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4 Questions to Better Understand Benign Prostatic Hyperplasia

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Benign prostatic hyperplasia (BPH) is a common health problem in men over 60 years old. Although the symptoms can be unpleasant, effective treatments to mitigate them are available. If you want to know more on the subject, you’ve come to the right place.

What is BPH?

Benign prostatic hyperplasia (or benign enlargement of the prostate) involves an enlargement of the prostate. The prostate is a small gland located underneath the bladder that is wrapped around the urethra (the tube through which urine flows from the bladder to the tip of the penis). It is associated with aging and generally affects men over 50 years old (50% of men aged 60 and 90% of men aged over 85).

We don’t know the exact causes of BPH, but it seems that this problem is due to changes in hormone production caused by the aging process.

It is important to mention that BPH is not an indication of prostate cancer. These are two completely different conditions that can sometimes produce similar symptoms.

What are the symptoms of BPH?

BPH is not life threatening, but its common symptoms can be quite disruptive. They are caused by the enlargement of the prostate, which in turn compresses the urethra and blocks the passage of urine from the bladder, leading to the following symptoms:  

  • Feeling of not having completely emptied the bladder after urinating
  • Need to urinate more frequently
  • Small quantity of urine each time
  • Need to urinate during the night
  • Inability to delay urination
  • Difficulty initiating urination
  • Intermittent urine flow
  • Weak urine flow
  • Dribbling

What complications can BPH cause?

Failure to treat BPH can lead to the following complications:

  • Repeated urinary infections because the bladder does not empty properly;
  • Urinary retention (total inability to urinate) due to the compression of the prostate by the urethra. This requires an urgent visit to the doctor;
  • Bladder stones;
  • Kidney dysfunction;
  • Blood in the urine.

It is important to know that BPH does not increase the risk of developing prostate cancer in the future.

What treatments are available for BPH?

Your doctor may decide that you don’t need treatment, but will certainly want to monitor your symptoms carefully.  

BPH treatments are designed to relieve symptoms rather than slow the progress of the illness. There are currently two classes of drugs for treating BPH. They can be used alone, or in combination when symptoms are more severe.   

  • The first class of drugs includes alfuzosin, tamsulosin, terazosin, doxazosin, and prazosin. They act by relaxing the tissue in the prostate. This relieves pressure on the urethra and reduces the associated BPH symptoms. These drugs start acting quite quickly, i.e. after about one or two weeks, depending on the drug. However, this group of drugs does not reduce the size of the prostate. The most common side effects are low blood pressure, dizziness, headaches, and fatigue.  
  • There are only two drugs in the second class: finasteride and dutasteride. They shrink the prostate but it can take up to six months before patients notice any improvement in BPH symptoms. The main side effect of these drugs is sexual dysfunction (e.g. lower sexual drive, ejaculation problems, and impotence). 

To take advantage of the beneficial effects of these drugs, it is important to take them every day as prescribed. Ask your pharmacist for more information on drugs used to treat BPH symptoms.  

Good to know

Some over-the-counter drugs are not recommended for men with BPH.

Pay particular attention to products marked with the code B on the label because they can increase the symptoms of BPH. These drugs include cold and allergy medications. When in doubt, check with your pharmacist to make sure that the over-the-counter drug you want is compatible with both your health condition and the drugs prescribed by your doctor.

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