A Comprehensive Guide on Benign Prostatic Hyperplasia Medication

Prostate issues are common among aging men, and the chance of developing them increases as you get older.

One of the most prevalent issues is benign prostatic hyperplasia (BPH), a condition that develops when the prostate gland becomes enlarged.

Although this condition is highly treatable, the medications your doctor recommends will depend on the cause and severity of your diagnosis.

What is Benign Prostatic Hyperplasia (BPH)?

BPH — also known as enlarged prostate — is a common condition among older men.

It develops when the prostate gland increases in size and presses against the urethra.

This can lead to various uncomfortable lower urinary tract symptoms and issues related to sexual performance.

While the exact cause of BPH is still unclear, most medical professionals agree that factors like aging, genetics, and hormonal imbalances can all influence prostate growth.

Which Medications are Commonly Used to Treat BPH?

Several medications can help treat and provide symptomatic relief from BPH.

These medications can also significantly improve the quality of life for individuals struggling with this condition.

Alpha-blockers

Alpha-blockers are one of the most commonly prescribed medications to treat BPH. They help provide quick relief from BPH symptoms, often within a few days of use.

This medication works by targeting alpha-adrenergic receptors in the prostate. It causes the prostate muscles, and those around the bladder neck, to relax.

This can help ease pressure on the urethra and provide relief from urination difficulties associated with BPH.

Less pressure on the urethra also enhances the urination stream and reduces the uncomfortable feeling of incomplete bladder emptying.

Alpha-blockers that are commonly prescribed for BPH include:

• Tamsulosin (Flomax)
• Alfuzosin (Uroxatral)
• Silodosin (Rapaflo)
• Doxazosin (Cardura)
• Terazosin (Hytrin)

These alpha-blockers are generally well-tolerated, but can cause side effects like dizziness, fatigue, and nasal congestion.

Any adverse reactions tend to improve as the body adjusts to the medication.

5-alpha-reductase inhibitors

5-alpha-reductase inhibitors are a class of drugs that can help mitigate processes in the body responsible for the development of BPH.

They work by inhibiting the enzyme 5-alpha-reductase, a component that plays an important role in converting testosterone into dihydrotestosterone (DHT).

Elevated levels of DHT tend to be more prevalent as men age and are one of the main causes of an enlarged prostate.

DHT can stimulate the growth of prostate tissue, causing the gland to enlarge and press against the urethra.

By reducing DHT levels, 5-alpha-reductase inhibitors can shrink the prostate gland back to a normal size and relieve pressure on the urethra.

Common 5-alpha-reductase inhibitors that your doctor may prescribe include:

• Finasteride (Proscar)
• Dutasteride (Avodart)

These drugs are known to be effective in treating BPH — especially in men with a higher prostate-specific antigen — but may cause some unwanted side effects.

These may include decreased libido, erectile dysfunction, and other sexual performance issues.

If these side effects have too significant of an impact on your daily life, it’s recommended to discuss alternative medications with your doctor.

Phosphodiesterase-5 (PDE-5) inhibitors

This medication is typically prescribed to treat erectile dysfunction and isn’t usually a first-line treatment for BPH.

However, some research has shown that PDE-5 inhibitors can also be used to treat mild to moderate BPH cases — especially when used in combination with other drugs.

This is because the medication allows the prostate and bladder muscle to relax and improves blood flow to the genitals.

When the muscles are relaxed, pressure on the urethra is reduced, which helps to improve urinary symptoms associated with BPH.

Common PDE-5 inhibitors that may be prescribed to treat BPH include:

• Sildenafil (Viagra)
• Vardenafil (Levitra and Staxyn)
• Tadalafil (Cialis)
• Avanafil (Strendra)

Other medications used to treat BPH

If none of the commonly used drugs have helped to mitigate your BPH symptoms, your doctor may recommend other options. These can include:

• Alpha-1A adrenergic receptor antagonists: These work similarly to alpha-blockers, but may have a more direct effect on the prostate to relax the muscles. This means that these drugs are less likely to cause adverse reactions like dizziness.

• Anticholinergic agents: These drugs are primarily used to treat overactive bladder symptoms and may be beneficial in managing urinary issues associated with BPH.

• Plant-based supplements: Although more research is needed to confirm their efficacy, supplements like palmetto, pygeum, or beta-sitosterol may be used to alleviate BPH symptoms. These supplements are usually available without a prescription.

Your doctor will determine if you should try any of these alternative medications to treat BPH.

If you’re worried about adverse reactions caused by traditional BPH medications, you can also speak with your doctor about using alternatives from the start.

Combination therapy

Combination therapy for treating BPH involves using two or more drugs together to address symptoms and underlying causes.

This approach can be useful for men with more severe cases of BPH or individuals who didn’t see any improvement in their symptoms when using a single medication.

Common combination therapies for BPH may include:

• Alpha-blockers and 5-alpha-reductase inhibitors
• An alpha-blocker combined with an anticholinergic agent — a type of medication that reduces muscle contractions
• PDE-5 inhibitors and alpha-blockers

When used together, these medications have a more significant effect on the enlarged prostate gland. This allows the medications to reduce severe symptoms and improve your quality of life.

In some cases, a healthcare provider may also recommend triple combination therapy — which involves an alpha-blocker, 5-alpha-reductase inhibitor, and anticholinergic agent — to treat BPH symptoms.

This treatment route is typically only used for men with extremely large prostates and significant urinary symptoms.

Precautions and Considerations to Keep in Mind

Side effects

All medications used to treat BPH have the chance of causing unpleasant side effects. These reactions are largely unavoidable, but most tend to improve as the body adjusts to the medication.

Common side effects of BPH drugs may include:

• Dizziness
• Headaches
• Sexual dysfunction
• Gastrointestinal issues
• Fatigue

It’s important to follow the dosage instructions provided by your doctor to reduce the risk of severe side effects.

You should also notify your healthcare provider if any adverse effects don’t improve or appear to worsen when using the medication.

They may then consider minimally invasive procedures — such as a prostatic urethral lift — as a more aggressive form of treatment.

Potential long-term complications

Although the long-term effects of BPH drugs vary from person to person, it’s important to know what to expect.

This can help you prepare for any complications ahead of time and avoid additional issues in the future.

Potential long-term complications caused by BPH medication may include:

• Impact on sexual function, like decreased libido and ejaculation disorders
• Hormonal imbalances that can contribute to conditions like gynecomastia
• Reduced effectiveness of cataract surgery
• A higher risk of acute urinary retention
• An increased risk of developing prostate cancer
• A higher risk of developing neurodegenerative diseases like dementia
• Higher risks of developing mental health issues, like depression

When you start using medication to treat BPH, maintaining open communication with your doctor is key.

This allows them to properly monitor your symptoms and any adverse reactions to adjust your dosage and prevent long-term issues.

Interactions with other drugs

Many BPH medications are known to interact with various other drugs. These include:

• Blood pressure medications
• Heartburn medication
• Hormonal therapies
• Certain antifungal medications
• Nitrates used for chest pain
• CYP3A4 inhibitors

When used alongside these medications, BPH drugs can cause more severe adverse reactions — like extremely low blood pressure — to develop.

Using these drugs together may also make both less effective. This can be especially harmful if you’re taking other medications to treat chronic conditions.

To ensure that your BPH drugs don’t interfere with any other substances, it’s important to tell your doctor about all the medication you’re currently using.

This can help them to recommend BPH medications that can be used safely while remaining effective.

Should You Speak to a Doctor About BPH Medications?

BPH is a condition that usually requires professional medical care to prevent it from becoming a more serious issue.

If you’ve been diagnosed with BPH and are wondering which medication would be best for your circumstances, it’s essential that you speak with your doctor.

They’ll also need to write you a prescription to obtain any of these drugs.

If you’re already using BPH drugs, it’s recommended that you see your doctor if you experience any of the following:

• New or worsening BPH symptoms
• Severe adverse reactions that don’t seem to improve
• Blood in your urine
• Recurrent urinary tract infections (UTIs)

You should also speak to your doctor if you’re planning on taking other medications or have to undergo any surgical procedures.

BPH drugs may negatively interact with these factors, so it’s important to take the right steps to manage your condition safely.

Where Can You Learn More About BPH and Similar Conditions?

If you’re concerned about your condition or want to know more about the medications used to treat BPH, LifeMD is here to help.

LifeMD can connect you to a team of medical professionals who can assist you with information and provide guidance on BPH medications to help you make the best choice — all from the comfort of your home.

Make an appointment today to get started.