Scientific augmentation of BPH and its treatment in Unani medicine the review

Background: Benign Prostatic Hyperplasia (BPH), or enlargement of the prostate gland, is a prevalent condition among aging males, especially those over 50. It presents with lower urinary tract symptoms (LUTS) that impact the quality of life. In Unani medicine, BPH correlates with conditions such as Izam Gudda-e-Mazi and is interpreted through the lens of humoral imbalance, particularly thick phlegm (Balgham Ghaliz) obstructing urinary pathways. Modern and Unani systems both recognize the progressive nature of BPH and its potential complications, such as acute urinary retention and infections. Methods: This review integrates modern scientific findings on the pathophysiology, epidemiology, and treatment of BPH with Unani perspectives. It draws on current biomedical data—highlighting hormonal factors (like DHT and estrogen), metabolic syndrome, and inflammation—and compares them to Unani etiologies rooted in humoral imbalance and organ inflammation. Management strategies from both systems are explored, including allopathic pharmacotherapy (e.g., alpha-blockers, 5α-reductase inhibitors), and Unani therapies such as Ilaj-Bil-Dawa (herbal remedies), Ilaj-Bil-Tadbeer (regimental therapy), and Ilaj-Bil-Ghiza (dietary measures). Results: Modern medicine provides pharmacological and surgical solutions for BPH, albeit with potential side effects such as erectile dysfunction and reduced libido. Meanwhile, Unani treatment emphasizes natural, multi-herbal preparations that possess anti-inflammatory, diuretic, and 5α-reductase inhibitory properties. Herbal combinations—such as those including Nepeta ruderalis, Zingiber officinale, and Foeniculum vulgare—are traditionally used to alleviate symptoms like dysuria and urinary retention. Complementary medicine's rising global popularity reflects a growing preference for safer, natural alternatives. Conclusion: The convergence of Unani and modern perspectives on BPH enhances our holistic understanding of the condition and expands the therapeutic options. Herbal formulations grounded in Unani medicine offer promising, less invasive alternatives with minimal side effects. Continued scientific validation of traditional remedies could significantly benefit BPH management by reducing reliance on surgical and synthetic pharmaceutical interventions. Keywords: Prostate gland, Prostate enlargement, LUTS, BPH, Unani, Greco-Arab medicine