Prostatitis, or prostate infection, is usually caused by bacteria, but a nonbacterial form of the disease also exists. Prostatitis is the most common genitourinary ailment in men younger than age 50, but the bacterial form occurs most often in men age 70 and older. If left untreated, infection can spread to the testicles and epididymis (tubules in back of the testis) and, in severe cases, destroy the prostate gland.

• Recurrent urinary tract infections (UTIs)
• Frequent and urgent urination
• Difficult or painful urination
• Urinating at night
• Fever; chills
• Generalized sense of ill health
• Painful ejaculation
• Bloody semen
• Sexual dysfunction
• Pain in the lower back, pelvis, or perineum (lining of the pelvic area)

Risk factors for prostatitis include the following.

• Recent urinary tract infection
• Prior sexually transmitted diseases, such as gonorrhea or chlamydia
• Smoking
• Excess alcohol consumption

Your health care provider will do a physical examination of the prostate and use laboratory tests, such as urinalysis or blood cultures.

Several antibiotics and other drugs are used to treat prostatitis. They are usually given orally, except in cases of sudden and severe prostatitis, which may require intravenous administration. The treatments may last 4 to 12 weeks, depending on how severe the infection is. Stool softeners, anti-inflammatory agents (such as ibuprofen), and hot sitz baths may also relieve symptoms.

If fever and pain persist, you may need surgery.

• Vitamin C (250 to 500 mg two times a day)
• Zinc (60 mg a day) has been shown to reduce the size of the prostate.
• Selenium (200 mcg a day) is an antioxidant concentrated in the prostate.
• Essential fatty acids (1,000 to 1,500 mg one to two times a day) are anti-inflammatory for optimum prostaglandin concentrations.
• Pumpkin seeds have been used historically for a healthy prostate.
• Avoid simple sugars, alcohol (especially beer), and coffee; drink plenty of water (48 oz. a day).

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per 1 cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, or 10 to 20 minutes for roots.

Studies show saw palmetto (Serenoa repens) may be as effective as Proscar (a common prostate medication). Dose of 160 mg twice a day is difficult to achieve in tea or tincture; extract standardized for 85 to 95 percent of fatty acids and sterols is recommended.

Cernilton, a flower pollen extract (500 to 1,000 mg two to three times a day), has been used extensively in Europe to treat prostatitis caused by inflammation or infection. It also has a contractile effect on the bladder and relaxes the urethra.

• Uva ursi (Arctostaphylos uva ursi): diuretic, urinary antiseptic
• Goldenseal (Hydrastis canadensis): diuretic, antiseptic, antimicrobial
• Coneflower (Echinacea purpurea): improves immune function
• Corn silk (Zea mays): diuretic, soothing demulcent

Take a combination of the above herbs (1 cup tea or 60 drops tincture) three times a day.

Some of the most common remedies used for prostatitis are listed below. Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four hours until your symptoms get better.

• Chimaphila umbellata for retention of urine with an enlarged prostate
• Pulsatilla for pain after urination, especially involuntary urination
• Pareira for painful urination, especially with painful urging
• Lycopodium for painful urination with reddish sediment in the urine, especially with impotence
• Thuja specifically if there is a forked stream of urine

Kegel exercises increase pelvic circulation and improve muscle tone.

Contrast sitz baths: You will need two basins that you can comfortably sit in. Fill one basin with hot water, one with cold water. Sit in hot water for three minutes, then in cold water for one minute. Repeat this three times to complete one set. Do one to two sets a day, three to four days a week.

May improve urinary flow and decrease swelling and inflammation.

May help reduce symptoms. Focus may be on the lower abdominal area, lower back, and around the sacrum.

Be sure you follow your health care provider's instructions for treatment and keep using the treatment as directed even if you start to feel better.

Men should have a yearly prostate examination after age 40, even if they have no symptoms of prostate problems. In recurring cases, you may need ongoing treatment with periodic checkups.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:52, 128, 203.

Berkow R, ed. The Merck Manual of Diagnosis and Therapy. 16th ed. Rahway, NJ: The Merck Publishing Group; 1992.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998:75, 201.

Buck AC, Rees RWM, Ebeling L. Treatment of chronic prostatitis and prostadynia with pollen extract. Br J Urol. 1989;64:496-499.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Conn RB, Borere WZ, Snyder JW, eds. Current Diagnosis 9. Philadelphia, Pa: WB Saunders Co; 1996.

Driscoll CE, Bope ET, Smith CW JR, Carter BL, eds. The Family Practice Desk Reference. 3rd ed. St. Louis, Mo: Mosby-Year Book; 1996.

Gruenwald J, Brendler T, Jaenicke C, et al., eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Co; 1998:817, 1229.

JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:119, 228-231, 341, 388-389.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:480-486.

Tierney LM Jr, McPhee SJ, Papadakis MA, eds. Current Medical Diagnosis & Treatment 1999. 38th ed. Stamford, Conn: Appleton & Lange; 1999.

Werbach, M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing; 1988:82-84.