Bodybuilding, steroids and prostatitis

[webslave]

The prostate is an organ I associate with old men. Surgical-gloved fingers. Not, in any way, an organ I should be aware of. And yet I was, because the benign little organ had swollen to the point where it felt like a fist-sized balloon pressed against my testicles. This is a fairly common side-effect; some professional bodybuilders get prostatitis to such an extent they require a catheter.

http://lifeandhealth.guardian.co.uk/hea ... 11,00.html

[J Dimitrakov]

The prostate is an organ I associate with old men. Surgical-gloved fingers. Not, in any way, an organ I should be aware of. And yet I was, because the benign little organ had swollen to the point where it felt like a fist-sized balloon pressed against my testicles. This is a fairly common side-effect; some professional bodybuilders get prostatitis to such an extent they require a catheter.

http://lifeandhealth.guardian.co.uk/hea ... 11,00.html

This is an interesting fact. I have had several bodybuilder and athletes that I have been treating for the past 5 years. One of them had changes notable in the prostate on DRE consistent with BPH even though he was only 30. He also had severe prostatitis symptoms and the only relevant fact in his past medical history was excessive use of steroids.

Best,
JD

[garyholc]

Perhaps this would help point to the muscles as the primary reason for Prostatitis/CPPS given the extreme stress many of these men place on their muscles in the pelvic area. Infact, should we even be using the word prostatitis anymore as to me, it sounds more like an infection. While there is a form of this condition caused by bacteria in a very small number of cases, I always speak now of it as chronic prostatitis / chronic pelvic pain syndrome and not prostatitis.

Going back to the pelvic muscles bit, something dawned on me a few days ago as to the possible cause of my condition. A few months before the onset of my symptoms, I remember having to push my motorbike into my garage as it wouldnt start. I had a heavy motorbike and my garage is uphil into my house. Pushing the bike was one hell of struggle, but got there eventually. I remember the next day aching so much in my pelvic region. Maybe that was the kick start for my condition and the stress and anxiety that followed just developed it more.

Maybe the doctor can answer this one, but would there not also be a high occurance of this condition with regards men who do a lot of cycling?

[superuse]

There seems to be a huge correlation between a bike and the PNE and pelvic pain patient boards. Mostly bicycle but motor also. About 30-40% alone of men (and perhaps women) have something to do with a bike, mostly long term but some for as little as a few weeks.

The risk factor seems to be earning your daily bread and livelihood sitting 50 or so hours a week (with all the stress that entails with deadlines and family commitments and such) combined with an amateur or semi pro relationship with a bike, running or weights. The pros (the small # earning their living doing it) seem to have far fewer problems especially proportionate to the amount of time and effort expended. They don't sit the 50 hours tensed staring at a crt.

With all the symptoms of testicular shrinkage and sexual dysfunction related to heavy steroid use, the prostate finding I find unsurprising, if anything that it is not more common. I think there were some grade schoolers caught distributing and taking them for knothole baseball around here.

--jjf

[J Dimitrakov]

Perhaps this would help point to the muscles as the primary reason for Prostatitis/CPPS given the extreme stress many of these men place on their muscles in the pelvic area.

Actually, at least in the bodybuilder/steroid users, the underlying mechanism is NOT related to muscle floor dysfunction. There is a large body of evidence examining the mechanisms involved, mostly related to BPH and its symptoms.

In contrast, in the case of bicycle riders, some patients show evidence of pelvic floor dysfunction. Another subset show evidence of abnormal blood flow in the pelvis. I think we need to be careful and not lump everything under the same umbrella. chronic prostatitis / chronic pelvic pain syndrome is MULTIFACTORIAL, and as we know, different things work for different people

Best,
JD

[webslave]

There were several posts from way back on google groups about androstenedione, a testosterone precursor eg
http://groups.google.com/group/sci.med. ... 1c73d6edfd

[J Dimitrakov]

There were several posts from way back on google groups about androstenedione, a testosterone precursor eg
http://groups.google.com/group/sci.med. ... 1c73d6edfd

Great point, webslave. Actually, there is some data to back this up now - in our adrenocortical paper we measured androstenedione and it was HIGHER in men with chronic prostatitis / chronic pelvic pain syndrome as compared with controls. Just an independent confirmation of an interesting observation from the Google posts. Therefore, whether you have an inborn (genetic, as shown in our paper) or acquired (by taking extra androstenedione as a supplement, as shown in the posts you refer to above), the HIGHER androsterone levels seem to correlate with (worse) chronic prostatitis / chronic pelvic pain syndrome symptoms

best,
JD

[TJ88]

Well I will admit when I stopped weight training my legs (deadlifts, squats), I felt a lot better. A lot of these exercises hit the pelvic floor muscle. The most noticeable thing is I had premature ejaculation, now that I stopped weight training my legs its 100% gone. Its actually quite the opposite now and is difficult to ejaculate sometimes. (although I much prefer that than premature =P)

[superuse]

Well I will admit when I stopped weight training my legs (deadlifts, squats), I felt a lot better. A lot of these exercises hit the pelvic floor muscle. The most noticeable thing is I had premature ejaculation, now that I stopped weight training my legs its 100% gone. Its actually quite the opposite now and is difficult to ejaculate sometimes. (although I much prefer that than premature =P)

All exercise hits the pelvic floor muscle, to one degree or another. This is especially true with weightlifting and the abdominal and bracing needed for just about anything. Some men will squeeze their ass and ab muscles on the last few reps of a arm curl as much as squats. (if they even train legs) Obviously deadlifts (especially stiff legged) or heavy squats and leg presses are the worst.

Most of the men on the chronic prostatitis / chronic pelvic pain syndrome boards in one way or another meet my signature below, a IT(mostly and especially IT), accounting or professional job sitting many hours a week combined with an amateur relationship with a bicycle, jogging or weights. Add an anxious nature (or anxiety disorder), an unrealized tendency to clench the ab and pelvic muscles and/or a heavy sexual load and you may have a majority of chronic prostatitis / chronic pelvic pain syndrome men (and perhaps women).

I would bet if Dr. Wise could have $100 for every time he's heard something of the sort, "When can I return to cycling/weightlifting/etc again?" or "are my cycling/lifting/running days over?" He would probably be doing the clinics for free and retired on the Malibu coast.

I probably cannot recommend enough, for most sufferers to DUMP THE WEIGHTS for an extended period. Also the bike or running, although more obvious for the bikers. ( the area involved is tender) This goes for all heavy exercise, with slow experimentation with light stretching and walking. Wise mentions stretch injury as one of the causes of pelvic pain, so Yoga, and especially its modified "power" forms is suspect too. If one feels like an empty life without the weights or cycle (or karate, tennis, racquetball, running), then the recommendation for eliminating it is doubled. The combination of hours of a sit down stressful job, with fewer hours weekly of heavy exercise as a compensation for job stress or anxiety may be what gets many here, and new mechanisms and hobbies have to be developed.

This is difficult as it catches most flat footed. The sit down job is still there, the job/life anxiety is still there, the new anxiety of the pelvic pain is here, and we must eliminate the exercise (the previous coping mechanism for job and life stress and now part cause of the pelvic pain) and deal with it all now. Complicating the issue is that this is not initially obvious (although many suspect it) and continue with the heavy lifting, running, biking, until the pelvic pain literally forces no or reduced exercise. For most this is accompanied by thousands of dollars of medical tests, scopes, the urology/procto/gastro visit du jour, and puzzled looks from medical professionals (who's Rx may eventually be "mental case").

Obviously this isn't the model for all. But the concept that it may closely describe close to 70 percent or more of cases I would think means the contribution of heavy exercise to pelvic pain can't be ignored.

As usual, good luck to all
--jjf

[benzo]

As you say, this will not work for everyone.

Personally I have found no direct correlation between weight lifting and my symptoms. I do find that working out in general relieves stress and contributes to general well being, which is crucial in fighting this condition. After a session, I do stretch extensively.

I'd say it's not necessary to drop all the things you love to do because in the long run that will cause more stress. The best thing is to find a balance between your work life, personal life and sports. You can practice the SF protocol and still be able to lead an active lifestyle as long as you find out what works for you and that really is a personal matter.

[garyholc]

One thing that worries me are my pelvic muscles wasting away so to speak due to no exercise. When I did some gardening the other week, my legs wouldnt stop shaking. Same when doing the cleaning in the house sometimes, my legs tremble. Its horrible!! But then we are advised against doing any exercise to build up the muscles, so are we lining ourselves up for trouble in old age - i.e are people with this condition more likely to end up with walking sticks in old age?

[webslave]

Not at all. After my bad years, I remember that walking up stairs would leave my legs trembling. Now I am strong again, even wrestle with my bodybuilder son! You have no idea how profound the body's recuperative powers are.