Prostatitis
Background
Prostate infections in men can be acute (sudden onset and severe) and require urgent antibiotics. These infections are associated with chills, fever, pain in the lower back and genital area, urinary frequency and painful urination, body aches, and a clear infection of the urinary tract. These are relatively uncommon, and are easily diagnosed and treated by most physicians.
Much more common is low grade prostate pain, called prostadynia or Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS), or chronic nonbacterial prostatitis. These account for 90-95% of chronic prostatitis diagnoses, and are poorly understood and treated by many physicians.
If pain is coming from up in the rectum in a male, one can use a finger to check up inside. Feel for a rounded area on the front part of the rectal wall near the end of your finger when the finger is all the way in. Normally, pushing on it will cause you to feel like you have to urinate. It should, however, not be painful. If it feels boggy when you push on it, or is painful — especially if it reproduces your pain — the prostate may be a major cause of your pelvic pain.
More Information Online
Articles on Prostate Health by Dr. T
Treatments
Medications
Antibiotics
If chronic pelvic pain is associated with prostate tenderness, especially if you have urinary urgency with low volumes or burning when you pass water, your doctor may recommend Cipro 500 to 750 mg twice a day or Doxycycline 100 mg twice a day (both are antibiotics) for six weeks. After six weeks, the antibiotics are usually stopped. If your symptoms improve and then recur when you stop the antibiotics, repeated 6-26 week courses of antibiotics may be considered until they stay gone. If they didn’t improve with the first course of antibiotics, switch to the other antibiotic. This may be a very helpful treatment for you.
A few cautions: Do not use Doxycycline that is expired or out of date. This is one of the few times that an expired prescription can cause you harm. Also do not take magnesium within 4 to 6 hours of taking Cipro or it will block the absorption of the Cipro. Take the Cipro first thing in the morning and the last thing at night and take the magnesium in the middle of the day while you are on the Cipro.
Recommended Supplements
Quercitin
This special highly absorbed form (500 mg 2x a day) can be very helpful.
Antifungals
When on either of these antibiotics it is critical that people be on antifungals (like the medication Diflucan and/or an herbal antifungal mix) and a low sugar diet to prevent yeast overgrowth. Otherwise you will initially feel better and then you will get worse and worse with the antibiotics. In my practice, I use a Diflucan dose of 200 mg a day for 6-12 weeks, and then 200 mg 2x day each Sunday for as long as the person is on antibiotics, plus an herbal antifungal mix each day for 2-5 months. Also note that coffee can aggravate the symptoms of prostatitis.
Other Therapies & Advice
If symptoms persist despite the antibiotics, see the sections on: