Who Needs A Drug
As we have already mentioned, many men with BPH dont have symptoms or their symptoms can be managed with lifestyle changes. About half of men of any age who have BPH will have symptoms that require attention and treatment that may involve taking one of the drugs we evaluate in this report. The percentage of men requiring treatment increases with age:
One in four men in their late 50s can expect to have symptoms that are bothersome enough to seek medical attention or treatment
One in three men in their late 60s can expect to have symptoms that are bothersome enough for them to seek medical attention or treatment, and
One in two men in their late 70s and beyond can expect to have symptoms bothersome enough to seek medical attention or treatment.
This means that millions of men are regularly taking drugs or using other treatment options to ease the symptoms of BPH.
The first advice wed give to any man bothered by problems when urinating is to see a doctor. Many men are reluctant to talk about urination problems with their doctor, but its important to get these issues evaluated as early as possible to prevent any complications that may be present, whether or not the patient is aware of them. Its important to note that some men dont notice any symptoms of BPH and their enlarged prostate is only discovered by their physician during a routine examination.
Getting a diagnosis
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
What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is an enlarged prostate gland. The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. This often causes problems with urinating.
BPH occurs in almost all men as they age. BPH is not cancer. An enlarged prostate can be a nuisance. But it is usually not a serious problem. About half of all men older than 75 have some symptoms.
Benign prostatic hyperplasia is also known as benign prostatic hypertrophy.
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What Are The Side Effects
Because alpha blockers reduce your blood pressure, they can lead to problems like dizziness too. They may also cause ejaculation problems, reducing the amount of semen released. It is possible to estimate how common these side effects are based on the results of studies:
- Ejaculation problems: In about 1 out of 100 men overall, and about 20 out of 100 men who are using silodosin.
- Dizziness: In about 4 out of 100 men.
- Feeling sluggish and tired: About 2 out of 100 men.
- Low blood pressure: About 2 out of 100 men.
- Stuffy and/or runny nose: About 1 out of 100 men.
But these side effects don’t necessarily last a long time and aren’t always considered to be a big problem. Only 1 out of 100 men in the studies stopped their treatment because of side effects.
To try to avoid side effects when taking doxazosin and terazosin, it is important to start with a low dose, and then gradually increase it.
If men who are taking alpha blockers for their prostate problems are thinking of using erection pills too, they should talk about it with their doctor first because the drugs may interact, causing problems like a drop in blood pressure.
What Is A Prostate
The prostate is a small gland that is part of the male reproductive system. Throughout a man’s life, the prostate produces semen, the fluid that contains sperm. As men age, the prostate gland may grow in size. This condition is referred to as an enlarged prostate or benign prostatic hyperplasia . Due to the position of the prostate in front of the bladder, BPH can cause pressure on the urinary system, and may cause a number of unpleasant symptoms.
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Your Quality Of Life With An Enlarged Prostate
If your enlarged prostate symptoms are mild and not bothersome, there’s likely no need for treatment. One-third of men with mild BPH find that their symptoms clear up without treatment. They may just watch and wait.
However, when enlarged prostate symptoms are bothersome or are affecting your quality of life or overall health, it’s time to talk to your doctor about the treatment options. Together you will determine if you would benefit most from medication, a minimally invasive procedure, or surgery.
It’s important to talk with a doctor when you begin noticing changes in urinary function. You need to find out what’s going on so you can be treated for enlarged prostate if necessary. For many men, especially those who are young when the prostate starts growing, getting early treatment can head off complications later on.
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What Happens When The Prostate Gland Enlarges
In benign prostatic hyperplasia, the prostate gland enlarges. Normally the size of a walnut, the prostate gland may become as large as a tennis ball. The enlarging prostate gland squeezes the urethra, which carries urine out of the body. As a result, urine may flow through more slowly, or less urine may flow through.
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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Using Pads Or A Sheath
Absorbent pads and pants can be worn inside your underwear, or may replace your underwear altogether. These will soak up any leaks.
Urinary sheaths can also help with dribbling. They look like condoms with a tube coming out of the end. The tube connects to a bag that you can strap to your leg under your clothing.
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How Effective Is Combining Drugs
Alpha blockers and 5-alpha reductase inhibitors are sometimes combined to try to relieve the symptoms as quickly as possible and at the same time prevent the prostate from growing further. This combination is considered for men who have severe symptoms and a very enlarged prostate gland. Their prostate gland is more likely to grow even larger.
Combining these drugs can lower the risk of the symptoms getting worse or complications arising. But these advantages only became apparent after one to two years of treatment, and only in men with very large prostate glands.
The disadvantage: Ejaculation problems and erection problems are more likely in people who use this combination than in people who only use alpha blockers.
Risk Factors For Prostate Cancer
Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesn’t mean that you will get prostate cancer. It just means that your risk of the disease is greater.
- Age. Men who are 50 or older have a higher risk of prostate cancer.
- Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
- Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a man’s relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
- Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.
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If You Don’t Have An Enlarged Prostate Diagnosis
Some men only discover they have underlying prostate problems when they begin taking decongestants. If you have only recently started experiencing urination problems and are using or have recently used any nasal or oral decongestant, it is important that you get your prostate symptoms checked as leaving this problem untreated can bring about secondary problems, such as:
Bladder infections: When urine is stored in the bladder and becomes infected.
Chronic retention of urine: When urine builds up over a period of months or years, the bladder can become desensitised and you are less likely to feel the need to go to the bathroom. This may result in a backflow of urine which can lead to kidney damage.
What Will They Give You To Relieve Your Prostate
Treatment options vary depending on the severity of the prostate issues, but they are typically as follows:
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What Causes Prostate Enlargement
The causes of prostate enlargement are not yet fully understood but are thought to be related to the male sex hormone which controls the growth of the prostate. The prostate is initially quite small, but as men age, testosterone feeds the prostate and it starts to get bigger. From birth to around the early teenage years, the prostate increases in size by around 8 times. It doubles again in size from around the early 20s through to 50 years of age, and then doubles again by around the age of 80. With such large increases in size, its easy to see why the prostate can begin to squeeze the urethra and make it difficult to urinate.
There may also be a genetic link to prostate enlargement, because the sons of men with an enlarged prostate are more likely to develop prostate disease.
Table 1 Classes Of Drugs Used To Treat Bph
|Generic Name||Available as a Generic Drug?|
1. Prazosin is prescribed off-label to treat BPH.
The erectile dysfunction medication, tadalafil , is approved for treating enlarged prostate symptoms, and a combination pill, Jalyn, which contains both dutasteride and tamsulosin, is also available. Neither of those were included in the analysis that forms the basis of this report, so we do not discuss them. However, the pros and cons of combination therapy with an alpha blocker and a 5-alpha-reductase inhibitor are discussed further below.
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About Half Of Men Older Than 50 Have An Enlarged Prostate Here Are Some Of The Basic Facts You Need To Know About This Common Condition
As men age, many experience prostate gland enlargement. This condition is known as benign prostatic hyperplasia .
The prostate gland surrounds the urethra, the hollow tube that carries urine out of the body. When the prostate gets bigger, it can squeeze or partially block the urethra, which leads to problems urinating.
BPH is quite common in older men. In fact, the condition impacts about 50% of men between the ages of 51 and 60. For men 80 and older, the prevalence of BPH is approximately 90%, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Aerobic And Resistance Exercises
Staying active is good for the prostate as well as overall health. Inactivity contributes to obesity, one of the risk factors for enlarged prostate.
Even a small amount of exercise like aerobic and resistance exercises can help reduce urinary problems caused by an enlarged prostate and can even prevent this problem.
- Aerobic exercises can help you maintain a healthy weight. Incorporate aerobic exercises like walking, jogging, running, tennis, basketball and rowing in your daily routine.
- Resistance exercises help improve strength and muscle tone, while reducing inflammation. Examples of resistance exercises are swimming, push-ups and lifting weights. Do these for 30 minutes, a few times a week.
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Table 5 Description Of Bph Drugs And Their Side Effects
|Type of medication|
|Alpha-blockers||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 youre also taking a high blood pressure drug or erectile dysfunction medicines such as sildenafil , vardenafil , and tadalafil . So dont 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.
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If doxazosin does not bring enough relief, you could try terazosin next. Or you could also try adding finasteride.
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Are There Any Side Effects Of Prostate Supplements
If prostate health supplements are manufactured by certain manufacturing standards and with proven and safe ingredients, they should cause no adverse effects. This is mainly because most prostate supplements contain natural and herbal ingredients that were found to be safe for most users.
However, because the FDA doesnt regulate dietary supplements, their safety can only be guaranteed and tested by the manufacturers, and product safety can be highly questionable under such circumstances.
According to a meta-analysis of saw palmetto studies, supplements in this category are associated with a lower rate of erectile dysfunction, but a slightly higher rate of gastrointestinal symptoms, when compared to finasteride.