Enlarged Prostate Treatment

Treating an Enlarged Prostate With Drug Therapy

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 two main types of drugs used for treating an enlarged prostate: alpha blockers and 5 alpha-reductase inhibitors. Alpha blockers relax muscles near the prostate, while 5 alpha-reductase inhibitors shrink the prostate gland. There is evidence that taking both drugs together for BPH treatment may be more beneficial than taking either drug alone.
 
Alpha Blockers
Alpha blockers used for treating an enlarged prostate 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 the symptoms of BPH within days.
 
Possible side effects for this form of treatment include:
 
5 Alpha-Reductase Inhibitors
5 alpha-reductase inhibitors, known as finasteride or dutasteride, shrink the prostate. This type of medication relieves 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 six months to one 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 it to prevent their symptoms from coming back. This type of 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.
 
Enlarged Prostate Medications
Category
Therapeutic Effect
Generic Name
Brand Name
Alpha blockers
Relax muscles near the prostate
prazosin
Cardura®
Flomax®
Hytrin®
Minipress®
5 alpha-reductase inhibitors
Slow prostate growth, shrink prostate
finasteride
dutasteride
 
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD
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