Chronic Prostatitis Tips
Things that Help and Hurt
This information is very brief and cryptic. Join our prostatitis and pelvic pain forum —which has a joining fee— for the very latest information, for full explanations, for case histories, and to ask questions and get support.
The following distilled wisdom has been gleaned from the experience of the site managers, the advice of prostatitis researchers and discussion among sufferers on our CPPS/prostatitis forum.
Things that help chronic prostatitis/CPPS
In general, to subdue symptoms you may have to change your lifestyle, diet, career, and approach to life psychologically. Maybe your genes will not comfortably allow you to be the go-getter or fire-eating Type-A personality you used to be before all this started. Maybe that high-stress power career is no good for you. At first you will mourn the loss of these things, but after a few years most men adjust and feel that the sickness has taught them valuable lessons about life, fostering a calmer, philosophical approach wherein attention is paid to relaxation, both physical and mental. Other men are able to maintain high pressure lifestyles with the addition of meditation, relaxation exercises and physical therapy (as outlined in the Wise-Anderson Protocol).
- Release pelvic muscle spasms
- Take Quercetin, which is a superb mast cell secretion blocker. The best forms are Prosta-Q and Q-Urol because they have guaranteed quercetin content, unlike many other brands that prostatitis expert Dr Shoskes tested and found to have variable amounts of the chemical. Cycle 3 weeks on, 1 week off. It seems to work better that way. Quercetin can also be obtained in smaller quantities from natural sources, like Rooibos (Redbush) Tea, which is delicious hot or cold.
- A good nonacidic multivitamin that does not irritate the lower urinary tract, for example MultiRight.
- Magnesium helps prevent muscle spasm and trigger points; you can also get magnesium by putting Epsom Salts in your bathwater.
- Buffered Vitamin C, up to 2g (2000mg) daily. Lowers histamine in blood by up to 38%. Protects against leaky gut. It’s a natural antihistamine (see studies 1 and 2)
- Avoid stress!
- Avoid excessive sitting (pressure can be a mast cell trigger) and use a donut cushion if you have a sitting job. Avoid truck-driving, bicycling and horse riding.
- Avoid excessive exercising (a mast cell trigger) and fatigue, but do take gentle exercise, like walking.
- Avoid foods to which you react with phlegm, stomach pain, diarrhoea, flushing, headache, rash, joint pain (allergens degranulate mast cells, releasing histamine, and this may be the cause of your condition). If you have IBS, investigate FODMAPs (google it) and consider excluding them from your diet.
- Climate: a hot, dry (immune-system-friendly) climate is preferable to a cold, wet one. Researchers in northern Europe report that cold weather (a mast cell trigger and muscle spasm promoter) co-incides with flares.
- Consciously relax during ejaculation, which helps to avoid overstimulating the pelvic nerves and leads to far less post-orgasmic pain. Do not tense the pelvic muscles during ejaculation. Let your pelvis remain “limp”.
- Try alpha blockers (Flomax, Hytrin, Cardura) because they relax smooth muscles in area. Also thought to work in as yet unexplained ways (e.g. Hytrin attenuates nociception-induced substance P upregulation).
- Antihistamines like Vistaril (hydroxyzine) antihistamine, inhibits bladder mast cell activation by neurogenic stimuli, and has anticholinergic, anxiolytic and analgesic properties. It is useful to take Flomax concurrently to stop Vistaril’s tensing (antimuscarinic) effect on bladder neck and peri-prostatic smooth muscle. Some people cannot tolerate hydroxyzine, and they may try Allegra (H1 receptor antagonist) and/or Zantac (H2 receptor antagonist).
- Neurontin (an anticonvulsant) can be useful for nerve pain.
- Elavil (amitriptyline) is a mast cell protector and muscle relaxant, and subdues nerve pain.
- Botox injections (only via expert uros, currently under research) temporarily stuns nerves, allowing neural “wind up”, which causes mast cell degranulation, to subside.
- Ultram (Tramadol) a synthetic analogue of codeine. Useful in breaking the pain cycle. Supposedly non-addictive, but some men have had problems. May degranulate mast cells, like other opioids (hydrocodone, Vicodin etc), so long term or frequent use not advised.
- Calcium Glycerophosphate takes acid out of food to help stop pain and urgency. Use when eating acid foods. Very useful. Cheap if you can buy the generic chemical from a lab, ridiculously expensive if you buy it as “Prelief”. Note: MultiRight also contains this chemical, so it may be a good idea to use that instead (you get dual benefits from multivitamin and urinary alkalizer).
- Benzodiazepines (Valium, Klonopin, Xanax, Ativan as well as Lorazepam, Librium) for anxiety (a hallmark of CPPS patients) and to help release muscular spasm. For short term or occasional use only. Careful with addiction.
- Cernilton (Cernitin) is an anti-inflammatory pollen extract. The best way to get it is in conjunction with Quercetin in Q-Urol
- TriVerex and Trinoboost help if you have libido problems (low sex drive, poor erections)
- Viagra and Cialis – also helps with sexual symptoms, if present, although after reports that Viagra can damage vision, I’d stick with the more natural remedies that Farr Labs sells, such as TriverexMD and Trinoboost.
- Hot baths, which relax muscle tension
- Chondroitin Sulfate also prevents mast cells from triggering pain by releasing a myriad of nasty chemicals when provoked by nerves, allergies or any of the many other things that stimulate these cells. You need to take it for a long time to get the full effect.
- Regular Ejaculation (about 2x a week) clears sequestered and irritating prostatic secretions, but avoid more than that
- Herbals / herbs : tribulus terrestris, nettle root, maca root, gotu kola and marshmallow
Things that hurt
The traditional treatment for this malady has been (and for many urologists still is) antibiotics. We frown upon the use of antibiotics after they have failed. The archives are full of men reporting negative side-effects from these drugs. Most knowledgeable urologists today will discourage the use of antibiotics if they fail to cure a patient and cultures are negative. Unfortunately, many men are temporarily helped by these drugs, for complex reasons, and this convinces them that they have an infection, sending them looking for new prescriptions again and again. In extreme cases men have taken antibiotics continuously for years without any lasting benefit.
Irritants and triggers
Different people have different triggers/irritants, but here are the most common you may wish to experiment with avoiding:
- Psychological stress in mice and cats triggers their bladder mast cells. Most likely this occurs in humans and other mammals too.
- Food: Excessive amounts of high sugar and acidic foods, alcohol, spices, vinegar, caffeine, coffee, chocolate, sodium benzoate (a histamine release trigger), milk products, tomatoes, cranberry drinks, Nutrasweet. An exclusion diet will define your unique list of food irritants and triggers.
- Wheat (and Gluten generally) can make mast cells more leaky and more prone to degranulate, and seems to be a specific trigger for many individuals, even those who test negative for celiac disease. Gluten can be a nerve poison in some individuals (see prostatitis forum). The issue of diet is a huge one for some men, who swear that by modifying their diets they were able to calm or eliminate the pain in their groins. These men tend to be “atopic”, reacting to some foods with diarrhoea, stomach pain, phlegmy or “tight” throats, headaches, rashes, excessive sweating, depression and fatigue.
- Sexual Activity: too much sex, too little sex. Find the right frequency for you. Be sure to avoid “Tantric” sexual practices, which involve grasping the penis tighly to prevent ejaculation. Some men have reported that this started their problems.
- Sitting excessively, or pressure on the perineum. Pressure may trigger mast cells.
- Marijuana is reported to be a trigger by many men.
- Exercise: strenuous exercise can provoke flares for some by triggering mast cells. Leg squats are particularly bad.
- Medications: avoid those which can cause urinary retention. Be careful of decongestants and antihistamines such as Sudafed, Tavist-D, Contact, Afrin etc. Some people report problems with SSRI antidepressants (Prozac, Zoloft, Celexa, Paxil etc). Some men say their condition was caused by thermogenics (Xenadrine, Hydroxycut). Several men have reported their condition being triggered by androstenedione (see prostatitis forum), a direct hormone precursor of testosterone, which is used (abused?) to build muscles in bodybuilding. Dr Shoskes says he has seen many men report getting symptoms after taking testosterone. Some men experience bad effects from drugs like Prilosec, Lipitor, Lescol, and Aciphex. One man reported Sectral to cause symptoms.