show that the most effective treatment for prostatitis is a dual approach that includes both antibiotics and prostate massage.
A study from the Philippines showed that patients with chronic prostatitis receiving antibiotics and prostate massage three times a week for 12 weeks reported significant decreases in symptom severity — greater than 60%. Patients were still reporting these decreases at their two-year follow-up appointments.
Eliminating Embarrassment
The time to think about a prostate massage is before prostatitis, cancer, or sexual dysfunction develops — before you absolutely need one.
To mitigate nervousness, it might help to think about clearing out your old prostatic fluid the same way you change the oil in your car because that’s basically what you’re doing. Besides, they both need to be done about every three months anyway.
The results I’ve seen in my patients who have prostate massage regularly have been dramatic.
In addition to the case I described earlier, I’ve seen conditions like erectile dysfunction, premature ejaculation, burning during urination, and chronic pelvic pain all significantly improve or resolve completely.
I’ve seen my patients’ relationships improve, physical pain abate, and emotional well-being increase — all from what is a relatively simple and quick procedure.
The prostate’s importance to men’s whole-body health cannot be overstated. The key to a healthy prostate is to embrace preventative care by getting regular prostate massage after age 50.
