Enlarged prostate – treatments

enlarged prostate There are common, effective treatment procedures for BHP (ie: enlarged prostate). Again, to clarify from our previous articles at ElderlyElder.com, enlargement does NOT necessarily mean cancer.

The least invasive approach is Drug Therapy. It’s non-surgical, and is widely offered throughout the medical community as standard practise. There are two basic types of drugs available and they work in different ways.

Alpha blockers relax the prostate muscle
This medication relaxes the muscle tissue around the prostate which improves urine flow. Like all drugs, there are side effects, which could show in a small amount of men (<10%), such as dizziness, tiredness, and retrograde ejaculation. Examples of alpha-blockers include tamsulosin, doxazosin, alfuzosin and terazosin. Before I move on, let’s briefly discuss this side effect:

Retrograde ejaculation is a common side effect of medications such as tamsulosin that are used to relax the muscles of the urinary tract as mentioned above. These medications may cause the bladder muscle to relax as well. Semen, which would normally be ejaculated via the urethra, is redirected to the urinary bladder. This retrograde-ejaculated sperm is simply lost at the next urination

As an interesting note, some Taoist and some alternate medicine groups actually teach retrograde ejaculation. This, in their belief, conserves the body’s energy and redirects it to the brain. They induce retrograde ejaculation by pressing against the perineum during ejaculation (the area between the testicles and anus). However, as mentioned, the ejaculate simply passes during the next urination.


Alpha blockers that relax the prostate muscle usually begin working within a few days, and continue as long as the medication is taken

Alpha-reductase inhibitors reduce the size of the prostate
These medications act on the hormones that contribute to the development of BPH – enlarged prostrate. Unlike the alpha-blockers above (relax the muscles) that work within a few days, alpha-reductase medications (shrink the prostate) can take a few months to show results. This type of drug therapy stops the future enlarging of the prostrate, reduces acute urinary retention, and helps to avoid future surgery related to an enlarged prostate. One study on the drug, finasteride, showed a reduction in the development of cancer up to 25%.

Side effects occur in <10% of men, and include loss of libido, erectile dysfunction, and decrease ejaculate volume.

Examples of Alpha-reductase inhibitors that reduce the size of the enlarged prostate include dutasteride and finasteride.

Combo therapy
As is often the case in drug therapies, combinations of different medications often provide superior results. It has been shown that a combo-therapy (using alpha-reductase inhibitor in combination with an alpha-blocker) offers the best improvement for complications of BHP / enlarged prostate, thus reducing issues of acute urinary retention, surgery and symptom progression. However, increased benefits are usually associated with increased side effects so the risk/reward should be discussed with your doctor.

Herbal remedies
Herbal remedies to treat the enlarged prostate are common, and many men take these herbs thinking they are a practical therapy. However, medical studies showing their effectiveness are lacking. While these herbal remedies are not proven, their side effects are minimal so some men consider this a low risk approach. As some herbs may conflict with pharmaceutical drug therapies, you should always advise your doctor if you’re taking herbal remedies.

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