Benign prostatic hyperplasia (BPH), commonly called an enlarged prostate, can cause changes in urination as men get older. Symptoms may include a weak or slow urine stream, difficulty getting started, frequent or urgent urination, waking during the night to use the bathroom, or feeling like you still need to urinate after finishing.
When these symptoms become bothersome, medication is often one of the first treatment options to consider. For some men, medication provides enough relief to manage symptoms without a procedure. Depending on your symptoms, prostate size, overall health, and other medications you take, your urologist may recommend one medication or a combination.
At Conrad Pearson Clinic, our urologists can help you understand your options and determine whether medication may be right for you. We consider your symptoms, health, and treatment goals when developing your treatment plan.
How BPH Medications Work
BPH medications work in different ways. Some relax the muscles around the prostate and bladder to make it easier for urine to flow. Others work gradually to reduce the size of an enlarged prostate.
The medication your urologist recommends depends on your symptoms, prostate size, overall health, and treatment goals. In some cases, two medications that work differently may be used together.
Medication does not cure BPH, but it can help manage symptoms and, depending on the type of medication, may reduce the effects of an enlarged prostate over time.
Types of BPH Medications
BPH medications work in different ways to improve urinary symptoms. Some relax the muscles around the prostate and bladder to help urine flow more easily, while others gradually reduce prostate size. Tadalafil (Cialis®) may also improve BPH symptoms and can be an option for men who also experience erectile dysfunction.
Medications That Improve Urine Flow
Alpha blockers relax the muscles around the prostate and bladder opening, helping urine pass more easily through the urethra. They may improve symptoms such as:
- Weak or slow urine stream
- Difficulty getting started
- Straining to urinate
- Feeling like the bladder has not completely emptied
Common alpha blockers include tamsulosin (Flomax®), alfuzosin (Uroxatral®), silodosin (Rapaflo®), and doxazosin.
Some men notice improvement relatively quickly with alpha blockers. However, these medications do not shrink the prostate. Instead, they relax the muscles around the prostate and bladder to help improve urine flow.
Dizziness or lightheadedness, particularly when standing, can occur with some alpha blockers. Some men may also experience changes in ejaculation. Your urologist will consider your blood pressure, overall health, and other medications when determining whether an alpha blocker is appropriate for you.
Medications That Reduce Prostate Size
5-alpha reductase inhibitors work differently from alpha blockers. They affect hormones involved in prostate growth and can gradually reduce the size of an enlarged prostate. As the prostate becomes smaller, these medications may help reduce blockage of urine flow and improve BPH symptoms.
Common medications in this category include finasteride (Proscar®) and dutasteride (Avodart®).
These medications generally take longer to work, and it may take several months to notice their full benefit. They may be particularly helpful for men with larger prostates.
Some men may experience sexual side effects, including decreased sex drive, erectile difficulties, or changes in ejaculation. Your urologist can explain the potential benefits and side effects so you can determine whether this type of medication is right for you.
Tadalafil (Cialis®)
Tadalafil (Cialis®) is another medication that may improve BPH symptoms. It is also commonly used to treat erectile dysfunction, making it an option for some men who experience both conditions.
Tadalafil works differently from alpha blockers and 5-alpha reductase inhibitors. Your urologist can determine whether it may be appropriate based on your urinary symptoms, sexual health, overall health, and other medications you take.
Combination Medication
If one medication does not provide enough relief, your urologist may recommend combining medications that work in different ways. For example, an alpha blocker may help improve urine flow while a 5-alpha reductase inhibitor gradually reduces prostate size.
Combination treatment does not necessarily mean your BPH is severe. For some men, using medications that work in different ways can provide better symptom relief than one medication alone.
Choosing the Right BPH Medication
There is no single BPH medication that is right for every man. Your urologist may consider:
- The type and severity of your urinary symptoms
- How your symptoms affect your daily life
- The size of your prostate
- Your overall health and other medical conditions
- Other medications, vitamins, and supplements you take
- Your blood pressure and cardiovascular health
- Potential side effects
- Your treatment goals and preferences
Your urologist may also recommend an evaluation to make sure BPH is contributing to your symptoms. Not every urinary problem is caused by an enlarged prostate, so identifying the cause of your symptoms is an important part of choosing the right treatment.
What to Expect From BPH Medication
How quickly you notice improvement depends on the medication. Some can improve urinary symptoms relatively quickly, while others work gradually and may take several months to provide their full benefit.
Your urologist may schedule a follow-up to see how you are responding to treatment and whether you are experiencing any side effects. If medication is working well and you are comfortable with your treatment, you may continue taking it long term.
You do not necessarily have to take BPH medication forever. How long you continue treatment depends on how well it controls your symptoms, whether you experience side effects, and your treatment preferences.
Before starting a BPH medication, make sure your urologist knows about all prescription and over-the-counter medications, vitamins, and supplements you take. Some medications can interact with one another or may not be appropriate with certain health conditions.
If you are not getting the improvement you expected or are experiencing bothersome side effects, let your urologist know. A different medication, combination treatment, or another BPH treatment may be an option.
When Medication Isn’t Enough
Medication works well for some men, while others may need a different approach. If symptoms continue despite medication, side effects become bothersome, or you prefer not to take medication long term, your urologist can discuss other options with you.
Depending on your symptoms, prostate size, overall health, and treatment goals, you may be a candidate for a minimally invasive procedure or surgical treatment.
Conrad Pearson Clinic offers several BPH treatment options. Your urologist can explain how these treatments compare with medication, including what to expect from treatment, recovery, and potential benefits.
Personalized BPH Care at Conrad Pearson Clinic
Your BPH treatment should fit your symptoms, health, and goals. At Conrad Pearson Clinic, our urologists take the time to understand your concerns and explain your options clearly.
Whether medication is appropriate or another treatment may be a better fit, we can help you understand your choices and determine the next step in your care.
