TLDR Treatment for benign prostatic hyperplasia involves drugs that either quickly relieve symptoms or reduce prostate size, with a combination offering more benefits but more side effects.
Medical treatment for lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) primarily involved α1-adrenoceptor antagonists (ARBs) and 5α-reductase inhibitors (ARIs). ARBs provided fast and persistent symptom relief but did not reduce prostate size or prevent disease progression, with alfuzosin and tamsulosin being the best tolerated. ARIs reduced prostate size and prevented disease progression, though symptom relief was slower and less pronounced compared to ARBs, with dutasteride and finasteride being similarly effective. Combining ARBs and ARIs had additive effects on disease progression but also increased side-effects. The choice between ARBs and ARIs should be based on individual patient treatment goals.
235 citations,
September 2004 in “The Journal of urology/The journal of urology” Drugs that block DHT production can effectively treat enlarged prostate and improve urinary issues with some sexual side effects.
1707 citations,
December 2003 in “The New England Journal of Medicine” Combination therapy of doxazosin and finasteride safely and effectively reduces benign prostatic hyperplasia progression risk.
1054 citations,
February 1998 in “The New England Journal of Medicine” Finasteride reduces urinary issues and surgery need in men with enlarged prostates by over 50%.
10 citations,
May 2010 in “Analytica Chimica Acta” New tests detect finasteride and dutasteride in urine quickly and easily.
52 citations,
February 2006 in “Current pharmaceutical design” 5α-reductase inhibitors and alpha-1 adrenergic antagonists together effectively treat benign prostatic hyperplasia, with long-term benefits.
5 citations,
August 2018 in “Sexual Medicine Reviews” 5α-Reductase inhibitors do not consistently increase testosterone levels in the blood.
May 2024 in “European urology focus” Drugs for prostate enlargement and hair loss were not linked to increased risk of depression or suicide.
17 citations,
February 2019 in “Journal of steroid biochemistry and molecular biology/The Journal of steroid biochemistry and molecular biology” AKR1D1 controls glucocorticoid levels and receptor activity in liver cells.
29 citations,
September 2014 in “Current Opinion in Endocrinology, Diabetes and Obesity” Finasteride and dutasteride effectively treat hair loss in men and women, but may cause side effects like low libido and depression.
