Prostatitis is inflammation of the prostate. The prostate is a walnut-sized gland in men that surrounds the urethra. It produces a fluid that is part of semen. There are three main types of prostatitis: acute bacterial, chronic bacterial, and chronic non-bacterial.

Acute bacterial prostatitis is the easiest form to treat, but it is also the least common. Symptoms include chills, fever, pain in the lower back and genital area, urinary frequency and urgency (often at night), burning or painful urination, and body aches. Examination of the urine shows white blood cells. Antibiotic treatment is highly successful for this form of prostatitis.

Chronic bacterial prostatitis resembles acute prostatitis, but it is milder and may go on for a long time (months or years). It is believed that chronic bacterial prostatitis is caused by a problem in the prostate that makes the gland a focus for infection. Antibiotic treatment usually relieves symptoms, but they often come back after treatment is stopped.

Chronic non-bacterial prostatitis, also known as chronic pelvic pain syndrome or prostatodynia, is the most common form of prostatitis. Unfortunately, it is also the least understood and the hardest to treat. Symptoms include urinary urgency, urinary frequency (especially at night), pain or burning while urinating, difficulty urinating, lower abdominal pain or pressure, rectal or perineal discomfort, lower back pain, painful ejaculation, and impotence. These symptoms may wax and wane for no obvious reason. Conventional medicine lacks a specific treatment for chronic non-bacterial prostatitis. Supportive treatments may be used, including stool softeners, pain medications, and warm sitz baths.

Quercetin belongs to a class of water-soluble plant coloring agents called bioflavonoids, which have anti-inflammatory and antioxidant properties. Bioflavonoids have been investigated for a wide variety of medical uses. A study published in 1999 suggests that quercetin may be helpful for chronic non-bacterial prostatitis. In this double-blind trial, 30 men with fairly severe chronic non-bacterial prostatitis were given either quercetin (500 mg twice daily) or placebo for a month.¹ The results showed that participants given quercetin improved to a significantly greater extent than those in the placebo group. The greatest gains were seen in reduction of pain.

A special grass pollen extract has also shown promise. In a 6-month, double-blind study of 60 men with non-bacterial prostatitis, use of the grass pollen extract was more effective than placebo.⁹ Grass pollen is better known as a treatment for benign prostatic hypertrophy (BPH). All the other commonly used natural treatments for this condition have also been suggested for prostatitis. However, while there is reasonably good supporting evidence that some of these help BPH, the evidence regarding their use in prostatitis remains weak. For example, uncontrolled trials and other highly preliminary forms of evidence hint that the herb pygeum might be helpful for prostatitis.^6,7 Also, an open-controlled trial (using a no-treatment group) found indications that saw palmetto might be helpful for prostatitis;⁸ however, an open comparative study found the drug finasteride more effective than the herb for this purpose.²

Interestingly, a combination of herbal extracts (including Serenoa repens (@saw palmetto@), Urtica dioica (@neetle@), @curcumin@ and quercitin) may turn out to be modestly beneficial as additional treatment. In a trial of 143 men with chronic bacterial prostatitis, the preparation enhanced the effectiveness of a two-week course of antibiotic (prulifloxacin in this case).¹¹

Other herbs and supplements sometimes recommended for prostatitis, but that lack almost any supporting evidence, include bromelain, buchu, couch grass, cranberry, echinacea, eleutherococcus, garlic, goldenseal, lapacho, marshmallow, multivitamin/mineral supplements, pipsissewa, proteolytic enzymes, vitamin C, watermelon seed, and zinc.

Acupuncture and biofeedback have been tried as well. A study involving 89 men with chronic nonbacterial prostatitis, a 10-week trial of acupuncture was modestly more effective than sham (fake) acupuncture at relieving symptoms, both during treatment and for a period of 6 months following treatment.¹⁰

Various herbs and supplements may interact adversely with drugs used to treat prostatitis. For more information on this potential risk, see the individual drug articles in the Drug Interactions section of this database.