What kind of medications are used to treat benign prostatic hypertrophy (aka: BPH)?

BPH is treated with a variety of medications to either reduce pressure of urine flow by relaxing smooth muscles or shrinking the size of the prostate that is obstructing urine flow. Each drug is associated with different side effects so you should discuss your medication with your doctor.

Drugs that widen the prostate outlet

Alpha blocker

This medicine directly relaxes the smooth muscles near the bladder outlet and in the prostate, alleviating lower urinary tract symptoms caused by BPH. The effects may be visible within one week from the day of oral administration. More common side effects include an ejaculation disorder called retrograde ejaculation and dizziness from lowered blood pressure. Additionally, since there is a rare possibility of a complication called intraoperative iris hypotonia syndrome (IFIS) occurring during eye surgery. Please be sure to inform your doctor in advance about the medications you are using before undergoing any surgeries.

Alpha1 blockers include drugs such as alfuzosin, doxazosin, terazosin, tamsulosin, and prazosin.

PDE5 inhibitor

This medicine causes nitric oxide (NO) to be produced from the walls of blood vessels which indirectly relaxes the smooth muscles of the prostate and urethra. By relaxing the smooth muscles, urine can flow more freely and alleviate symptoms of BPH. The effects may be visible within one week from the day of oral administration. More common side effects include gastrointestinal symptoms, hot flashes, low blood pressure, and headache. Depending on the dose, PDE5 inhibitors can also be used to treat erectile dysfunction and erectile dysfunction (ED). However, if you are taking nitrate drugs used to treat heart conditions like high blood pressure or coronary artery disease, these medicines should not be used together as they can cause your blood pressure to drop.

PDE5 inhibitors include drugs such as sildenafil, vardenafil, tadalafil, and avanafil.

Drugs that reduce the size of the prostate

5 alpha reductase inhibitor

This medicine suppresses prostate cell growth caused by male hormones which then leads to shrinking the prostate gland. By shrinking the prostate gland, pressure is relieved on the smooth flow of urine, relieveing symptoms of BPH. The effects usually gradually become noticeable within 1 month to 6 months from the start of oral administration. The main side effects include erectile dysfunction, ejaculation problems, decreased libido, and gynecomastia. Your provider will often check a prostate-specific antigen (PSA) tumor marker when starting this medication to establish a baseline as this medication can lower it.

5α-reductase inhibitors include drugs such as finasteride and dutasteride.