Benign prostatic hyperplasia (BPH) is a common condition that can cause frustrating urinary symptoms like:
- A slow stream
- Frequent nighttime trips to the bathroom (nocturia)
- Trouble starting to urinate
Your prostate is a small gland located just below the bladder. It surrounds the urethra, the tube that carries urine out of the body. As men age, the prostate gland often grows in a way that can lead to these symptoms. As the prostate grows larger, it can squeeze or block the urethra, causing changes in how you urinate.
Fortunately, there are several BPH drugs available to help you control unwanted symptoms and reclaim your life.
Can BPH Drugs Help My Symptoms?
Yes, BPH drugs can be an effective way to manage enlarged prostate symptoms.
Medications are often the first step in treatment. This is especially true if your symptoms are mild to moderate. Some medications relax the muscles in the prostate and bladder neck to improve urine flow. Others gradually shrink the prostate over time. Your doctor may recommend one or a combination of these medicines based on your symptoms.
Oral Medications for BPH
Most people begin treatment with medications taken by mouth. There are several different drug classes, each working in a different way.
Alpha-blockers
These medications relax the muscles around the bladder neck and prostate, making it easier to urinate. They're often the first option used, especially when symptoms need quick relief. You may notice improvement within a few days to a couple of weeks.
Common alpha-blockers are:
- Tamsulosin
- Alfuzosin
- Doxazosin
- Terazosin
Possible side effects may include:
- Feeling dizzy or lightheaded, especially when you stand up
- Tiredness or low energy
- Stuffy nose
- Changes in ejaculation, such as less semen during orgasm
- Low blood pressure, which is more likely with older medications like terazosin
These medications can interact with drugs for erectile dysfunction (ED). It's important to discuss all prescriptions with your provider.
5-alpha-reductase inhibitors (5-ARIs)
Unlike alpha-blockers, these medications shrink the prostate over time by lowering levels of a hormone called DHT (dihydrotestosterone). This hormone is responsible for prostate growth. These drugs take longer to work, usually 3 to 6 months, and are most effective in men with significantly enlarged prostates.
Common 5-alpha-reductase inhibitors are:
- Finasteride
- Dutasteride
Possible side effects may include:
- Reduced libido
- Erectile dysfunction
- Smaller semen volume
- Breast tenderness or enlargement, called gynecomastia
These drugs may lower PSA levels, which is important to remember during prostate cancer screening.
Some men get better results by taking both an alpha-blocker and a 5-alpha reductase inhibitor. This combination offers the advantage of quick symptom relief from the alpha-blocker and long-term prostate shrinkage from the 5-ARI. One example is a single pill that combines dutasteride and tamsulosin. While symptoms may start to improve early on, the full benefits, especially reduced prostate size, can take several months. Because two medications are used together, there may be a higher chance of side effects.
Phosphodiesterase-5 inhibitors (PDE5 inhibitors)
Tadalafil, a medication often prescribed for ED, is also FDA-approved to treat BPH. It helps by relaxing the smooth muscles in the prostate and bladder, which can ease urinary symptoms. This option may be especially useful for men who have both BPH and erectile dysfunction. Some symptom relief may begin within 2 to 4 weeks.
Possible side effects include:
- Headache
- Back pain
- Indigestion
- Dizziness
- Warmth or redness in the face or body
Which BPH Drugs are Right for You?
BPH is a common condition that affects many men as they age. The good news is that several effective medications are available to help you feel better. An experienced urologist can help you find the right BPH drugs for your unique situation.
If you're dealing with ongoing urinary symptoms, it's time to schedule an appointment!