Medical Therapies

Alpha Blockers

Alpha blockers are pills that relax the muscles of the prostate and bladder. They improve urine flow. They reduce blockage. They reduce symptoms of BPH. The pills do not reduce the size of the prostate. Alpha blockers include alfuzosin (Uroxatral), terazosin (Hytrin), doxazosin (Cadura) and tamsulosin (Flomax).

What are The Benefits, Risks and Side Effects of Alpha Blockers?

One benefit of alpha blockers is that they work right away. Side effects include dizziness, lightheadedness, fatigue and difficulty ejaculating.

Who Are Good Candidates for Alpha Blockers?

This treatment is good for men with moderate to severe BPH. Men who are bothered by their symptoms are good candidates. This is not a good choice if you are about to have cataract surgery.

What Are 5-Alpha Reducatase Inhibitors?

5-Alpha reducatase inhibitors block the production of dihydrotestosterone (DHT). DHT is a male hormone that plays a role in prostate development and growth. DHT accumulates in the prostate and may cause prostate growth. 5-Alpha reducatase inhibitors are pills that increase urine flow and shrink the prostate. These drugs include finasteride (Proscar) and dutasteride (Avodart).

What Are The benefits, Risks and Side Effects of 5-Alpha Reducatase Inhibitors?

These drugs lower the risk of BPH complications. They lower the need for surgery. Side effects are sexual, such as erectile dysfunction and reduced libido (sex drive). You must take them indefinitely to prevent symptoms.

Who Are Good Candidates for 5-Alpha Reducatase Inhibitors?

These drugs may be best for men with very large prostate glands. Older men are good candidates.

What is Combination Therapy?

Combination therapy uses an alpha blocker and a 5-alpha reducatase inhibitor together. Several studies, such as the Medical Therapy of Prostatic Symptoms (MTOPS) study, have shown that combining two classes of medications, instead of using just one, can more effectively improve symptoms, urinary flow, and quality of life. The combinations include:

  • Finasteride (Proscar) and doxazosin
  • dutasteride (Avodart) and tamsulosin (Jalyn ), a combination of both medications that is available in a single tablet
  • alpha blockers and antimuscarinics

A urologist may prescribe a combination of alpha blockers and antimuscarinics for patients with overactive bladder symptoms. Overactive bladder is a condition in which the bladder muscles contract uncontrollably and cause urinary frequency, urinary urgency, and urinary incontinence. Antimuscarinics are a class of medications that relax the bladder muscles.

What Are The Benefits, Risks and Side Effects of Combination Therapy?

Alpha blockers and 5-alpha reducatase inhibiters work better together than either one alone. They prevent BPH from getting worse. They improve symptoms. But there may be more side effects. There may be side effects from each drug.

Who Are good candidates for combination therapy?

Men with larger prostates are good candidates for this treatment.

What Are Phytotherapies?

These are herbal therapies. They are very popular. They are "self treatment." They are not prescribed by a health care provider. One popular herb is saw palmetto.

What Are The Benefits, Risks and Side Effects of Phytotherapies?

Herbal treatments have not been proven to work. In fact, some studies show they do not work. Also, the quality and purity of these over-the-counter supplements vary.

Who are Good Candidates for Phytotherapies?

This treatment is not currently recommended by health care providers.

Other Groups' Resources

National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)

Prostate Enlargement: Benign Prostatic Hyperplasia


Enlarged Prostate (BPH) (English)
Agrandamiento de la próstata (Español)


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