BPH Prostate Health
Nov 29, 2011
By Barret Procyshyn, Pharmacist at the Dauphin Clinic Pharmacy
November is really a time for men! It is a month of deer hunting, curling and hockey. The snowmobiles are getting their tune ups and the Grey cup is on. It is also Movember, so no matter what our girlfriends and wives think we can grow a moustache. Since November seems to be somewhat of a mans month it might be a good time to close out the month with some information on prostate health.
This discussion involves lower urinary tract symptoms and a big long word called benign prostatic hyperplasia (BPH). Simply BPH means the prostate enlarges or gets bigger. The male prostate is a reproductive organ found below the bladder. The problem with it enlarging is the urethra runs from the bladder right through the middle of the prostate. When it enlarges it closes in on the urethra, blocking the flow of urine and causing urinary problems. Prostate growth begins at around age 30 and 50% of men have evidence of enlarged prostate by the time they are fifty. Seventy five percent of men have enlarged prostates by the time they are 80. Almost 50% of those with an enlarged prostate will show symptoms of BPH.
The signs are symptoms of BPH are classified as storage or voiding issues. Storage symptoms include urinary frequency, urgency to void, urgency incontinence and voiding at night. This may mean waking up multiple times during the night to use the washroom. Some men may think they have a sleeping problem, when really it is BPH causing them to wake up because of the urge to use the washroom. Voiding symptoms include small urinary stream, a need to wait for the stream to begin, a stream which stops and starts intermittently and straining to void.
If symptoms are minimal or sporadic further monitoring and assessment is performed. Caffeinated beverages and alcohol should be avoided in the evening. Some medications such as decongestants can also be avoided to improve symptoms. If the symptoms progress and become bothersome your doctor may start a medication. The good news on BPH is it is very treatable with medications we have available.
A class of drugs which includes tamsulosin (Flomax), doxazosin, alfluzosin and terazosin all work by changing the muscle tone in the bladder neck and prostate. This helps increase the flow of urine from the bladder. Side effects from these medications include dizziness, weakness in muscle strength, headaches and nasal congestion. These medications may also potentiate the effect of blood pressure medications. Tamsulosin is extremely popular because it is a controlled release medication and is very selective to the prostate, therefore decreasing the risk of bothersome side effects.
Finasteride is in a class of medications which works by altering a mans testosterone. By doing this it creates a reduction in prostatic volume. When the volume of the prostate is reduced there is less bladder obstruction. This medication works best in males with a large prostate. There was concern Finasteride increased the risk of prostate cancer, however; new studies show the drug may even decrease the risk of it. It shrinks the prostate making cancer cells easier to detect but does not cause cancerous cells. A newer medication in this class called dutasteride (Avodart) is another good treatment option.
There are also products available in pharmacies, health food stores and on the internet which boast to cure urinary issues naturally. A lot of these products contain the plant extracts Saw Palmetto and African Plum Tree. They may have some positive effect, we just do not know how they work, how well they work or if they are safe long term. If you are looking at trying one of these products consult your pharmacist first.
Unfortunately BPH treatment is indefinite because symptoms will reoccur if the medication is stopped. Medications can be switched and doses can be altered to lessen side effects and create better urine flow. If you have questions about your medications, make sure to ask your pharmacist.
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor,
pharmacist or other health care professional.
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