Therapeutic Management of Benign Prostatic Hyperplasia: From Synthetics to Naturals

Benign prostatic hyperplasia (BPH) is a common urological disorder of men with multi-factorial etiology, particularly affecting the lifestyle of elderly patients. Sex steroid hormones essential for the development and growth of normal prostate are recognized as major risk factors, though many others such as aging, genetic, diet, hypertension, obesity, smoking, alcohol and physical activity have been identified as playing a significant role. Depending on the stage of BPH, and complications involved, the treatment includes different classes of synthetic drugs and/or surgery while some phytotherapeutic agents also represent the first line of treatment. Numerous plant extracts, fruits, and beverages are used alone or in combinations for the management of BPH with few having emerged as the choicest treatment. The public interest in natural agents is largely because of the side effects related to synthetics and a general fear of morbidity arising out of surgery. The phytotherapeutic agents represent the most promising and safe alternative as antiBPH agents signifying a strong area for further exploration by medicinal chemists. This review provides a complete insight on the epidemiology, pathophysiology, various risk factors involved, and different therapeutic approaches available. A brief outline of the surgical and synthetic treatment with detailed note on phytotherapeutics as the treatment options for the prevention and management of benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) is provided.