What Are Natural Ways to Shrink an Enlarged Prostate (BPH)? What Are the Risks and Benefits of TURP?
Last Updated: November 2025
In this FAQ, Dr. Jessica Knape of HealthSpan Internal Medicine in Boulder, CO, explains how benign prostatic hyperplasia (BPH) can cause urinary symptoms as men age and outlines natural and medical strategies to reduce prostate inflammation, balance hormones, and improve quality of life—often without surgery.
Benign Prostatic Hyperplasia (BPH), or prostate enlargement, affects more than half of men over age 50 and nearly 80% by age 80.
While it isn’t cancer, it can make life uncomfortable — causing frequent urination, nighttime awakenings, weak stream, and incomplete bladder emptying.
At HealthSpan Internal Medicine in Boulder, CO, we help men find both natural and medical strategies to reduce prostate inflammation, balance hormones, and improve quality of life — while understanding when surgery might be necessary.
The good news: most men can significantly improve symptoms without surgery. But it’s important to know your options, and where each approach fits in your broader health picture.
HealthSpan Insight
BPH is largely driven by hormonal and inflammatory changes with aging.
Natural therapies and lifestyle changes can reduce symptoms for many men.
TURP (Transurethral Resection of the Prostate) remains the surgical gold standard — but it carries risks that should be weighed carefully.
1. What Causes BPH?
The prostate is a small gland located below the bladder that surrounds the urethra (the tube that carries urine).
As men age, the prostate gradually enlarges due to:
Hormonal shifts: Testosterone declines while dihydrotestosterone (DHT) — a more potent form — accumulates in prostate tissue.
Estrogen dominance: With age, estrogen levels can rise relative to testosterone, promoting prostate growth.
Inflammation and oxidative stress: Chronic inflammation in the prostate and pelvic tissues triggers cell proliferation.
Metabolic changes: Insulin resistance, obesity, and high blood sugar increase the risk of BPH.
This combination squeezes the urethra, making urination difficult and disrupting sleep and energy.
2. Common Symptoms of BPH
Weak or interrupted urinary stream
Difficulty starting urination
Dribbling after urination
Frequent urination (especially at night)
Feeling of incomplete bladder emptying
Urgent or uncontrollable need to urinate
These symptoms can mimic or overlap with prostatitis (inflammation) or early prostate cancer, so proper diagnosis is key.
3. How BPH Is Diagnosed
At HealthSpan, evaluation typically includes:
Digital rectal exam (DRE): to assess prostate size and texture.
PSA (prostate-specific antigen): a blood marker to screen for cancer risk.
Urinary flow study and bladder scan: to measure residual urine and flow strength.
Hormone panel: testosterone, DHT, estradiol, and SHBG (sex hormone–binding globulin).
A functional approach also screens for inflammation, metabolic imbalance, and oxidative stress, which often drive prostate growth.
4. Natural and Integrative Ways to Shrink the Prostate
A. Target Hormone Balance
Saw Palmetto (Serenoa repens)
Blocks 5-alpha-reductase, the enzyme that converts testosterone to DHT.
Reduces inflammation and improves urinary flow.
Shown in multiple trials to perform similarly to finasteride with fewer sexual side effects.
Beta-Sitosterol
A plant sterol that improves urinary flow and reduces residual urine.
Found in pumpkin seeds, avocado, and soy.
Pygeum africanum (African plum bark)
Anti-inflammatory and anti-edema properties in prostate tissue.
Helps reduce nighttime urination and urgency.
Stinging Nettle Root (Urtica dioica)
Inhibits DHT binding to receptors.
Supports urinary flow when combined with saw palmetto.
B. Optimize Metabolic Health
BPH is closely linked to metabolic syndrome.
Men with insulin resistance or central obesity have higher DHT and estrogen levels.
Balance blood sugar: Lower refined carbs and added sugars.
Exercise regularly: Improves testosterone balance and circulation.
Lose excess abdominal fat: Reduces estrogen production and pelvic inflammation.
Limit alcohol and caffeine: Both irritate the bladder.
C. Anti-Inflammatory Nutrition
Foods that calm inflammation also support prostate health:
Tomatoes (lycopene): a potent antioxidant shown to reduce prostate volume.
Green tea: polyphenols lower DHT and reduce oxidative stress.
Cruciferous vegetables: (broccoli, kale, cauliflower) support estrogen metabolism.
Omega-3 fatty acids: from fish or flaxseed oil to reduce inflammation.
D. Support Pelvic Circulation
Sedentary habits impair pelvic blood flow, worsening congestion and inflammation.
Move every hour: even short walks improve lymph flow.
Kegel exercises: strengthen pelvic floor muscles and improve bladder control.
Avoid prolonged cycling or tight clothing: both can irritate the prostate.
6. What Is TURP (Transurethral Resection of the Prostate)?
TURP is the most common surgical procedure for BPH.
A urologist inserts a small instrument through the urethra and removes excess prostate tissue with an electrical loop.
Benefits:
Immediate improvement in urine flow.
Effective for large prostates or severe obstruction.
No external incisions.
Risks and Side Effects:
Retrograde ejaculation (semen flows backward into the bladder) — occurs in up to 75% of men.
Erectile dysfunction (5–10%).
Urinary incontinence (1–2%).
Bleeding or infection post-procedure.
Possible re-growth requiring future procedures (about 10% within 10 years).
TURP can be life-changing for men with severe obstruction or urinary retention — but for mild to moderate cases, lifestyle and natural therapies often provide meaningful relief with fewer risks.
7. Newer, Less Invasive Procedures
Several modern options now exist between medication and TURP:
UroLift®: tiny implants lift and hold prostate tissue away from the urethra.
Rezum® water vapor therapy: uses steam to shrink prostate tissue.
Laser ablation: precisely vaporizes excess tissue with minimal bleeding.
These procedures often preserve sexual function and have quicker recovery times.
8. When to Consider Surgery
Consider TURP or minimally invasive procedures if:
Urine flow is severely obstructed.
You develop bladder stones or infections.
There’s evidence of kidney strain or retention.
You fail to improve with lifestyle or medication.
For most men, early intervention with integrative care can delay or avoid surgery entirely.
9. The Whole-Body Connection
BPH doesn’t happen in isolation — it’s a marker of aging, inflammation, and hormonal imbalance.
The same processes that enlarge the prostate also drive:
Cardiovascular disease
Insulin resistance
Low testosterone and metabolic slowdown
Cognitive inflammation
By treating BPH through lifestyle and metabolic repair, you also strengthen your HealthSpan — protecting the heart, brain, and vitality simultaneously.
Bottom Line
An enlarged prostate is common, but it’s not inevitable or untreatable.
Many men can shrink prostate volume naturally through anti-inflammatory nutrition, hormone balance, and metabolic repair.
When needed, medications and procedures like TURP are effective — but come with risks that should be carefully considered.
At HealthSpan Internal Medicine in Boulder, CO, we take an integrative approach: combining evidence-based natural therapies with modern urology to restore urinary comfort, hormonal balance, and long-term vitality.
👉 Want a personalized evaluation and treatment plan?
Schedule a consultation with Dr. Knape to review your symptoms, labs, hormones, and prostate health.
Sources
National Institutes of Health (NIH) – Benign Prostatic Hyperplasia (BPH) Overview
https://www.niddk.nih.gov/health-information/urologic-diseases/benign-prostatic-hyperplasia-bphMayo Clinic – Benign Prostatic Hyperplasia: Symptoms & Natural Treatment Options
https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/diagnosis-treatment/drc-20370093Harvard Health – Natural Remedies & Lifestyle Approaches for BPH
https://www.health.harvard.edu/mens-health/natural-remedies-for-an-enlarged-prostateCleveland Clinic – TURP (Transurethral Resection of the Prostate): Risks & Benefits
https://my.clevelandclinic.org/health/treatments/5187-turp-transurethral-resection-of-the-prostateAmerican Urological Association – BPH Treatment Guidelines (Including TURP)
https://www.auanet.org/education/bph-guideline
Medically reviewed by
Dr. Jessica Knape, MD, MA Board Certified in Internal Medicine and Integrative and Holistic Medicine
Healthspan Internal Medicine — serving patients in Boulder, CO
Book a Discovery Call | About Dr. Knape
This content is for educational purposes and does not replace personalized medical advice.
