Although the exact cause is unknown, changes in male sex hormones that come with aging may be a factor. Any family history of prostate problems or any abnormalities with your testicles may raise your risk for BPH.
Common symptoms include:. Talk with your doctor if you have any of these symptoms. When checking you for BPH, your doctor will usually begin by doing a physical exam and asking you about your medical history. The physical exam includes a rectal examination that allows the doctor to estimate the size and shape of your prostate. Other tests can include:. Your doctor can make any necessary medication adjustments.
Treatment of BPH can begin with self-care and lifestyle adjustments. Your age and general health will also influence the prescribed treatment. Learn more about BPH treatment. Natural treatment can include specific actions or lifestyle changes that you can make to help relieve your symptoms of BPH.
These include:. Some people also include natural remedies in their treatment of BPH. Learn more about BPH natural remedies. These medications include:. Learn more about BPH medications. Alpha-1 blockers are medications that relax the muscles of the bladder and prostate. Alpha-1 blockers relax the neck of the bladder and make it easier for urine to flow. Examples of alpha-1 blockers include:. Learn more about PSA screening for prostate cancer. Prostatitis is a painful condition in which the prostate is inflamed, swollen, and tender.
It can be caused by a bacterial The prostate not prostrate uses male hormones called androgens, such as testosterone and dihydrotestosterone DHT , to trigger and maintain male sex characteristics and reproduction. What is BPH? Learn More Prostatitis Prostatitis, what is it? Finasteride Proscar blocks the conversion of testosterone to dihydrotestosterone, the major male sex hormone found in cells of the prostate.
In some men, finasteride can relieve BPH symptoms, increase urinary flow rate and shrink the prostate, though it must be used indefinitely to prevent recurrence of symptoms, and it may take as long as six months to achieve maximum benefits. In a study of its safety and effectiveness, two-thirds of the men taking finasteride experienced:.
A study published last year suggests that finasteride may be best suited for men with relatively large prostate glands. An analysis of six studies found that finasteride only improved BPH symptoms in men with an initial prostate volume of over 40 cubic centimeters — finasteride did not reduce symptoms in men with smaller glands.
Since finasteride shrinks the prostate, men with smaller glands are probably less likely to respond to the drug because the urinary symptoms result from causes other than physical obstruction for example, smooth muscle constriction.
Finasteride use comes with some side effects. Finasteride may also decrease the volume of ejaculate. Another adverse effect is gynecomastia breast enlargement.
A study from England found gynecomastia in 0. Because it is not clear that the drug causes gynecomastia or that it increases the risk of breast cancer, men taking finasteride are being carefully monitored until these issues are resolved. Men exposed to finasteride or dutasteride are also at risk of developing post-finasteride syndrome, which is characterized by a constellation of symptoms, including some that are sexual reduced libido, ejaculatory dysfunction, erectile dysfunction , physical gynecomastia, muscle weakness and psychological depression, anxiety, suicidal thoughts.
These symptoms can persist long term despite discontinuation of finasteride. The fall in PSA levels, and any adverse effects on sexual function, disappear when finasteride use is stopped. To obtain the benefits of finasteride for BPH without compromising the detection of early prostate cancer, men should have a PSA test before starting finasteride treatment.
Subsequent PSA values can then be compared to this baseline value. If a man is already on finasteride and no baseline PSA level was obtained, the results of a current PSA test should be multiplied by two to estimate the true PSA level. Any increase in PSA levels while taking finasteride also raises the possibility of prostate cancer. These drugs, originally used to treat high blood pressure, reduce the tension of smooth muscles in blood vessel walls and relax smooth muscle tissue in the prostate.
As a result, daily use of an alpha-adrenergic drug may increase urinary flow and relieve symptoms of urinary frequency and nocturia. Some alpha-l-adrenergic drugs — for example, doxazosin Cardura , prazosin Minipress , terazosin Hytrin and tamsulosin selective alpha 1-A receptor blocker — Flomax — have been used for this purpose.
Lower daily doses of terazosin 2 and 5 mg did not produce as much benefit as the 10 mg dose. Possible side effects of alpha-adrenergic blockers are orthostatic hypotension dizziness upon standing, due to a fall in blood pressure , fatigue and headaches. In this study, orthostatic hypotension was the most frequent side effect, and the authors noted that taking the daily dose in the evening can mitigate the problem. An advantage of alpha blockers, compared to finasteride, is that they work almost immediately.
They also have the additional benefit of treating hypertension when it is present in BPH patients. When the two drugs were compared in a study published in The New England Journal of Medicine , terazosin appeared to produce greater improvement of BPH symptoms and urinary flow rate than finasteride.
But this difference may have been due to the larger number of men in the study with small prostates, who would be more likely to have BPH symptoms from smooth muscle constriction rather than from physical obstruction by excess glandular tissue. Doxazosin was evaluated in three clinical studies of men with BPH.
Patients took either a placebo or 4 mg to 12 mg of doxazosin per day. Despite the previously held belief that doxazosin was only effective for mild or moderate BPH, patients with severe symptoms experienced the greatest improvement.
Among men treated for hypertension, the doses of anti-hypertension drugs may need to be adjusted due to the blood-pressure-lowering effects of an alpha-adrenergic blocker. Phosphodiesterase-5 inhibitors, such as Cialis, are commonly used for erectile dysfunction, but when used daily, they also can relax the smooth muscle of the prostate and overactivity of the bladder muscle.
Studies examining the impact of daily Cialis use compared to placebo demonstrated a reduction in International Prostate Symptom Score by four to five points, and Cialis was superior to placebo in reducing urinary frequency, urgency and urinary incontinence episodes.
Surgical treatment of the prostate involves displacement or removal of the obstructing adenoma of the prostate. Surgical therapies have historically been reserved for men who failed medical therapy and those who developed urinary retention secondary to BPH, recurrent urinary tract infections, bladder stones or bleeding from the prostate. However, a large number of men are poorly compliant with medical therapy due to side effects. Surgery is usually only recommended for moderate to severe symptoms that have not responded to medicine.
Page last reviewed: 10 February Next review due: 10 February Symptoms of benign prostate enlargement The prostate is a small gland, located in the pelvis, between the penis and bladder. This can affect how you pee and may cause: difficulty starting to pee a frequent need to pee difficulty fully emptying your bladder Credit:.
Video: prostate enlargement This animation explains the possible causes of prostate enlargement or benign prostatic hyperplasia. Media last reviewed: 12 January Media review due: 12 January
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