Since the early 1990s, millions of American men with mild-to-moderate symptoms of BPH have chosen prescription drugs over surgery as their treatment approach.
There are three main types of drugs used for treating BPH:
- 5 alpha-reductase inhibitors
- Phosphodiesterase type 5 inhibitors (PDE5 inhibitors).
Alpha-blockers used to treat BPH help relax muscles near the prostate to relieve pressure and let urine flow more freely, but they don't shrink the size of the prostate. For many men, these drugs can improve urine flow and reduce BPH symptoms within days.
Possible side effects for this BPH treatment include:
5 Alpha-Reductase Inhibitors
5 alpha-reductase inhibitors, known as finasteride or dutasteride, shrink the prostate. These medications reduce symptoms by blocking an enzyme that acts on the male hormone, testosterone, to boost organ growth. When the enzyme is blocked, growth slows down. This helps to:
- Shrink the prostate
- Reduce blockage
- Limit the need for BPH surgery.
Taking this type of drug for at least 6 months to 1 year can increase urine flow and reduce the symptoms of BPH. It seems to work best for men with very large prostates. Patients must continue to take the drug to prevent their symptoms from coming back. This drug is also used to treat baldness in men (Propecia®).
5 alpha-reductase inhibitors can cause the following side effects in a small percentage of men:
- Decreased interest in sex
- Trouble getting or keeping an erection
- Smaller amount of semen with ejaculation.
It is important to note that taking this drug can lower your prostate-specific antigen (PSA) test levels. There is also evidence that finasteride lowers the risk of getting prostate cancer, but whether it lowers the risk of dying from prostate cancer is still unclear.