When you are diagnosed with an enlarged prostate caused by BPH, your doctor's first course of action is often to recommend lifestyle changes that may alleviate your symptoms. Especially if your prostate issues are mild, simple changes to your daily routine such as avoiding drinking water before bed or reducing consumption of mild diuretics such as caffeine or alcohol can noticeably improve your condition. However, if urinary symptoms persist, doctors typically advise taking one of three classes of medications: phosphodiesterase inhibitors, alpha-reductase inhibitors, or alpha-blockers. Unfortunately, the question remains: is the cure worse than the problem?
Phosphodiesterase inhibitors are rarely prescribed for BPH symptoms. Also serving as erectile dysfunction drugs, doctors sometimes recommend this class of medication for older men with mild prostate issues who are also having some trouble in the bedroom. Unfortunately, clinical evidence of their effectiveness is lacking, and they cannot be used by men taking nitrates or with diminished kidney function.
Alpha-reductase inhibitors are the only type of prescription drug known to prevent growth of the prostate gland, often even causing it to shrink. Since this medication relieves the source of most BPH issues, clinical studies have proven its effectiveness in improving urine flow, bladder retention, and frequent urges in less than 6 months of treatment. Unfortunately, the side effects of these drugs are often undesirable. Many men experience a diminished libido, difficulty achieving or maintaining an erection, and even feelings of depression.
Alpha-blockers are a type of hypertension drug that doubles as a treatment for BPH. Alpha-blockers work by relaxing the muscles surrounding the prostate and bladder, allowing urine to pass more freely through the urethra. This does not shrink the size of the prostate but does improve urine flow, reduces stopping and starting, and promotes more complete bladder emptying. Despite the effectiveness of these drugs, they can occasionally cause some unwanted side effects. Because they are also prescribed as a blood pressure medication, alpha-blockers can cause dizziness, lightheadedness, drowsiness, and headaches. For this reason, they are also associated with an increased risk of falling and of breaking a bone, particularly in the first several weeks of treatment. Perhaps more concerning, they have the potential to cause urinary incontinence, especially in the event of a stressful situation.
Ultimately, each of these three main categories of BPH medication are still recognized as safe, effective, and well-tolerated by the FDA and are commonly prescribed by physicians. If you struggle with urinary symptoms related to BPH, talk with your doctor about your options and the optimal treatment for your unique situation.
