sean000

I was also about 36 when I had my first bout with prostatitis. Like you I had been riding over 20 years. I entered my first race when I was 13, raced off and on until I was 20, then got into mountain biking, and later a mix of road, mountain, and touring. My mileage isn't as high as it used to be, so by 36 I was carrying a bit of a spare tire but overall ate healthy food and stayed active. I'm 39 now and still active, but it would be good to lose ten or fifteen pounds (working on it). I pretty much always used racing saddles...a Flite was my longest used saddle (even on my mountain bikes I rode narrow saddles) and in later years Brooks B17. The effect of the saddle of open to much debate, but of course most saddles put pressure on the perineum, which could affect blood flow down there. My regular doctor, and my brother who is a doctor and a cyclist, do not think the saddle has anything to do with it. They both see patients with similar symptoms who are not cyclists. The specialist I saw did advise switching to a cut-out, but for comfort reasons more than anything else. I tried a conventional cutout saddle and switched back to the Brooks after a single ride! It was my fault though...I knew I was buying a saddle that was too wide and too padded. I may try a Brooks Imperial. The Brooks B17 is totally comfortable most of the time, but when I have a flare up that feels like sitting on a golf ball a cut-out saddle would be nice.

I did not cut out caffeine, alcohol spicy foods, citrus, tomatoes, etc. I probably drink two cups of coffee a day (three some days), and most days I will have a beer or a glass of wine with dinner. My doctor did not think diet had much effect, but again this is one of those areas open to debate since the evidence isn't absolutely clear. If my symptoms had gotten worse, or not gotten better, I probably would have started to cut things out of my diet just to try something. I have read about using saw palmetto on some sites, as well as cutting out spicy or acidic foods, alcohol, and caffeine; but these are all things I enjoy so much! And everything I've read says that sex, or at least regular ejaculations, is supposed to be excellent treatment for prostatitis!

Since 2006 I have had flare ups usually in late Winter to early Spring. Flare ups have happened during periods when I haven't been riding at all. Neither my doctor or the urologist wanted to give me a PSA test. They said they don't like to give those to guys in the 30s and that the test results would not change their opinions as to how I should be treated - which is basically to not treat it. My regular doctor, as well as my previous doctor, put me on long courses of antibiotics when my symptoms were at their worst. I hated taking lots of antibiotics, and when I finally saw a urologist he agreed that I should not be treating it with antibiotics. He also advised Advil if symptoms got bad, but said to call my doctor if things get really bad. His advice was to take care of myself by staying in shape, eating well, getting enough sleep, and managing stress.

One thing that has helped me has been to keep a diary of symptoms. I don't think my prostate will every be a normal size again (the urologist agreed), but most of the time I barely notice any symptoms like more frequent urination, the sensation of sitting on a golf ball, pain with urination, etc. Those types of symptoms come and go...sometimes lasting a single day to a few days. If they last more than a week they tend to get worse. When I do have symptoms, I log them into an iPhone app with notes about how I otherwise feel, what I ate, how much I slept, stress, levels, if I've been riding, etc. Based on doing that for a couple of years it seems like my flare ups happen more frequently when I am less active and too overweight (my ideal weight is around 175, but I usually range between 185 and 195). Once I get to be 20 pounds overweight, all kinds of problems happen. If I keep it down I tend to feel better and have fewer flare ups. Is it weight or the fact that I'm more active and in better shape when I'm closer to my ideal weight? I don't know... but it just keeps driving me back to one comforting fact: Cycling is not part of the problem. It is part of the solution. I put in more mileage between the months of June and November, and those are the months I tend to go the longest in between symptoms.

The urologist also suggested I make sure I stay well hydrated. My symptoms have always been worse in the morning, so the first thing I do when I get out of bed is to drink a tall glass of water. I try to stay hydrated throughout the day. When I am having symptoms this seems to really help.

It has been about a year since my last really bad bout with symptoms. I have days every now and then when it feels like I'm sitting on a golf ball, and I may notice a slight increase in the number of bathroom visits, but I can live comfortably with that. I'm just hoping it doesn't get more acute and more frequent as I get older. Just one more reason I need to keep exercising and keep my weight down.

Forgot to add that last year I was also treated during a major bout with Doxazosin (Cardura I believe). I'm not sure why he prescribed that instead of Flomax, but the idea was to improve blood flow to the prostate. Not sure if it helped much, but he did not want me to continue after it got better.