Enlarged Prostate: Should I Take Medicine?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Enlarged Prostate: Should I Take Medicine?
Get the facts
Your options
- Take prescription medicine to help your symptoms.
- Don't take medicine. Instead, try
and manage your symptoms at
home.
Watchful waiting and medicines are usually the first
things considered for an enlarged prostate. But surgery is sometimes needed for
more serious symptoms. If you are trying to decide whether to have surgery,
see:
Enlarged Prostate: Should I Have Surgery?
Key points to remember
- As a rule, you don't need medicine for an enlarged prostate
unless
the symptoms bother you or you have other problems such as backed-up urine,
, or
.
- About 4 out of 10 men get better without treatment. That means
that 6 out of 10 men need medicine or surgery to help their symptoms.3
- The side effects of medicine may bother you more than your
symptoms.
- Taking medicine may help keep you from needing surgery in the
future.4
FAQs
Benign
prostatic hyperplasia, or BPH, is better known as an enlarged
. It happens to almost all men as they age. It
is not cancer.
An enlarged prostate is usually harmless, but it
often causes problems with urination. About half of all men older than 75 have some
symptoms.
The most important thing in
deciding whether to get treatment is
how much the symptoms bother you and affect your quality of life.
Medicines are sometimes used to help relieve bothersome, moderate to
severe urination problems caused by an enlarged prostate. If you stop using
medicine, the symptoms will probably return.
Medicine choices
include:
- , such as terazosin (Hytrin), which relax muscle tissue.
- ,
such as finasteride (Proscar) and dutasteride (Avodart), which shrink the
prostate.
- A combination of the two, which may help
your symptoms more than either medicine alone.5
Comparing medicines 5-alpha reductase inhibitor | Alpha-blocker |
|---|
- For some men, it can shrink the prostate.
- It
may not work as well for symptom relief as alpha-blockers.4
- In general, men have a 3 point decrease in their AUA symptom score. Most men are happy with this change.2
- Symptoms get better in about 6 months.
- It may lower your risk of needing
or surgery for blocked urine
flow.4
- include:
- Decreased sex drive.
- Less semen when you ejaculate.
- Trouble getting an erection.
| - It doesn't affect prostate size.
- It may work
better than finasteride for symptom relief.4
- In general, men have a 4 to 6 point decrease in their AUA symptom score. Most men are happy with this change.2
- Symptoms get better in 2 to 3 weeks.
- For some people, it also helps lower high blood pressure
a little.
- include:
- Weakness or fatigue.
- Lightheadedness, dizziness, or fainting when you
stand up.
- A slight decrease in blood pressure.
- Headaches and a stuffy nose.
|
If you don't want to take medicine, you can try
and managing your symptoms at
home.
Watchful waiting means you have regular checkups to be sure
that your symptoms aren't getting worse. And you try making these small changes
to your lifestyle to control your symptoms:
- Don't try to rush your urination. Try to
relax while using the bathroom.
- Don't limit
to avoid having to urinate. Drink fluids throughout the
day. Limit fluids in the evening if you often wake up at night to
urinate.
- If you can, avoid
that make your symptoms worse.
- Try
herbal supplements, such as saw palmetto or
beta-sitosterol. Talk with your doctor first.
About 4 out of 10 men get better without treatment. This
means that 6 out of 10 men need medicine or surgery to help their
symptoms.3
Your doctor may recommend taking medicine for BPH if:
- You have tried to manage your symptoms through watchful
waiting, but they still bother you.
- You have a large prostate, and your doctor feels that you may
be at risk for urinary retention. (Urinary retention means you can't urinate
because your prostate blocks your urethra.)
- You have a history of
serious urinary retention.
- You have kidney problems associated with
urinary retention.
Compare your options
| | | |
|---|
What is usually involved? |
| |
What are the benefits? |
| |
What are the risks and side effects? |
| |
Take medicine
Take medicine
- You take medicine every day for
life.
- You have regular checkups.
- You may need to use
special
bathroom techniques, such as learning to relax and
double voiding.
- Taking medicine works for most
men.1
- You may lower your risk of urinary retention and future surgery.
- Side effects of
include decreased sex
drive and trouble getting an erection.
- Side effects of
include tiredness, dizziness,
headaches, and a stuffy nose.
- Some medicines are available in generic forms that may cost less,
but medicines can be very expensive.
Don't take medicine
Don't take medicine
- You have regular
checkups.
- You use special bathroom techniques.
- You make sure you don't cut back on fluids.
- About 4 out of 10 men get
better without treatment.3
- You avoid the side effects of the medicines.
- You may keep
having symptoms that bother you. About 6 out of 10 men need medicine or surgery
to help their symptoms.3
- If your prostate is large, you may be at risk for backed-up
urine.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
I've been
having a lot of trouble getting a good night's sleep now that I have this
enlarged prostate. I'm up 4 or 5 times a night to go to the bathroom, and then
both my wife and I are tired all day. My doctor said these medicines often
help with that problem, so I'm going to try them. Even if I still had to get up
a couple of times a night, I would get more rest and have more energy during
the day.
When I started having problems urinating,
my first thought was that it had to be cancer. My brother-in-law had similar
symptoms, but he ignored them for a long time and eventually died of prostate
cancer. I decided not to ignore them, so I went right to my doctor. He did a
rectal exam and a PSA test and said that he was confident that my prostate was
just enlarged and that it did not appear that I had cancer. He said if I wanted
something to treat the symptoms, he could prescribe medicine. But I was just
happy that the problem wasn't due to cancer, so I decided to manage the
symptoms on my own for now.
I've been taking medicine to lower my
blood pressure for several years now. Then a few months ago I started having to
urinate often and feeling like I never really emptied my bladder. My doctor
checked it out and said my prostate is enlarged and that it is most likely
causing my problems. He said that if the symptoms bother me enough, there is a
medicine I can take that will also lower my blood pressure. So it wouldn't
mean taking several different medicines. I'm going to give it a try.
Several months ago, I started taking
medicine to treat my prostate symptoms. The doctor said that most men don't
have serious side effects, but I guess I'm one of the few who do. Feeling
dizzy, lightheaded, and tired was affecting me more than my prostate symptoms
were, so I decided to stop taking the medicine. I found that my symptoms
actually got a little better by themselves. For now, I'm managing okay with
home treatment. My doctor and I will keep talking about other options if my
symptoms get worse and I decide I want to try something
different.
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take medicine
Reasons not to take medicine
I have symptoms that really bother me.
My symptoms don't really bother me.
More important
Equally important
More important
I would rather live with side effects from medicine than have my symptoms.
I worry about the side effects of medicine.
More important
Equally important
More important
I don't mind taking medicine every day.
I don't want to take medicine every day.
More important
Equally important
More important
I'm not worried about how much the medicine will cost.
I really worry about how much the medicine will cost.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicine
NOT taking medicine
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
1.
I may not need to take medicine if my symptoms don't bother me very much.
- TrueYou're right. As a rule, you don't need medicine unless your symptoms bother you or you have other problems such as backed-up urine, bladder infections, or bladder stones.
- FalseSorry, that's wrong. As a rule, you don't need medicine unless your symptoms bother you or you have other problems such as backed-up urine, bladder infections, or bladder stones.
- I'm not sureIt may help to go back and read "Key points to remember." As a rule, you don't need medicine unless your symptoms bother you or you have other problems such as backed-up urine, bladder infections, or bladder stones.
2.
I may get better without treatment.
3.
Medicines can cause side effects that may be worse than my symptoms.
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps.
Your summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Key concepts that you understood
Key concepts that may need review
Credits
| Author | Healthwise Staff |
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Specialist Medical Reviewer | Christopher G. Wood, MD, FACS - Urology, Oncology |
References
Citations
- Wilt TJ, N'Dow J (2008). Benign prostatic hyperplasia. Part 2—Management. BMJ, 336(7637): 206–210.
- AUA Practice Guidelines Committee (2003). AUA
guideline on management of benign prostatic hyperplasia (2003). Chapter 1:
Diagnosis and treatment recommendations. Journal of Urology, 170(2, Part 1): 530–547. Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
- Roehrborn CG, McConnell JD (2007). Benign prostatic
hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In
AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 3,
pp. 2727–2765. Philadelphia: Saunders Elsevier.
- Webber R (2006). Benign prostatic hyperplasia, search
date May 2005. Online version of BMJ Clinical Evidence.
Also available online: http://www.clinicalevidence.com.
- Roehrborn CG, et al. (2008). The effects of
dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms
in men with benign prostatic hyperplasia and prostatic enlargement: 2-year
results from the CombAT study. Journal of Urology,
179(2): 616–621.
Enlarged Prostate: Should I Take Medicine?
You can use it to talk with your doctor or loved ones about your decision.
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Take prescription medicine to help your symptoms.
- Don't take medicine. Instead, try
watchful waiting and manage your symptoms at
home.
Watchful waiting and medicines are usually the first
things considered for an enlarged prostate. But surgery is sometimes needed for
more serious symptoms. If you are trying to decide whether to have surgery,
see:
- Enlarged Prostate: Should I Have Surgery?
Key points to remember
- As a rule, you don't need medicine for an enlarged prostate
unless
the symptoms bother you or you have other problems such as backed-up urine,
bladder infections, or
bladder stones.
- About 4 out of 10 men get better without treatment. That means
that 6 out of 10 men need medicine or surgery to help their symptoms.3
- The side effects of medicine may bother you more than your
symptoms.
- Taking medicine may help keep you from needing surgery in the
future.4
FAQs
What is benign prostatic hyperplasia?
Benign
prostatic hyperplasia, or BPH, is better known as an enlarged
prostate. It happens to almost all men as they age. It
is not cancer.
An enlarged prostate is usually harmless, but it
often causes problems with urination. About half of all men older than 75 have some
symptoms.
The most important thing in
deciding whether to get treatment is
how much the symptoms bother you and affect your quality of life.
What medicines are used to treat an enlarged prostate?
Medicines are sometimes used to help relieve bothersome, moderate to
severe urination problems caused by an enlarged prostate. If you stop using
medicine, the symptoms will probably return.
Medicine choices
include:
- Alpha-blockers, such as terazosin (Hytrin), which relax muscle tissue.
-
5-alpha reductase inhibitors,
such as finasteride (Proscar) and dutasteride (Avodart), which shrink the
prostate.
- A combination of the two, which may help
your symptoms more than either medicine alone.5
Comparing medicines 5-alpha reductase inhibitor | Alpha-blocker |
|---|
- For some men, it can shrink the prostate.
- It
may not work as well for symptom relief as alpha-blockers.4
- In general, men have a 3 point decrease in their AUA symptom score. Most men are happy with this change.2
- Symptoms get better in about 6 months.
- It may lower your risk of needing
or surgery for blocked urine
flow.4
- include:
- Decreased sex drive.
- Less semen when you ejaculate.
- Trouble getting an erection.
| - It doesn't affect prostate size.
- It may work
better than finasteride for symptom relief.4
- In general, men have a 4 to 6 point decrease in their AUA symptom score. Most men are happy with this change.2
- Symptoms get better in 2 to 3 weeks.
- For some people, it also helps lower high blood pressure
a little.
- include:
- Weakness or fatigue.
- Lightheadedness, dizziness, or fainting when you
stand up.
- A slight decrease in blood pressure.
- Headaches and a stuffy nose.
|
What can you do if you don't want to take medicine?
If you don't want to take medicine, you can try
watchful waiting and managing your symptoms at
home.
Watchful waiting means you have regular checkups to be sure
that your symptoms aren't getting worse. And you try making these small changes
to your lifestyle to control your symptoms:
- Don't try to rush your urination. Try to
relax while using the bathroom.
- Don't limit
your fluid intake to avoid having to urinate. Drink fluids throughout the
day. Limit fluids in the evening if you often wake up at night to
urinate.
- If you can, avoid
medicines that make your symptoms worse.
- Try
herbal supplements, such as saw palmetto or
beta-sitosterol. Talk with your doctor first.
About 4 out of 10 men get better without treatment. This
means that 6 out of 10 men need medicine or surgery to help their
symptoms.3
Why might your doctor recommend medicine for BPH?
Your doctor may recommend taking medicine for BPH if:
- You have tried to manage your symptoms through watchful
waiting, but they still bother you.
- You have a large prostate, and your doctor feels that you may
be at risk for urinary retention. (Urinary retention means you can't urinate
because your prostate blocks your urethra.)
- You have a history of
serious urinary retention.
- You have kidney problems associated with
urinary retention.
2. Compare your options
| | Take medicine
| Don't take medicine
|
|---|
| What is usually involved? | - You take medicine every day for
life.
- You have regular checkups.
- You may need to use
special
bathroom techniques, such as learning to relax and
double voiding.
| - You have regular
checkups.
- You use special bathroom techniques.
- You make sure you don't cut back on fluids.
|
| What are the benefits? | - Taking medicine works for most
men.1
- You may lower your risk of urinary retention and future surgery.
| - About 4 out of 10 men get
better without treatment.3
- You avoid the side effects of the medicines.
|
| What are the risks and side effects? | - Side effects of
5-alpha reductase inhibitors include decreased sex
drive and trouble getting an erection.
- Side effects of
alpha-blockers include tiredness, dizziness,
headaches, and a stuffy nose.
- Some medicines are available in generic forms that may cost less,
but medicines can be very expensive.
| - You may keep
having symptoms that bother you. About 6 out of 10 men need medicine or surgery
to help their symptoms.3
- If your prostate is large, you may be at risk for backed-up
urine.
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about using medicine for benign prostatic hyperplasia
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I've been having a lot of trouble getting a good night's sleep now that I have this enlarged prostate. I'm up 4 or 5 times a night to go to the bathroom, and then both my wife and I are tired all day. My doctor said these medicines often help with that problem, so I'm going to try them. Even if I still had to get up a couple of times a night, I would get more rest and have more energy during the day."
"When I started having problems urinating, my first thought was that it had to be cancer. My brother-in-law had similar symptoms, but he ignored them for a long time and eventually died of prostate cancer. I decided not to ignore them, so I went right to my doctor. He did a rectal exam and a PSA test and said that he was confident that my prostate was just enlarged and that it did not appear that I had cancer. He said if I wanted something to treat the symptoms, he could prescribe medicine. But I was just happy that the problem wasn't due to cancer, so I decided to manage the symptoms on my own for now."
"I've been taking medicine to lower my blood pressure for several years now. Then a few months ago I started having to urinate often and feeling like I never really emptied my bladder. My doctor checked it out and said my prostate is enlarged and that it is most likely causing my problems. He said that if the symptoms bother me enough, there is a medicine I can take that will also lower my blood pressure. So it wouldn't mean taking several different medicines. I'm going to give it a try."
"Several months ago, I started taking medicine to treat my prostate symptoms. The doctor said that most men don't have serious side effects, but I guess I'm one of the few who do. Feeling dizzy, lightheaded, and tired was affecting me more than my prostate symptoms were, so I decided to stop taking the medicine. I found that my symptoms actually got a little better by themselves. For now, I'm managing okay with home treatment. My doctor and I will keep talking about other options if my symptoms get worse and I decide I want to try something different."
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take medicine
Reasons not to take medicine
I have symptoms that really bother me.
My symptoms don't really bother me.
More important
Equally important
More important
I would rather live with side effects from medicine than have my symptoms.
I worry about the side effects of medicine.
More important
Equally important
More important
I don't mind taking medicine every day.
I don't want to take medicine every day.
More important
Equally important
More important
I'm not worried about how much the medicine will cost.
I really worry about how much the medicine will cost.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicine
NOT taking medicine
Leaning toward
Undecided
Leaning toward
5. What else do you need to make your decision?
Check the facts
1.
I may not need to take medicine if my symptoms don't bother me very much.
You're right. As a rule, you don't need medicine unless your symptoms bother you or you have other problems such as backed-up urine, bladder infections, or bladder stones.
2.
I may get better without treatment.
You're right. About 4 out of 10 men get better without treatment.
3.
Medicines can cause side effects that may be worse than my symptoms.
Correct. The side effects of medicine may bother you more than your symptoms.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps.
Credits
| Author | Healthwise Staff |
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Specialist Medical Reviewer | Christopher G. Wood, MD, FACS - Urology, Oncology |
References
Citations
- Wilt TJ, N'Dow J (2008). Benign prostatic hyperplasia. Part 2—Management. BMJ, 336(7637): 206–210.
- AUA Practice Guidelines Committee (2003). AUA
guideline on management of benign prostatic hyperplasia (2003). Chapter 1:
Diagnosis and treatment recommendations. Journal of Urology, 170(2, Part 1): 530–547. Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
- Roehrborn CG, McConnell JD (2007). Benign prostatic
hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In
AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 3,
pp. 2727–2765. Philadelphia: Saunders Elsevier.
- Webber R (2006). Benign prostatic hyperplasia, search
date May 2005. Online version of BMJ Clinical Evidence.
Also available online: http://www.clinicalevidence.com.
- Roehrborn CG, et al. (2008). The effects of
dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms
in men with benign prostatic hyperplasia and prostatic enlargement: 2-year
results from the CombAT study. Journal of Urology,
179(2): 616–621.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Last Updated:March 23, 2010
Wilt TJ, N'Dow J (2008). Benign prostatic hyperplasia. Part 2—Management. BMJ, 336(7637): 206–210.
AUA Practice Guidelines Committee (2003). AUA
guideline on management of benign prostatic hyperplasia (2003). Chapter 1:
Diagnosis and treatment recommendations. Journal of Urology, 170(2, Part 1): 530–547. Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
Roehrborn CG, McConnell JD (2007). Benign prostatic
hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In
AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 3,
pp. 2727–2765. Philadelphia: Saunders Elsevier.
Webber R (2006). Benign prostatic hyperplasia, search
date May 2005. Online version of BMJ Clinical Evidence.
Also available online: http://www.clinicalevidence.com.
Roehrborn CG, et al. (2008). The effects of
dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms
in men with benign prostatic hyperplasia and prostatic enlargement: 2-year
results from the CombAT study. Journal of Urology,
179(2): 616–621.