International Prostate Symptom Score
You’ll be asked to complete a questionnaire to assess your symptoms. Each question has five possible answers that carry a score, and your overall score is used to assess the severity of your symptoms.
The checklist includes the following questions.
Over the past month:
- How often have you had the sensation of not completely emptying your bladder after urinating?
- How often have you had to urinate again less than two hours after finishing urinating?
- How often have you found that you stopped and started again when urinating?
- How often have you found it difficult to postpone urination?
- How often have you had a weak stream of urine?
- How often have you had to push or strain to begin urinating during the course of one night?
- How often have you had to get up during the night to urinate?
After your GP has assessed the severity your symptoms, they’ll aim to rule out other conditions with similar symptoms using certain tests.
Frequent Urination Especially At Night
You might also feel the need to pee more often. This can happen because your urine stream stops before your bladder has emptied, so you quickly feel the need to go again.
Youre never really getting all the pee out, Dr. Linehan explains, because the enlarged prostate can block the urinary channel. Since your bladder isnt empty, you wont get the sensation of having just voided it. And you may start to get up at night to go, Linehan adds. Usually if thats happening, the prostate has some type of involvement.
Its Complicated: Enlarged Prostate And Sex
BPH and sexual function
Prostate enlargement, also known as benign prostatic hyperplasia , and erectile dysfunction are separate problems. Both increase with age, but one causes problems in the bathroom and the other in the bedroom. However, the two are somewhat linked.
BPH happens when your prostate becomes enlarged, but cancer isnt the cause. A mans prostate continues growing throughout most of his adult life. This is why many older men are affected by the condition.
ED is the inability to get or maintain an erection. It can be caused by physical conditions such as:
It can also be caused by psychological issues.
These two conditions dont necessarily seem linked, but certain treatments that relieve BPH can cause ED and other sexual side effects. On the other hand, treating ED can improve enlarged prostate symptoms.
- inability to empty the bladder
- a weak urine stream
A surgery called transurethral resection of the prostate can help relieve these symptoms. Men who have this procedure often experience sexual side effects after surgery.
Between 50 and 75 percent of men experience retrograde ejaculation after TURP, according to Harvard Medical School. This means that semen released during orgasm enters the bladder rather than exiting the penis. Retrograde ejaculation is sometimes called dry orgasm. Its not harmful but can affect male fertility.
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Foods That Shrink The Prostate Gland
Benign prostatic hyperplasia becomes a common ailment as we age. It is an enlargement of the prostate gland and causes various urinary symptoms.
BPH is not cancer, but sometimes the prostate gland grows too much, and doctors decide to practice surgery. But if you have a slightly increased gland, you may need non-invasive treatment instead.
The normal prostate is made up of a given number of cells. In a prostate with BPH, the number of cells increases.
The exact cause is unknown, but aging and hormones are both critical factors. It is the primary cause of urinary symptoms in men, especially urinary retention and frequent urination.
Urination becomes frequent and sometimes difficult and wakes them up at night. Some patients may also have erectile dysfunction, but this symptom is usually due to other health conditions.
The majority of these problems can be solved by reducing the size of the prostate gland. But is it possible? How can you shrink the prostate gland with foods?
What Are The Most Common Prostate Problems
For such a little gland, the prostate seems to cause a lot of concern. Like a troubled, war-torn country, its in the news all the time and something always seems to be going wrong there, but you dont really know where it is or why its important.
All men are at risk for prostate problems. Thats because all men have a prostate. Take a look at this overview of prostate problems to assess your risk for trouble with your prostate.
Benign prostatic hyperplasia .BPH, also known as an enlarged prostate, is growth of the prostate gland to an unhealthy size. A mans chances of having BPH go up with age:
- Age 31-40: one in 12
- Age 51-60: about one in two
- Over age 80: more than eight in 10
However, only about half of men ever have BPH symptoms that need treatment. BPH does not lead to prostate cancer, although both are common in older men.
Prostate Cancer. Prostate cancer is the most common cancer in men . About one man in six will be diagnosed with prostate cancer in their lifetime. Lets keep these numbers in perspective, though. Because prostate cancer is usually slow growing, only about one in 35 men will die of prostate cancer.
Like BPH, the risk for prostate cancer increases with age. About two out of every three men with prostate cancer are over age 65. No one knows exactly what causes prostate cancer, but risk factors associated with it include:
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What Are Male Sex Hormones
Hormones are substances that are made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs.
Androgens are a class of hormones that control the development and maintenance of male characteristics. The most abundant androgens in men are testosterone and dihydrotestosterone .
Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make semen. Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .
Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .
Diagnosing Benign Prostate Enlargement
To find out whether your prostate gland is enlarged, you’ll need to have a few tests.
Some tests will be carried out by your GP and others will be carried out by a urologist .
First, your GP will ask about your symptoms. If it seems that you have symptoms of benign prostate enlargement, the next stage is to calculate your International Prostate Symptom Score .
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Why Is This Medication Prescribed
Tamsulosin is used in men to treat the symptoms of an enlarged prostate which include difficulty urinating , painful urination, and urinary frequency and urgency. Tamsulosin is in a class of medications called alpha blockers. It works by relaxing the muscles in the prostate and bladder so that urine can flow easily.
What Is Benign Prostatic Hyperplasia
An enlarged prostate is also known as a benign prostatic hyperplasia . An enlarged prostate can cause bladder and urination difficulties. BPH does not raise the risk of developing . Treatment for benign prostatic hyperplasia includes taking medications and surgery. Common drug classes used to treat benign prostatic hyperplasia are 5-alpha reductase inhibitor / alpha blocker combinations, 5-alpha reductase inhibitors, alpha blockers, and PDE5 inhibitors.
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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 urinary sheaths, which are condom-shaped and fit over the penis to drain urine into a small bag strapped to the leg.
- 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.
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How Effective Are Alpha Blockers
Studies have shown that alpha blockers can relieve the symptoms caused by an enlarged prostate gland:
- The symptoms improved in about 50 out of 100 men who took a fake medication ,
- compared to about 70 out of 100 men who took alpha blockers.
In other words, the alpha blockers relieved the symptoms in about 20 out of 100 men.
There is usually a noticeable improvement after several days, and the full effect is reached within a month. But alpha blockers generally don’t make the symptoms go away completely. If a man doesn’t notice an improvement within eight weeks of starting to use a medication, that medication probably won’t ever work in him.
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How Does Hormone Therapy Work Against Prostate Cancer
Early in their development, prostate cancers need androgens to grow. Hormone therapies, which are treatments that decrease androgen levels or block androgen action, can inhibit the growth of such prostate cancers, which are therefore called castration sensitive, androgen dependent, or androgen sensitive.
Most prostate cancers eventually stop responding to hormone therapy and become castration resistant. That is, they continue to grow even when androgen levels in the body are extremely low or undetectable. In the past, these tumors were also called hormone resistant, androgen independent, or hormone refractory however, these terms are rarely used now because the tumors are not truly independent of androgens for their growth. In fact, some newer hormone therapies have become available that can be used to treat tumors that have become castration resistant.
What Are The Side Effects Of Hormone Therapy For Prostate Cancer
Because androgens affect many other organs besides the prostate, ADT can have a wide range of side effects , including:
- loss of interest in sex
Studer UE, Whelan P, Albrecht W, et al. Immediate or deferred androgen deprivation for patients with prostate cancer not suitable for local treatment with curative intent: European Organisation for Research and Treatment of Cancer Trial 30891. Journal of Clinical Oncology 2006 24:18681876.
Zelefsky MJ, Eastham JA, Sartor AO. Castration-Resistant Prostate Cancer. In: Vincent T. DeVita J, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology, 9e. Philadelphia, PA: Lippincott Williams & Wilkins 2011.
Smith MR, Saad F, Chowdhury S, et al. Apalutamide and overall survival in prostate cancer. European Urology 2021 79:150158.
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What Other Bph Treatments Available
Treatments for BPH usually include one or more medications. For example, tamsulosin, finasteride, and others.
But most urologists are open to using phytotherapy, Ayurveda, and other side therapies. Moreover, they also recommend a few lifestyle changes to recover your prostate health.
Heres a list with some of them :
- Rye-grass pollen: Rye-grass pollen used by millions worldwide, and improves the most concerning urinary symptoms. Most patients report they are not urinating so frequently at night and sleeping better.
- Ganoderma lucidum: Extracts prepared with this fungus inhibit prostate growth. It inhibits 5 alpha-reductase, an important hormone in the progression of BPH and prostate cancer.
- Lycopene: Foods with carotenes, including lycopene, can inhibit the progression of BPH. It is found abundantly in tomatoes and other red-colored fruits.
Other recommendations include performing pelvic floor exercises, known as kegel exercises. They are meant to increase control of your pelvic muscle and help you control urination.
It is vital to eat a healthy and balanced diet based on fruits and vegetables. Do not forget to include cruciferous vegetables in your grocery list, and listen to the recommendations by your doctor.
Best Bph Medications For Enlarged Prostate Treatment
Not too long ago, men who were looking for relief from BPH had only one option which is surgery. In recent years, that has changed. Drugmakers have come out with a number of medicines which give you more choices to treat your problems.
BPH can cause problems like a weak urine stream or need to pee a lot. Some of the medicines ease these BPH symptoms by calming the muscles in the prostate and bladder. Medicine is the most common way to treat men with mild. So, here are the medicines which are helpful in treating BPH:
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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
Tips For Coping With An Enlarged Prostate
When a man reaches about age 25, his prostate begins to grow. This natural growth is called benign prostatic hyperplasia and it is the most common cause of prostate enlargement. BPH is a benign condition that does not lead to prostate cancer, though the two problems can coexist.
Although 50% to 60% of men with BPH may never develop any symptoms, others find that BPH can make life miserable. The symptoms of BPH include:
- a hesitant, interrupted, weak urine stream
- urgency, leaking, or dribbling
- a sense of incomplete emptying
- more frequent urination, especially at night.
As a result, many men seek treatment. The good news is that treatments are constantly being improved. Patients and their physicians now have more medications to choose from, so if one doesnt do the trick, another can be prescribed. And thanks to some refinements, surgical treatments are more effective and have fewer side effects than ever before.
But there are some things men dealing with BPH can do on their own. When symptoms are not particularly bothersome, watchful waiting may be the best way to proceed. This involves regular monitoring to make sure complications arent developing, but no treatment. For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication. Often this will be enough to relieve the worst symptoms and prevent the need for surgery
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Does Masturbation Help Prevent Prostate Enlargement
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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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Table 4 Common Dosages Of Bph Drugs
|2 mg to 8 mg daily|
|Doxazosin extended-release||4 mg to 8 mg daily|
|Prazosin||2 mg to 10 mg daily|
|Silodosin||4 mg to 8 mg daily||4 mg to 8 mg daily|
|Tamsulosin||0.4 mg or 0.8 mg daily|
|Terazosin||2 mg to 10 mg daily|
|0.5 mg daily||0.5 mg daily|
Also, little research has been done on whether race or age makes a difference in how men respond to the BPH drugs. Some major studies have included very elderly men and black men, but so far there is no definitive evidence that the effectiveness or side effects of treatment differ between black and white men or older men.
Silodosin is the newest alpha-blocker. The FDA approved this medicine in late 2008. In two studies involving a total of 923 men, those receiving Rapaflo showed an improvement in their symptoms and urinary-flow rate compared with those who took a placebo pill over 12 weeks. But since the drug does not have the long track record of use of some of the other alpha-blockers, its safety profile is not yet firmly established. In addition, its more expensive. At $159-$163 per month, depending on dose, it is one of the most expensive alpha-blockers, and costs significantly more than generic doxazosin, which runs $8 or less per month. For those reasons, wed advise it not be used as initial treatment at this time.
How the drugs work
Studies dont indicate any difference in the effectiveness or safety of finasteride and dutasteride, and, at the current time, neither is known to have any advantages over the other.