Prostatitis is a common condition affecting men. It is defined as inflammation of the male prostate gland and may be due to a bacterial or fungal infection or simply irritation.
In many cases, the gland is inflamed, and there is no apparent infection or other cause of the condition.
Prostatitis is not cancer, and studies show it does not cause or predispose a man to cancer. However, it is frequently associated with men that have Benign Prostatic Hyperplasia (BPH). 1
It is a common problem for men of all ages and is most prevalent in middle-aged men between 35 and 55 years old. It is estimated to affect nearly half of all men at some point in their lives.
The male prostate tends to grow throughout life in most men. This continuing growth can increase the risk of prostatitis. This article will discuss prostatitis treatment options.
Symptoms
- Burning sensation when urinating
- Abdominal, rectal, groin, or low back pain
- Pain in the area just behind the scrotum or at the base of the penis
- Fever, chills, and/or malaise
- Pus or other urethral discharge
- Sexual dysfunction. Typically ED or inability to ejaculate
Depending on the type and severity of the condition, some men may experience excruciating symptoms, while others may have little to no bothersome symptoms
All types of prostatitis are treatable. However, prostatitis treatment approaches may be quite different, and very dependent on the scope of the problem.
Many of the symptoms of prostatitis can also be associated with urinary tract infections (UTIs), and the condition is often accompanied by a coexisting UTI. 2
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Types of Prostatitis
The National Institutes of Health has divided prostatitis into four main groups:
- acute bacterial prostatitis
- chronic bacterial prostatitis
- chronic prostatitis/chronic pelvic pain syndrome (CPPS)
- asymptomatic prostatitis/ inflammatory prostatitis.
In this paper, we consider a fifth type called fungal prostatitis. This type represents an infection of the prostate from a fungal, rather than bacterial source, and is likely a subset of Chronic Pelvic Pain Syndrome.
In most men, prostatitis presents initially as an acute infection, typically combined with:
- a UTI
- pain
- fever
This condition, known as acute bacterial prostatitis is a bacterial infection and usually successfully treated with a short course of antibiotics.
Warning: Acute bacterial prostatitis is an emergency medical condition. It should be treated promptly by a qualified medical professional. Untreated, it can lead to severe consequences, including death.
In many men, antibiotic treatment is all that is needed, but in some, recurrence occurs. When the condition recurs frequently, it is usually diagnosed as chronic bacterial prostatitis and treated with longer courses of antibiotics. This subacute prostate infection may also present with a variety of the above symptoms. Albeit at a lower level than the acute infection and is often characterized by recurrent urinary tract infections.
When long-term courses of antibiotics do not resolve the condition completely, some practitioners will diagnose it as chronic pelvic pain syndrome or inflammatory prostatitis. This diagnosis is quite common, and since the etiology is generally unknown, it is sometimes followed with a recommendation to “just live with it.”
Chronic pelvic pain and voiding symptoms are often hard for a man to discount. Some men will bounce between multiple doctors looking for a solution. Often they receive a myriad of diagnoses and possible fixes for the condition. These can range from long-term treatment with powerful antibiotics to surgical removal of the prostate.
Men who have prostatitis often present at urology clinics for many years due to pelvic pain, urinary tract symptoms, and cloudy urine. While the condition is common, many practitioners are not well aware of it, especially when the etiology of the condition is fungal rather than bacterial. Suffering men are often treated for BPH and/or chronic bacterial prostatitis with little successful results. 3
Nonbacterial prostatitis should be investigated as possible. Having a fungal source and may be termed fungal prostatitis. Treatment requires long-term antifungal agents, either prescription or natural. (See Treating Fungal Prostatitis below.)
Causes of Prostatitis
Prostatitis can be caused by bacteria or fungi that embed themselves into the prostate gland. Their source is either the urinary tract or the rectum. It can also result from various sexually transmitted diseases or, in the case of fungal prostatitis, from frequent vaginal yeast infection of the person or his sexual partner.
Acute bacterial prostatitis is often caused by common strains of bacteria such as; E. coli. The infection can be due to bacteria from either the urine or rectum leaks into the prostate. It begins abruptly with high fever, chills, joint and muscle aches, and fatigue.
It is typically diagnosed by patient symptoms, but blood and semen can also be tested for bacteria, white blood cells, or other signs of infection.
If blood and semen do not indicate bacterial infection, the source may be physical (injury, etc.), or prostatitis might be due to a fungal infection such as Candida.
Treatment For Bacterial Prostatitis
Conventional medical treatment for bacterial prostatitis is typically fluoroquinolones such as ciprofloxacin (Cipro) or levofloxacin. Treatment is usually needed for one week or less. However, fluoroquinolone antibiotics have some nasty side effects.
Many men might opt for natural treatment instead. Natural treatments for prostatitis typically need much longer-term treatment, but it has few if any side effects.
According to a press release in Nov of 2018 from the European Medicines Agency regarding fluoroquinolones:
“These medicines can cause long-lasting, disabling, and potentially permanent side effects involving tendons, muscles, joints, and the nervous system.” 4
The antibiotic treatment is, of course, needed if the prostate infection is bacterial in nature. However, many practitioners have found that prostate infections and prostatitis are not always bacterial. Fungal prostatitis is also common in many men. Especially those whose sexual partners are often subject to vaginal yeast infections.
Candidiasis is a fungal infection caused by the common yeast Candida albicans, a type of fungus. Candidiasis in the vagina is commonly referred to as a vaginal yeast infection. It is common in women and, if the fungus invades the prostate, it can result in fungal prostatitis.
Treatment For Fungal Prostatitis
A fungal infection of the prostate often results in many of the same symptoms as a bacterial infection.
Fungal infections can be caused by microscopic fungi in the environment as well as sexual activity with a woman prone to, or with a vaginal yeast infection. Some men are also prone to fungal infections, usually of the skin.
Regardless of the source, once the fungus migrates and embeds itself into the prostate, it can cause prostatitis that mimics a bacterial infection. Some men, especially those that have compromised immune systems, are more susceptible to fungal infections. Still, it can strike anyone at any time.
Unfortunately, many practitioners dismiss fungal prostatitis or are unfamiliar with them. Diagnosis can be established by urine cultures, symptom overview, and careful analysis. However, with a fungal infection, antibiotics are typically ineffective. They may even make the condition worse by deteriorating beneficial bacteria.
Fungal prostatitis and UTIs affect mainly patients who have urinary tract obstruction accompanied by Benign Prostatic Hyperplasia or are immuno-compromised by other medical treatments or diabetes or both.
A practitioner should suspect a fungal UTI in any patient with prostatitis, which has clinical or laboratory findings consistent with UTI but with no bacterial findings.
Treatment for fungal prostatitis can involve prescription antifungal medications. However, natural antifungal treatment is more effective for prostatitis and has far fewer side effects. The list below shows some common natural antifungal agents:
- Oregano oil– this herbal antifungal, while its taste is not very appetizing, is quite powerful. Oil of oregano is made from the leaves and shoots of the oregano plant (Origanum vulgare). It contains potent antifungals and antibacterial agents, and research shows it can stop the growth of the various fungus species, including Candida.
- Tea Tree oil – a popular, topical treatment for various fungal and bacterial skin infections. However, it must be used internally with extreme caution. It should not be used internally except by a qualified practitioner and must be significantly diluted. Pure Tea Tree oil can cause significant irritation when misused. It is best to leave its use to a skilled practitioner.
- Probiotics– Men that have previously had prostatitis have a 20%-50% risk of a recurrence (1). Research has also found that men with chronic prostatitis have lower levels of seminal lactobacilli than healthy men (3).
- Curcumin– a potent bioactive constituent in the spice Turmeric. Turmeric is regularly used in India for cooking and in traditional medicine. A clinical study was carried out to see if a combination of curcumin and calendula treatment was able to help treat chronic non-bacterial prostatitis (4).
- Saw palmetto – is regularly used to treat prostate enlargement. This is because of its ability to reduce DHT, which is a potent hormone that plays an essential role in prostate enlargement. Saw palmetto also has potent anti-inflammatory properties and has been suggested as a potential treatment for prostatitis.
- Probiotic supplementation– can restore the loss of healthy bacteria in your gut microflora caused by antibiotic treatment. This would lower the risk of a bacterial infection recurrence. The benefits of probiotics for treating bacterial prostatitis have been demonstrated in human clinical research.
The prostate is an organ that contains many small capillaries and vessels. When it is subject to infection, it is critical that the agent used to treat it be applied on a long-term basis, so that it has a chance to reach infected cells.
The typical duration of treatment is at least three months for most natural products. For some severe infections, treatment for up to a year may be needed.
Note that the disappearance of symptoms is not an indication that the infection is eliminated. Some infections may appear to be eliminated in as little as two weeks. Both fungal and bacterial infections of the prostate can linger at a low, symptom-less level, only to flare up again if treatment is terminated.
In cases where the man′s sexual partner is subject to recurring vaginal yeast infections, long-term treatment is necessary for both partners to effect a cure. 5 6 7
A Healthy Lifestyle Can Help Relieve Prostatitis
Prostatitis is, by definition, inflammation of the male prostate gland. The inflammation can be due to a bacterial or fungal infection or of an unknown source.
While I found no specific studies of the influence of obesity on the risk for prostatitis, several studies support obesity as a risk factor for both (BPH) and prostate cancer, and men with BPH frequently develop prostatitis.
Obesity is known to alter endocrine status, increase oxidative stress, and contribute to increased inflammation. Lifestyle issues, such as poor diet, lack of exercise, stress, and other issues are also contributors. 8
Another risk factor for the development of prostatitis is diabetes. It is well known that diabetes is associated with ED and BPH, both of which are common in older men. Obese men with high blood sugar levels seem to have a high risk of prostatitis.
There are many conditions, both dietary and lifestyle, that can negatively alter the overall health of the body and increase systemic inflammation. Chronic nonbacterial prostatitis affects around 10 to 15 percent of men in the United States, most of them over the age of 50.
Any man experiencing chronic nonbacterial prostatitis, should take a hard look at his diet and lifestyle and take steps to decrease his inflammatory loading. Bacterial prostatitis should be evaluated by a urologist, especially if it is associated with a UTI.
Discussion
Some medical doctors tend to minimize the impact of prostatitis on the male population. Men that present with pelvic pain and inflammation are often given a prescription for Cipro or a similar antibiotic without further testing or analysis.
Nonbacterial prostatitis is not affected by antibiotics. And, if the condition is due to fungal overgrowth, an antibiotic might even exacerbate it.
Many doctors are in denial about fungal sources of prostatitis. Reports often dismiss it, but it appears that it is more widespread than generally indicated. Men that are suffering, but have no confirmed diagnosis, might find the medical consensus of opinion is wrong. 9
Fortunately for many men, prostatitis is often a self-limiting condition that will sometimes resolve without the presence of an antibiotic or other medical intervention.
If a man is experiencing recurrent prostatitis, especially if there is no UTI present, a fungal source is likely. Sex with a partner that gets recurrent vaginal yeast infections could be a primary source and should be considered. Treatment as a couple might be needed to resolve the issue completely.
There are no surgical treatments for prostatitis, but some doctors take the easy way out and recommend the removal of the entire prostate gland (prostatectomy) as a solution. A man getting such a recommendation from his doctor should seek medical help from a different practitioner.
A prostatectomy is a major surgery involving all the associated surgical risks. The side effects of major surgery like prostatectomy far outweigh the discomfort and danger of prostatitis. There are far simpler and less debilitating ways to resolve it, and a recommendation for surgery is, in my opinion, tantamount to overtreatment.
Conclusion
The primary purpose of the male prostate gland is to secrete fluid to lubricate and nourish ejaculated sperm. This secretion, combined with sperm cells produced by the testicles, makes up the bulk of the fluid released when a man ejaculates.
Men who have nonbacterial prostatitis, especially if they have a sparse sex life, should be encouraged to ejaculate regularly by masturbation. Studies show that prostate secretions can build up and cause prostatitis when left unreleased for long periods. Thus, normal and regular sexual activity can help decrease the incidence of prostate malfunction.
Prostatitis is a common condition, especially for older men. Urology clinics in the United States see about 2 million cases per year, and more than 25 percent of men will receive a prostatitis diagnosis throughout their lifetime.
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A man who has prostatitis, especially if the condition is constant, or reoccurs regularly, should seek medical help from a professional that is well versed in treating prostate issues and is aware of the latest research into this condition.
