Autoimmune prostatitis

I’ve been thinking more and more about autoimmune prostatitis, as I feel it strongly correlates with my symptoms, so I’m creating this topic so we can share theories and treatments with regards to this condition.

I have two posts from this forum bookmarked on this topic:
viewtopic.php?p=53662#p53662
viewtopic.php?p=55822#p55822

A small introduction about myself, I tried propecia for only a few days 5 years ago. I developed prostatitis a few days later, and I’ve had pain for pretty much every single day since then. I’ve pursued the antibiotic route with no success, and the pelvic pain/trigger point therapy with equal success.
The only thing that gives me relief are Testosterone injections, which strongly correlates with what has been written about EAP (experimental autoimmune prostatitis). As does keeping my Estradiol low, with aromatase inhibitors. I’m currently having a relapse of symptoms because I didn’t notice the arimidex I was taking had expired, so I began having symptoms of high E2, and then prostatic inflammation significantly increased.

I’ve tried many things now, but only a couple of them targetting the autoimmune pathway, so I’d like to try these in the near future:

  • eviprostat (antihistamine and mast cell stabilizer, user 19 had success with it)
  • short trial of dexa or prednisolone (autoimmune conditions should respond to this, albeit not a good long term strategy)
  • PEA (palmitoylethanolamide, down-regulates hyperactive mast cells)
  • mepartricin (there were a couple of studies that had success using this in chronic prostatitis, apparently it works by reducing plasma and intraprostatic estrogen concentration. Neat!)
  • cabergoline (I remember reading somewhere that decreasing prolactin would have a beneficial effect, as would decreasing estrogen, in EAP)

VDRA have also shown promise in regards to autoimmune prostatitis, I read somewhere that there was study on elocalcitol, but it didn’t meet expectations.

It is very likely in my opinion that there is an element of prostatitis. It is not bacterial and is related to hormones. Estrogen induced prostatitis is thought to occur.

ncbi.nlm.nih.gov/pmc/articles/PMC2731137/

When i tried tribulus alone my prostate symptoms got much worse. Tribulus can increase testosterone (although evidence questionable) and it can increase estrogen. I have tried prednisolone in the past and also PEA and a dopamine agonist. None helped.

You can try something like eviprostat. You can try doxycycline and you can try progesterone. Reducing estrogen and increasing progesterone is in my opinion the best option. Perhaps testosterone too. I actually think solving this element is the a large contributing cause of erectile dysfunction.

Oops, I meant to write Ketotifen instead of Eviprostat, as you wrote that it significantly reduced and shifted your pain. How did that experience turn out btw?

I haven’t tried progesterone. I did try pregnenolone but without much success. Whats the rationale behind it?

Regarding testosterone it definitely helps, but you have to keep the levels near the upper limit, and also control your estradiol. That’s about the only thing that helped me significantly.

Doxy was one of the many antibiotics I took back when I thought I had bacteria. I don’t think it helped enough for me to notice. There was only one that did, moxifloxacin. I did that antibiotic 3 times, and when on it my pain was greatly reduced, so each time it reinforced the idea of a bacterial prostatitis and I kept going back on it. But last time, I figured something interesting, I did hormonal tests while on it: it showed estradiol very low (I could’ve guessed that one as I always get brain fog and knee pain when it’s overly low), and pregnenolone was like 5 times the upper limit. I now believe that is how moxifloxacin was helping me.

Anyway, another aspect of all this, is how come we now have symptoms, even though my homeostasis is about the same before and after taking propecia. Yes, I did have hormonal tests before taking propecia, and I had numerous after as well.
Maybe propecia just triggered autoimmune prostatitis that was bound to happen some years from now anyway. And perhaps intraprostatic aromatase and hormone levels are more difficult to manipulate than corresponding plasma levels.

“Thus, the observed enhancement of prostatic proliferation and cyclin-D1 overexpression might be attributed to auto-augmentation interaction between inflammation and oestrogenic activity.”
academia.edu/3673960/Estroge … ancer-LCMS

unboundmedicine.com/medline/ … secretion_

I’ll add a COX-2 inhibitor to my shopping list. There was a study on rofecoxib that showed significant improvement.

ncbi.nlm.nih.gov/pubmed/18514386
Intravesical botulinum toxin A injection has shown promise as a novel treatment for CPPS as well.

I’ve been looking into this for a while. I think there’s merit to it, at least in my case

urologytimes.modernmedicine.com/ … ng-chronic