When one thinks of possible erectile dysfunction causes, some that come to mind include use of drugs and medications, prostate cancer treatments, medical conditions such as diabetes, and low testosterone. Although erectile dysfunction most often affects men age 65 and older, this new study points out a possible cause of erectile dysfunction that applies to younger men.

The study included 400 men who had not had erectile dysfunction before entering the trial. Yet the investigators found that 40% of men experienced some type of erectile dysfunction after six months of practicing “timed intercourse,” which means men were under pressure to perform sexual intercourse either often and/or at specific times when it was considered an optimal time for his partner to conceive.

The researchers noted that “stress incurred by the thought of obligatory coitus, or compulsory sexual behavior, causes sexual dysfunction in men facing timed intercourse.” An unexpected finding of the study was that the stress associated with obligatory sexual intercourse was prompting 10% of the men to also have affairs.

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A new study by researchers at Henry Ford Hospital has shown that black men and white men have different outcomes following prostatectomy (prostate surgery). The good news is that one factor regarding prostatectomy outcomes that did not differ between blacks and whites—in-hospital mortality rates were similar.

Although this study is the first to explore racial differences following prostatectomy, previous studies have indicated differences not only in other areas of medical treatment between white men and black men but also differences concerning prostate cancer itself. For example, it is well established that compared with white men, the risk of prostate cancer in black men is about 60% greater.

In addition, prostate cancer is more aggressive in black men than in white, and the death rate is also higher. Generally, it is recommended that black men be screened for prostate cancer beginning at age 40 to 45, which is 5 to 10 years earlier than what is recommended for white men.

In this new study, investigators reviewed data from 7,408 black and 51,319 white prostate cancer patients who had undergone prostatectomy. A comparison of the immediate and short-term outcomes after prostate surgery, classified by race, showed that black men experienced significantly higher rates of blood transfusions, more complications during and after surgery, and longer hospital stays than white patients.

The reasons for the differences between black men and white men regarding prostatectomy are not clear, although the study notes several possibilities, including anatomical differences in the pelvis or tumor characteristics. Lead author Quoc-Dien Trinh, MD, a Fellow at Henry Ford Hospital’s Vattikuti Urology Institute, noted that “it’s also a question of quality of care for ethnic minorities, especially in the American health care system. And that needs to be raised.”

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Most hormone therapy drugs for prostate cancer work by inhibiting androgen production in the testes and adrenal glands but not within the prostate tumor itself. Abiraterone can target hormone production in all three sites.

A phase II clinical trial of abiraterone plus prednisone and prostatectomy was conducted in 58 men with high-risk prostate cancer whose disease had not spread beyond the gland. Before undergoing prostatectomy, all the men received either three or six months of abiraterone plus prednisone.

According to lead author Mary-Ellen Taplin, MD, of Dana-Farber, “Therapies that combine surgery with older androgen-inhibiting drugs have not historically improved outcomes.” In this study, however, after prostatectomy, examination of prostate tissue samples showed that tissue tumor had nearly disappeared or was gone completely in one-third of the men.

Investigators were encouraged by the results of this study and are planning another phase II study using one of the latest prostate cancer treatments in the pipeline, MDV3100. Additional trials of abiraterone are also under development.

Read more on Abiraterone for Prostate Cancer Treatment

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Currently the conventional treatment for nonbacterial prostatitis involves drugs for BPH (benign prostatic hyperplasia), which are not always effective. Therefore the challenge to treat chronic prostatitis/chronic pelvic pain syndrome has prompted some men to look beyond conventional medications and to explore alternatives.

Prostatitis, a condition in which the prostate becomes inflamed and causes a range of urinary tract symptoms, affects about half of all men at some point during their lives. Of the four types of prostatitis, two involve bacteria (acute bacterial prostatitis and chronic bacterial prostatitis),  which make up only about 5% of all cases. Another uncommon form is asymptomatic inflammatory prostatitis.  All three of these forms of prostatitis are typically treated with antibiotics.

The most common and most challenging type of prostatitis to treat is nonbacterial chronic prostatitis/chronic pelvic pain syndrome. Nonbacterial chronic prostatitis symptoms include a strong urge to urinate immediately, weak urinary stream, difficulty starting urinary stream, dribbling, frequent urination during the night, pain and/or burning during urination, genital or pelvic pain, blood in the urine or semen, and painful ejaculation.

What is Special about Pollen?

Pollen extract comes from a number of plant sources, and when it is gathered from specific flowering plants, then the end product can be standardized, which means it contains the same amount of active ingredients in each batch. Most of the studies that have involved the use of pollen and its effect on prostatitis have included the use of pollen called cernilton/Graminex.

Graminex is composed of pollen from rye, corn, and timothy, and this combination has been used to help manage prostatitis and enlarged prostate (benign prostatic hyperplasia) in Europe for nearly four decades. The property that makes pollen extract special is its ability to fight inflammation. This extract has been shown to cause the bladder to contract while also allowing the urethra to relax, which improves urinary flow.

Pollen and Prostatitis Studies

Here are some examples of how pollen extracts performed in studies of men with prostatitis.

• Ninety men with chronic prostatitis were divided into two groups: those without complicating factors (72 men) and those with complicating factors (18 men). All the men took cernilton three times a day for six months and were tested at three and six months. After six months, 56 men who did not have complicating factors said they had a favorable response to cernilton: 26 had no symptoms and 30 had significant improvement. Among the 18 men with complicating factors, only one said he had a response to pollen. (Rugendorff)
• A group of 60 men with chronic prostatitis/chronic pelvic pain syndrome were assigned to receive either pollen extract or a placebo for six months in a double-blind study. At the end of the six months, men who had taken pollen extract reported either a significant improvement or elimination of their prostatitis symptoms. Therefore the authors concluded that pollen extract was “superior to placebo in providing symptomatic relief in men with chronic nonbacterial prostatitis/chronic pelvic pain syndrome.” (Elist)
• A randomized, double-blind, placebo-controlled phase 3 study compared cernilton with placebo in men with chronic prostatitis/chronic pelvic pain syndrome. Seventy men took pollen extract and 60 men took placebo daily for 12 weeks. Compared with men in the placebo group, those who took pollen reported significant improvements in total symptoms, pain, and quality of life, and this was achieved without severe side effects. (Wagenlehner)

Before taking pollen extract, consult your healthcare provider and discuss any allergies you may have to flowers, grass, or other plants. He or she can help you determine if this extract is safe to use and at which dose.

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References

Elist J. Effects of pollen extract preparation Prostat/Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a randomized, double-blind, placebo-controlled study. Urology 2006 Jan; 67(1): 60-63

Rugendorff EW et al. Results of treatment with pollen extract (Cernilton N) in chronic prostatitis and prostatodynia. Br J Urol 1993 Apr; 71(4): 433-38

Wagenlehner FM et al. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomized, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol 2009 Sep; 56(3): 544-51

Numerous studies have shown that saw palmetto works for prostate conditions and in particular can improve urinary tract symptoms in men who have BPH. This is important because one benefit of using saw palmetto for BPH rather than the conventional medications, such as alpha-blockers and 5-alpha-reductase inhibitors, is that the herbal remedy is not associated with erectile dysfunction whereas the drugs have been shown to disrupt sexual function.

In this new study, 82 men with moderate to severe symptoms of BPH plus sexual problems (e.g., erectile dysfunction or loss of libido) were assigned to take 320 mg daily of saw palmetto extract daily for eight weeks. At the end of the eight weeks, the International Prostate Symptom Score (IPSS) was significantly reduced by 51% and erectile dysfunction, libido, and other sexual functions had improved by an average of nearly 40%.

According to Dr. Eugen Riedi, MD, a urologist in Switzerland and the study’s lead researcher, “This is one of the first therapies ever to show an improvement of BPH symptoms and of sexual dysfunctions at the same time.” Saw palmetto also was well tolerated and patient compliance was “excellent.”

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The researchers, who presented their findings at the 9^th European Congress on Obesity in Lyon, France, studied overweight men who received testosterone injections for up to five years to treat erectile dysfunction and other symptoms associated with low testosterone, which can include loss of sex drive, depression, fragile bones, and difficulty concentrating, among others. According to one of the researchers, Farid Saad, DVM, the weight loss “was an incidental finding that was entirely unexpected.”

All the men in the study received two injections of testosterone during the first six weeks of treatment and then an injection every three months. Men who were treated the longest lost more than an average of 30 pounds and also had improvements in blood pressure, LDL cholesterol, and blood glucose levels.

Low testosterone levels are common among men who are obese. Excess weight leads to elevated levels of estrogen, which in turn lowers testosterone levels. Therefore, obese men who lose weight can increase their testosterone levels naturally.

Low testosterone levels may also be associated with type 2 diabetes, and can be one of the risk factors for prostate cancer. Men who are considering testosterone therapy for any reason should discuss the benefits and risks with their healthcare provider and also investigate natural ways to increase testosterone.

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Over the years, experts have identified a number of causes of erectile dysfunction causes ranging from lifestyle and nutrition choices (smoking, alcohol use, dietary habits, exercise), use of drugs and medications, side effect of prostate cancer treatment,  psychological causes, and blunt trauma. Certain medical and environmental factors (e.g., diabetes, cardiovascular disease, exposure to toxins) also have been named as causes of erectile dysfunction.

Investigators from the University of Florence and the University of Manchester explain that as many as 60% of men with hyperthyroidism could have erectile dysfunction. Hyperthyroidism is characterized by excessive production of two thyroid hormones, thyroxine and triiodothyronine, which have an impact on bodily functions such as heart rate.

In the study, which included 6,573 men, the researchers found that men with hyperthyroidism were 14 times more likely than men without the thyroid disease to experience erectile dysfunction. The reverse was not observed, however: men with erectile dysfunction were not at greater risk of developing hyperthyroidism.

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The list of symptoms associated with low testosterone or testosterone deficiency in men includes reduced sex drive, depression, erectile dysfunction, weight gain, loss of strength, and muscle loss. These conditions may appear as testosterone levels decline with age: men lose about 1% of their testosterone per year after reaching middle age.

In a new study from the University of Edinburgh, researchers found that low testosterone levels are linked to insulin resistance, a hallmark of type 2 diabetes. This study, which was conducted in mice, is the first to directly identify how low testosterone in fat tissue has a role in onset of the disease.

An especially important finding was noted by Dr. Kerry McInnes, from the University of Edinburgh’s Endocrinology Unit, who stated “This study shows that low testosterone is a risk factor for diabetes no matter how much a person weighs.” This sentiment was supported by Dr. Iain Frame, director of research at Diabetes UK, who said “this study provides evidence that there can be increased risk even when body mass is not affected,” and that “a healthy balanced diet is important for everyone and particularly for those already at high risk of developing Type 2 diabetes.”

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Curcumin has been turning up increasingly in labs and clinical studies as scientists uncover more and more of its medicinal abilities. One area in which curcumin has demonstrated cancer-fighting potential is in prostate cancer, where the spice has been shown to enhance hormone therapy, kill cancer cells, and inhibit cancer cell growth.

Individuals with advanced colon cancer are typically given a combination of three chemotherapy drugs, but 40% to 60% of patients do not respond, and among those who do, the side effects can be so severe, people cannot continue treatment. Experts propose curcumin may increase the sensitivity of colon cancer cells to chemotherapy so these patients can be treated at a lower dose, for a longer time, and with fewer side effects.

About 40 patients with bowel cancer will be enrolled in the study, 30 of whom will be given curcumin and the remainder will receive chemotherapy only. According to Professor William Steward, ECMC director at the University of Leicester and the study’s chief investigator, “Investigating the potential of plant chemicals to treat cancer is an intriguing area that we hope could provide clues to developing new drugs in the future.”

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