
Benign prostatic hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) is the most common cause of prostatic enlargement which results from proliferation of stromal and glandular elements. It is a common condition as men get older and can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder There is a very important role of androgen-dependent proliferation of glands and stroma
Clinical benign prostatic hyperplasia (BPH) is one of the most common diseases in ageing men and the most common cause of lower urinary tract symptoms (LUTS). The prevalence of BPH increases after the age of 40 years, with a prevalence of 8% till 60% at age 90 years..
The pathophysiology of BPH/BPE is still incompletely understood. The dominant role of the androgen system and the androgen receptor is well defined. Androgen receptors are expressed in BPH tissue in which they are activated by the potent androgen dihydrotestosterone. Synthesis of dihydrotestosterone is under control of the 5a-reductase enzyme. More recently, the impact of prostatic inflammation and metabolic parameters particularly for the development of BPE and LUTS has increasingly been recognized. (Gerontology 2019;65:458–464 https://doi.org/10.1159/000496289).
Dihydrotestosterone accumulation within the gland serves as the hormonal mediator for the hyperplasia. The accumulation probably occurs in part because of decreased catabolism of the molecule and in part because of enhanced intracellular binding of the molecule. The process is accelerated by estrogen, which enhances the level of the androgen receptor in the gland. Increase in the androgen receptor allows for androgen-mediated growth even in the face of declining androgen production in advanced age. (The American Journal of Medicine Volume 68, Issue 5, May 1980, Pages 745-756)

Flower Pollen extract Graminex
A review of 2 placebo controlled trials and 11 open label studies indicate that flower pollen extract is a safe and effective therapy for the management of mild to moderate LUTS. The studies showed a consistent reduction in subjective symptoms and overall effectiveness ratings of 75% and greater. The extract reduces bothersome symptoms thereby improving quality of life. The two placebo-controlled, double-blind studies provide evidence that the extract is effective in reducing nocturia, daytime frequency and sensation of residual urine.
Sufficient evidence exists in the primary and secondary literature to indicate that Graminex’s Flower Pollen Extract is safe and effective for the treatment of mild to moderate LUTS. This dietary supplement ingredient has the potential to be used in combination with other dietary supplements or pharmaceuticals to provide relief of bothersome symptoms and improve quality of life for millions of men with this common condition.”
Bibliography: A Critical Review of Graminex Flower pollen extract for Symptomatic Relief Of Lower Urinary Tract Symptoms (LUTS) in Men Walter G. Chambliss, Ph.D. National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, University of Mississippi, University, Ms. 38677 January 12, 2003
Serenoa repens
The therapeutic effect of a 160-mg, twice-daily, oral dose of Serenoa repens extract was studied during a 3-month open trial in 505 patients with mild-to-moderate symptoms of BPH. The efficacy of the regimen was evaluated in 305 of these patients. Traditional parameters for quantifying prostatism, such as the International Prostate Symptom Score, the quality of life score, urinary flow rates, residual urinary volume, and prostate size, were found to be significantly improved after only 45 days of treatment. After 90 days of treatment, a majority of patients (88%) and treating physicians (88%) considered the therapy effective. In addition, the serum prostate-specific antigen concentration was not modified by the drug, thus limiting the risk of masking any possible development of prostate cancer during treatment. The incidence of side effects (5%) was low and compares favorably with that reported for existing medical therapies used in BPH patients. The extract of Serenoa repens appears to be an effective and well-tolerated pharmacologic agent in treating the mictional problems accompanying BPH
Bibliography: Current Therapeutic Research Volume 55, Issue 7, July 1994, Pages 776-785
Zn
The bell-shaped concentration response of Zn2+ on cultured BPH SMC proliferation suggests that changes in prostate Zn2+ concentrations, during aging, diet, or inflammatory conditions, may be of importance in the pathogenesis of BPH.
Bibliography: Urology Volume 85, Issue 3, March 2015, Pages 704.e15-704.e19
** All data above are published as clinical trials and do not refer to EFSA claims. This means that they do not intend to be medical or therapeutical advice.