What Treatments Are Available For An Enlarged Prostate
For men diagnosed with benign prostatic hyperplasia , there are various treatment optionsfrom lifestyle changes, medication, to surgery. Men may be overwhelmed by the amount of options available and fearful of potential side effects. Urologist Dr. Stephen Summers explains what treatments are available and which options may work best for you.
Interviewer: For men who have been diagnosed with an enlarged prostate, there are a lot of treatment options, but it can be a little overwhelming. And some men fear about the side effects of those treatment options. We’re going to sort through that today.
Dr. Stephen Summers is a urologist at University of Utah Health, and he’s going to help us better understand the treatment options available for an enlarged prostate and, more importantly, understand what you would want to weigh as a patient when you’re having a discussion with your physician or urologist about those different treatment options. So you were telling me that sometimes men put off treating an enlarged prostate because of the fear of side effects. So let’s start there. Treatment options have side effects. Do they all have side effects?
Interviewer: Okay. So can you talk us through that a little bit? So, if I understand, the hierarchy is lifestyle changes first. And you’ve given us a great reason to want to do that to avoid the side effects of medication. But then it would be medication next. So talk us through, what are some of the options there?
Best Drugs To Shrink Prostate
Question posted by warren123 on 29 April 2012
After a medical procedure i developed a blatter infection and my prostate squeezed off my urine flow. I am on a catheter and .4 mg of Tamsulosin per day. They took the catheter out after a week and had to put it back in. Is there a stronger drug that may help or maybe stronger Tamsulosin dosage. I have just finished the doxycycline 100mg for 10 days. The infection is gone should my prostate shrink back? Before the procedure the prostate was weak but OK for my age. IE once or twice a night if i drank within 2-3 hours and occasionally I did not have to get up at all. Weak stream but ok I am 66.
Can i expect the prostate to go back down in size with time or should i be aggressive with my meds?
Enlarged Prostate Beware Of These Dangerous Drugs
If you walk into your doctors office with symptoms of an enlarged prostate, chances are youll walk out with a hormone-based drug.
These medications are a standard treatment. They include the drugs Avodart and Proscar. But a new study shows that when you take them, its likely youll only be trading one health problem for another.
The research shows the medications can lead to type 2 diabetes, high levels of bad cholesterol, liver disease, and worsening erectile dysfunction.1
Boston University School of Medicine scientists looked at 460 men treated for enlarged prostate.
Half were prescribed Avodart . It uses hormones to reduce the size of the prostate. This in turn improves urinary function.2
The other half were prescribed Flomax , a non-hormonal alpha blocker. It doesnt shrink the prostate. Instead, it works by causing the smooth muscle tissue of the gland to relax. This makes urination easier.3
After a follow-up of 36-42 months, the researchers performed blood tests and assessed prostate size and function. Compared to Flomax, they found that Avodart was associated with an ongoing rise in blood sugar levels, and an increase in LDL bad cholesterol levels. It also increased markers for liver disease.
Men on Flomax experienced smaller but still significant side effects. Their cholesterol also went up. But their good HDL levels went up along with their LDL.
The study appears in the journal Hormones Molecular Biology and Clinical Investigations.
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How We Picked The ‘best Buy’ Drugs For Bph
Our evaluation of medicines used to treat urinary problems due to BPH is based primarily on a systematic review conducted by researchers at the U.S. Department of Veterans Affairs and Oregon Health & Science University Evidence-based Practice Center.
Researchers screened studies conducted from 1966 through July 2006 and focused on 62 that were well-conducted, and closely examined the effectiveness and/or safety of the drugs. A consultant to Consumer Reports Best Buy Drugs is also a member of the Oregon-based research team, which has no financial interest in any pharmaceutical company or product.
The full review of drugs for BPH is available at
In addition, we adapted material from Consumer Reports Health, an online subscription Web site presenting treatment options and Ratings .
Consumers Union and Consumer Reports is solely responsible for selecting the Best Buy Drugs. Our methodology is described in more detail in the Methods section at www.CRBestBuyDrugs.org.
Alpha Blockers: Risk And Benefits
These BPH medications work fast to address symptoms, but they are not without risk. These drugs work by lowering blood pressure and may contribute to dizziness, headaches, weakness, and other side effects. In addition, they may result in sexual performance issues, including difficulty ejaculating. The impact on your blood pressure will certainly need to be evaluated so that other health issues are not adversely impacted. Although these drugs do tend to lower cholesterol, there is some evidence of long term negative effects on heart health.
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Proven Ingredients In Best Prostate Supplements Learn The Science
The research on prostate supplements and natural ingredients used in the treatment of BPH is insufficient to know for sure if these products work.
Most research was done on Saw Palmetto, Green Tea, Zinc, and Calcium and the study findings are frequently inconclusive. However, these ingredients were found to help some men find relief from their symptoms, and more research is needed to understand how these products help men treat BPH.
Saw Palmetto An herbal extract thats been consistently found useful in clinical trials investigating its effect on prostate function.
One such study was published in 2000 in the Journal of Urology by researchers at the University of California Los Angeles School of Medicine.
In this study, 44 men with an enlarged prostate received either a saw palmetto supplement or a placebo pill. Saw Palmetto can help shrink your prostate and improve urinary symptoms.
Beta-Sitosterol It has powerful prostate-shrinking effects. A clinical trial conducted by researchers in Germany followed a group of men randomly selected to receive either a beta-sitosterol supplement or a placebo for six months.
After six months of follow-up, the researchers reviewed the results and determined that the beta-sitosterol supplement was effective at reducing symptoms compared to a placebo. The researchers then followed a subset of these subjects for another twelve months.
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Possible Cancer Protection From Prostate Drugs
Early research suggested that 5-alpha-reductase inhibitors , a class of drugs used to treat prostate enlargement, might increase the risk of developing more aggressive prostate cancer. However, newer studies have found that not only do the drugs appear to pose no extra risk, they may even protect against prostate cancer.
For instance, research from the Prostate Cancer Prevention Trial study in 2013 showed that taking the 5-ARI finasteride for seven years could lower the chance of getting low-grade prostate cancer by 25% among men ages 55 and older. A follow-up study of almost 9,500 men, published in the Nov. 1, 2018, issue of the Journal of the National Cancer Institute, also showed that finasteride lowered the risk by a similar amount , and found the protective effect lasted for at least 16 years.
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Using Medication To Reduce Symptoms
How To Treat Enlarged Prostate Naturally At Home: 5 Tips
Enlarged prostate, aka benign prostatic hyperplasia , is the disorder generally impacting males over 50 years old and older. This condition is not similar to prostate cancer.
If left untreated, an enlarged prostate could block the urine flow, resulting in other complications such as UTIs, kidney damage, urinary retention, and bladder stones.
There are a few effective treatments for this condition, containing medications, surgery, and therapies. However, before you go for those treatments, consider using some natural ingredients available in your home to deal with your problem naturally. Here, VKool.com introduces some useful tips on how to treat enlarged prostate naturally at home that you could implement right instantly. Check out now!
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Supplements That Show Promise
Other supplements show hopeful signs of helping in studies so far, but thereâs less research on these than the more common options.
Pumpkin seeds: These and pumpkin seed oil extract seem to help with BPH symptoms and may shrink the size of the prostate. It may also be helpful when used along with other supplements such as saw palmetto.
Stinging nettle: This is a type of herb, and its root may help with urine flow and waking up a lot at night to pee. Itâs sometimes used along with other supplements to treat BPH symptoms.
Combination Therapy: Risk And Benefits
The benefits of combination therapy are clear however, side effects may be more likely. The potential interactions of both BPH medications with other health issues and medications are more complicated with combination therapy. Common side effects of combination therapy may include any of the issues from each drug class. These include, but are not limited to:
- Reduced sexual desire
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Table 5 Description Of Bph Drugs And Their Side Effects
|Type of medication
|Relaxes muscles in bladder
|Shrinks prostate tissue by blocking a hormone
Decreased sex drive
Decreased ability to get and keep an erection
With the older drugsdoxazosin, terazosin, and prazosinyour doctor should start you on a low dose and build up to a higher dose over a period of a few weeks to give your body time to adjust to the medicine. That process is not necessary with the newer alpha-blockers .
Low blood pressure caused by the alpha-blocker medicines can fall to dangerous levels if you’re also taking a high blood pressure drug or erectile dysfunction medicines such as sildenafil , vardenafil , and tadalafil . So don’t take an alpha-blocker with those other drugs without first discussing it with your doctor.
Men with prostate enlargement who are planning to have cataract surgery should be aware that all alpha-blockers can cause a complication called intra-operative floppy iris syndrome, or IFIS. This condition causes the iris of the eye to become limp due to increases in fluid levels in the eye. This is a concern because it can raise the risk of a painful and extended recovery period from cataract surgery, and a reduction in visual acuity or sharpness after the surgery. You should alert your eye surgeon that you are taking alpha-blockers if you plan on having this surgery.
Our Best Buy Pick
If doxazosin does not bring enough relief, you could try terazosin next. Or you could also try adding finasteride.
What The Researchers Did
Dr. Rose and his colleagues speculated that this doubling occurs infrequently in the general medical community. To investigate, they looked at 80,750 prostate cancer cases documented in the Veterans Affairs database between 2001 and 2015. They focused specifically on differences between men who either were or were not taking 5-ARIs when they were diagnosed with prostate cancer. The men on 5-ARI inhibitors had been taking the drugs for a median of 4.8 years before the prostate cancer was detected.
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Lifestyle Tips For Managing Bph
Lifestyle tips that may help someone manage the symptoms of an enlarged prostate include the following:
- Attempt to urinate at least once before leaving home to avoid urinary leakage or other incidents in public that can be very stressful and embarrassing.
- Double void by trying to urinate again a few minutes after urinating the first time, to drain the bladder as much as possible during bathroom visits.
- Try not to drink fluids in the 2 hours before bedtime to avoid going to sleep with a full bladder.
- Try to stay hydrated by drinking at least 2 liters of water daily.
- Try maintaining a healthy body weight as much as possible.
- Exercise regularly and as often as possible.
- Try not to drink too much at one time.
- Try to reduce or avoid stress to reduce the urge for urination.
- Avoid or limit products that cause dehydration, such as cold medications and decongestants
- Use absorbent urinary pads or pants to absorb urine leaks and decrease wetness and discomfort.
- Use urethral massage, after urinating, by gently pressing the fingers upwards from the base of the scrotum to try to squeeze out any urine left in the urethra and prevent any leakage later.
Popular Drugs Used For Treating Enlarged Prostates Associated With High
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
If a man has an enlarged prostate, theres a good chance hell be treated with a type of drug called a 5-alpha reductase inhibitor . These drugs shrink the gland to improve urinary flow, and the approved forms used for treating enlarged prostates come in two varieties: Proscar and Avodart .
However, a side effect of 5-ARI inhibitor treatment is that it suppresses blood levels of prostate-specific antigen by about 50%. Doctors measure PSA during prostate cancer screening, and if a man on 5-ARI therapy winds up with results that are artificially low, then he might be falsely reassured that he doesnt need any additional prostate cancer testing.
A new study with just over 80,000 prostate cancer patients highlights this risk. Men in the study who developed prostate cancer while taking a 5-ARI inhibitor had significant delays in diagnosis compared to nonusers. And because those cancers were discovered at more advanced stages, the mens outcomes were also comparatively worse. The study was led by Dr. Brent S. Rose, assistant professor in the department of radiation medicine and applied sciences at the University of California, San Diego School of Medicine.
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Causes Of Benign Prostate Enlargement
The exact cause of benign prostate enlargement is unknown, but research suggests that hormones probably play an important role in the condition’s development.
Hormones are powerful chemicals that can have a wide range of effects on the cells of the body.
One theory is that as some men and anyone with a prostate gets older, the levels of a type of hormone called dihydrotestosterone increases, which may stimulate the growth of the prostate.
Another theory suggests that two hormones, testosterone and oestrogen, play a role. Younger men and anyone with a prostate produce high levels of testosterone and much smaller levels of oestrogen. But as they get older, levels of testosterone decrease, which means they then have a higher proportion of oestrogen in their body. It’s been suggested that the relative increase in oestrogen may stimulate prostate growth.
How Should This Medicine Be Used
Tamsulosin comes as a capsule to take by mouth. It is usually taken once a day. Take tamsulosin 30 minutes after the same meal each day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tamsulosin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow tamsulosin capsules whole do not split, chew, crush, or open them.
Your doctor will probably start you on a low dose of tamsulosin and may increase your dose after 2 to 4 weeks.
Tamsulosin may help control your condition, but it will not cure it. Continue to take tamsulosin even if you feel well. Do not stop taking tamsulosin without talking to your doctor.
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Medication And Surgical Treatments
You can also take dutasteride or finasteride , a different kind of medication for reducing BPH symptoms. These block the hormones that cause the prostate to grow.
Combining several types of medications may also be recommended. Your doctor might also recommend surgery to remove the extra prostate tissue. One common surgical procedure for BPH is known as transurethral resection of the prostate .