Medical Therapies

Medical Therapies

Alpha Blockers

Alpha blockers are pills that relax the muscles of the prostate and bladder. They improve urine flow, reduce blockage of the urethra, and reduce BPH symptoms. They do not reduce the size of the prostate. Alpha-blocking drugs include alfuzosin (Uroxatral), terazosin (Hytrin), doxazosin (Cadura), and tamsulosin (Flomax).

What are The Benefits, Risks and Side Effects of Alpha Blockers?

One benefit of alpha blockers is they start to work right away. Side effects may include dizziness, lightheadedness, fatigue, and trouble ejaculating.

Who Are Good Candidates for Alpha Blockers?

Men with moderate to severe BPH and men who are bothered by their symptoms are good candidates. Alpha blockers are not a good choice for men who are about to have cataract surgery.

5-Alpha Reducatase Inhibitors

5-alpha reductase inhibitors are pills that block the production of DHT, a male hormone that can build up in the prostate and may cause prostate growth. They shrink the prostate and increase urine flow. These drugs include finasteride (Proscar) and dutasteride (Avodart).

What Are The benefits, Risks and Side Effects of 5-Alpha Reducatase Inhibitors?

These drugs reduce the risk of BPH complications. They also make it less likely that you will need surgery. Side effects include erectile dysfunction and reduced libido (sex drive). You must keep taking the pills to prevent symptoms from coming back.

Who Are Good Candidates for 5-Alpha Reducatase Inhibitors?

These drugs may be best for men with very large prostate glands. Older men are good candidates.

Combination Therapy

In combination therapy, an alpha blocker and a 5-alpha reductase inhibitor are used together. Many studies, such as the Medical Therapy of Prostatic Symptoms (MTOPS) study, have shown that combining two types of medication, instead of using just one, can more effectively improve symptoms, urine flow, and quality of life. Possible drug combinations include

  • Finasteride (Proscar) and doxazosin (Cadura)
  • Dutasteride (Avodart) and tamsulosin (Jalyn), a combination that is available in a single tablet

A urologist may prescribe a combination of alpha blockers and drugs called antimuscarinics for patients with overactive bladder symptoms. In overactive bladder, the bladder muscles contract uncontrollably and cause urinary frequency, urinary urgency, and urinary incontinence. Antimuscarinics are medications that relax the bladder muscles.

What Are The Benefits, Risks and Side Effects of Combination Therapy?

Alpha blockers and 5-alpha reductase inhibiters work better together than either drug does alone. They improve symptoms and prevent BPH from getting worse. But each drug can cause side effects. By taking two drugs, you may have more side effects than if you were taking just one.

In the MTOPS study, the most common side effects in patients on combination therapy were dizziness, erectile dysfunction, weakness or lack of energy, and a drop in blood pressure when moving from sitting or lying down to standing.

Who are Good Candidates for Combination Therapy?

Men with larger prostates are good candidates for this treatment.


Phytotherapies are herbal treatments. They are a popular form of "self-treatment." They are not prescribed by a doctor. Instead, you buy them over the counter as dietary supplements. One popular herb is saw palmetto. However, herbal therapy is not recommended by health care providers. Several important studies show they don’t work. Also, the quality and purity of supplements vary.

What Are The Benefits, Risks and Side Effects of Phytotherapies?

The well-designed studies of herbal treatments studies show that they do not work. Also, herbal treatments do not go through the same testing process or have to follow the same manufacturing rules that drugs do. As a result, the quality and purity of over-the-counter supplements can vary.

Who are Good Candidates for Phytotherapies?

Doctors do not currently recommend herbal treatments for BPH.

Related Resources

BPH in Men Video

Urology 101 Video

BPH Podcast Episode

Listen to more podcasts

Prostate Health Playbook

Prostate Health Playbook



CareBlog Articles

Prostate Health 101

How To Keep Your Prostate Happy


Other Groups' Resources

National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)

Prostate Enlargement: Benign Prostatic Hyperplasia


Enlarged Prostate (BPH) (English)
Agrandamiento de la próstata (Español)