Medications for an Enlarged Prostate

Medications for an Enlarged Prostate 645d52f4a790c.png

Medications for an Enlarged Prostate

Selective alpha-blockers and 5-Alpha reductase inhibitors are usually the first choices of medication to treat benign prostate hyperplasia.

Alpha-Blockers are a type of blood pressure medication, that work by “blocking” the hormone norepinephrine (also known as noradrenaline) and thereby prevent the muscles in the walls of veins and smaller arteries from constricting. This allows these vessels to remain open and relaxed, and as a result, blood flow is improved and blood pressure is lowered.

Due to their ability to relax the muscles in the prostate and around the bladder, men taking this alpha-blocker may have an easier time urinating.

In fact, according to some studies, it is estimated that around 3 out of 5 men that take alpha-blockers find that their urinary symptoms improve within the first month of treatment.

In clinical studies, alpha-blockers have shown promising results in their ability to improve urinary symptoms related to BPH, and have proven to do so faster than another commonly prescribed medication for BPH, which is 5-alpha reductase inhibitors.

5-alpha reductase is what drives both normal and abnormal prostate growth. It is influential in the formation of dihydrotestosterone, also known as DHT, which is an androgen formed from testosterone.

Administering a 5-Alpha Reductase Inhibitor, such as finasteride and dutasteride, can inhibit the production of DHT and result in a decrease in prostate volume, as well as improvement in urinary issues.

In clinical studies, alpha-blockers have shown an ability to improve lower urinary tract symptoms related to an enlarged prostate and work faster than the 5-alpha reductase inhibitors at relieving these symptoms. However, alpha-blockers have not provided clinical evidence to support their effect on reducing the long-term risk of acute urinary retention, as well as the risk of needing to have prostate surgery.

Both alpha-blockers and 5-alpha reductase inhibitors result in different actions in the body, and the combination of these two types of medications is oftentimes considered synergistic.

According to a study published in Science Direct, which was originally published in The Journal of Urology, researchers found that combination therapy with an alpha-blocker and 5-alpha-reductase inhibitor provided a greater improvement in lower urinary tract symptoms compared to using one or the other medication solely.

In another study published in Science Direct,  researchers found that the combination of the alpha-blocker, tamsulosin, and the 5-alpha reductase inhibitor dutasteride, significantly reduced the risk of acute urinary retention, as well as reduced the need for prostate surgery.

This particular study followed 3195 men over a 4 year period and found that combination therapy reduced the risk of urinary retention and the need for prostate surgery by 66% when compared to the impact of the alpha blocker tamsulosin alone, and by 20% compared to dutasteride alone.

Though numerous studies have shown that combination therapy is more effective in treating both the symptoms and the prostate condition itself, combination therapy of alpha-blockers and 5-alpha reductase inhibitors does come with its increased risks of adverse effects.

In our next article, we will take a look at some of the side effects and risks associated with the combination therapy of alpha-blockers and 5-alpha reductase inhibitors.

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