BPH Medicines: How They Work, Side Effects & When to Consider Surgery

Introduction: The First Step in Treating an Enlarged Prostate

If you’ve been diagnosed with an enlarged prostate (Benign Prostatic Hyperplasia or BPH), your doctor may first prescribe medicines. For many men, medications can ease urinary symptoms like frequent urination, urgency, or weak stream.

But medicines have their limits. They can improve symptoms but rarely shrink the prostate enough to be a permanent solution. And for some, side effects like dizziness, low blood pressure, or even sexual dysfunction make long-term use difficult.

This article explains the main types of BPH medicines, how they work, their side effects, and when it may be time to move from medicines to surgery or minimally invasive procedures like PAE (Prostate Artery Embolization).

Main Types of BPH Medicines

1. Alpha Blockers (e.g., Tamsulosin, Alfuzosin, Silodosin)

• How they work: Relax the smooth muscles of the prostate and bladder neck, making urination easier.
• Effect: Works quickly — within days to weeks.
• Does it shrink prostate? No, it just eases urine flow.

⚠️ Common side effects:

• Dizziness, lightheadedness (especially when standing up)
• Retrograde ejaculation (semen goes into bladder, not out)
• Nasal congestion

2. 5-Alpha-Reductase Inhibitors (e.g., Finasteride, Dutasteride)

• How they work: Block conversion of testosterone to DHT, the hormone that drives prostate growth.
• Effect: Shrinks the prostate slowly over 6–12 months.
• Best for: Larger prostates (>40 grams).

⚠️ Common side effects:

• Reduced libido
• Erectile dysfunction
• Decreased semen volume
• Breast tenderness/swelling (rare)

3. Combination Therapy

Doctors often prescribe both alpha blockers + 5-alpha inhibitors for men with larger prostates and severe symptoms.

• Example: Tamsulosin + Dutasteride.
• Works faster, but side effects from both classes may add up.

4. Other Medicines

• Anticholinergics: Used when urgency and frequency dominate.
• Beta-3 agonists (e.g., Mirabegron): For overactive bladder symptoms.
• Phosphodiesterase-5 inhibitors (e.g., Tadalafil): May help with both urinary symptoms and erectile dysfunction.

Do BPH Medicines Really Work?

• Good for early/moderate symptoms (IPSS 8–15).
• Less effective for severe cases (IPSS >20).
• Medicines improve scores by only 2–4 points on average.
• They don’t cure BPH — symptoms return if medicines are stopped.

Side Effects of BPH Medicines – Patient Stories

• Mr. Sharma, 63 (Mumbai): Started on Tamsulosin, felt dizzy and nearly fainted while climbing stairs.
• Mr. Patel, 58 (Pune): On Dutasteride for 6 months, noticed reduced sexual drive and decided to stop.
• Mr. Khan, 70 (Chembur): Took combination therapy, symptoms improved slightly but catheter was still needed during travel.

When Is It Time to Move Beyond Medicines?

Doctors usually advise moving from medicines to a procedure when:

• IPSS score remains >15 despite treatment.
• Recurrent urinary retention (catheter required).
• Recurrent UTIs, bladder stones, or kidney effects.
• Patient preference (doesn’t want lifelong medicines/side effects).

Options After Medicines – TURP vs PAE

• TURP: Traditional surgery, effective but invasive.
• PAE: Modern, minimally invasive procedure, done under local anesthesia, same-day discharge, almost no risk of erectile dysfunction or incontinence.

📌 Key takeaway: Medicines can buy time, but for long-term relief and quality of life, PAE offers a safer, durable solution.

FAQs on BPH Medicines

Q1. How long should I take prostate medicines?
Usually lifelong, unless symptoms improve enough for safe discontinuation or a procedure is done.

Q2. Can BPH medicines cure enlarged prostate?
No, they control symptoms but do not cure BPH.

Q3. Are side effects common?
Yes — especially sexual side effects (with Dutasteride/Finasteride) and dizziness (with Tamsulosin).

Q4. Is it safe to stop medicines suddenly?
Usually yes, but symptoms may return quickly. Always discuss with your doctor first.

Conclusion

Medicines are often the first step in managing BPH. They can ease symptoms and delay the need for surgery. But they are not a permanent solution — and for many men, side effects or insufficient relief push them to look for better options.

That’s where PAE comes in — the most advanced, minimally invasive treatment for BPH, now available in Mumbai through Docsy.

At Docsy, we ensure:

• Free Care Navigator + urologist consultations
• Free OPD + ultrasound for accurate diagnosis
• End-to-end support if you choose PAE