Do you frequently have to get up in the middle of the night to use the restroom? Are you finding it harder and harder to go when you need to? You may be suffering from benign prostatic hyperplasia (BPH), a common condition in men as they age. Luckily, there are many medications available to treat BPH. In this blog post, we will discuss what BPH is, how to treat it with medication, and the different types of medications available.
What is BPH?
BPH occurs when the prostate gland enlarges. The prostate is a small, walnut-sized gland that is located just below the bladder and in front of the rectum. It surrounds the urethra, which is the tube that urine passes through from the bladder and out of the body. When the prostate enlarges, it can squeeze or pinch the urethra and cause urinary problems.
BPH is not cancerous and will not lead to prostate cancer. However, BPH can cause serious urinary problems if left untreated. These problems can include:
- Frequent urination (more than eight times a day)
- Urgency (a strong need to urinate)
- Nocturia (needing to urinate more than once at night)
- Difficulty starting urination
- Weak stream
- Straining to urinate
- Dribbling after urination is finished
Medications Used for BPH Treatment
There are several medications available to treat the symptoms of BPH. These medications can be divided into four main categories: Alpha Blockers, 5-Alpha Reductase Inhibitors, Phosphodiesterase-5 Inhibitors, or a combination of medications.
Alpha Blockers
Alpha blockers are the most commonly prescribed type of medication for BPH. Although they do not decrease the size of your prostate, they work by relaxing the muscles around the prostate gland and making it easier to urinate. Some alpha blockers also lower blood pressure, but they should not be relied on to treat high blood pressure. If you are planning cataract surgery, tell your eye surgeon, because these drugs can affect the iris during the operation; starting an alpha blocker is often postponed until after surgery. Alpha blockers include drugs such as:
- Tamsulosin (Flomax)
- Alfuzosin (Uroxatral)
- Terazosin (Hytrin)
- Doxazosin (Cardura)
Side effects of alpha blockers can include ejaculation changes (little or no semen) and lightheadedness or fainting when standing up, as well as:
- Headache
- Dizziness
- Drowsiness
- Nausea
- Weakness
- Diarrhea
5-Alpha Reductase Inhibitors
Another common type of medication for BPH are the five-alpha reductase inhibitors. These drugs work by shrinking the prostate gland and can take several months to see results. They are ideal for men with larger prostate glands. They also lower PSA levels by about half, so your doctor needs to account for this when interpreting PSA tests. The two main types of drugs in this category are:
- Finasteride (Proscar)
- Dutasteride (Avodart)
Side effects of five-alpha reductase inhibitors can include:
- Erectile dysfunction
- Decreased libido
- Trouble ejaculating
Phosphodiesterase-5 Inhibitors
The third type of medication used to treat BPH are the phosphodiesterase-five inhibitors. These drugs work by relaxing the muscles around the prostate gland and making it easier to urinate. They are ideal for men who have BPH and erectile dysfunction. They must never be taken with nitrate medicines for chest pain, because the combination can cause a dangerous drop in blood pressure. The two main types of drugs in this category are:
- Tadalafil (Cialis) approved by the FDA for BPH treatment
- Sildenafil (Viagra), which is not FDA-approved for BPH
Side effects of phosphodiesterase-five inhibitors can include:
- Headache
- Flushing
- Nasal congestion
- Dizziness
- Upset stomach
Combination Therapy
There are also medications available that combine two or more of the above therapies. These combinations can be helpful for men with bothersome symptoms and an enlarged prostate, because combining an alpha blocker with a five-alpha reductase inhibitor lowers the risk of symptoms worsening, urinary retention, and needing surgery. The most common combinations are:
- Doxazosin and Finasteride
- Dutasteride and Tamsulosin (Jalyn)
Side effects of combination therapy are more likely and can include:
- Erectile dysfunction
- Decreased libido
- Trouble ejaculating
- Headache
In Conclusion
In this blog post, we have discussed what BPH is and how it can be treated with medication. We have defined and discussed BPH, then explained how medical management can help alleviate symptoms. Next, we listed and described the different types of medications for treating BPH: Alpha Blockers, Five-Alpha Reductase Inhibitors, Phosphodiesterase-Five Inhibitors, Combination. For each medication, we explained what it is, how it works, who it is recommended for, and side effects. If you are experiencing any urinary problems, be sure to talk to your doctor about which treatment option is right for you.
Sources
- Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026). American Urological Association, 2026.
- The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med, 2003.
- The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol, 2010.
- A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with α-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol, 2012.
- Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg, 2005.
- Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). ALLHAT Collaborative Research Group. JAMA, 2000.
- The interpretation of serum prostate specific antigen in men receiving 5alpha-reductase inhibitors: a review and clinical recommendations. J Urol, 2006.
- Tadalafil: MedlinePlus Drug Information. MedlinePlus (U.S. National Library of Medicine).
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