The prostate is a gland that produces the fluid that carries sperm during ejaculation. It surrounds the tube through which urine passes out of the body (the urethra).
An enlarged prostate means the gland has grown bigger. As the gland grows, it can block the urethra and cause problems, such as:
Not being able to fully empty your bladder
Needing to urinate two or more times per night
Slowed or delayed start of the urinary stream and dribbling at the end
Straining to urinate and a weak urine stream
Strong and sudden urge to urinate or a loss of urinary control
Lifestyle Changes
The following changes may help you control symptoms:
Urinate when you first get the urge. Also, go to the bathroom on a timed schedule, even if you do not feel a need to urinate.
Avoid alcohol and caffeine, especially after dinner.
Do not drink a lot of fluid all at once. Spread out fluids over the day. Avoid drinking fluids within 2 hours of bedtime.
Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms.
Reduce stress. Nervousness and tension can lead to more frequent urination.
Medicines, Herbs, and Supplements
Your provider may have you take a medicine called alpha-1- blocker. Most people find that these medicines help their symptoms. Symptoms often get better 3 to 7 days after starting on the medicine. You must take this medicine every day. There are several medicines in this category, including terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatrol), and silodosin (Rapaflo).
Common side effects include nasal stuffiness, headaches, lightheadedness when you stand up, and weakness. You may also notice less semen when you ejaculate. This is not a medical problem but some men don't like how it feels.
Ask your provider before taking sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) with alpha-1- blockers because there can often be an interaction.
Other medicines such as finasteride or dutasteride may also be prescribed. These medicines help shrink the prostate over time and help with symptoms.
You will need to take these medicines every day for 3 to 6 months before your symptoms begin to improve.
Side effects include less interest in sex and less semen when you ejaculate.
Watch out for medicines that may make your symptoms worse:
Try not to take over-the-counter cold and sinus medicines that contain decongestants or antihistamines. They can make your symptoms worse.
Men who are taking water pills or diuretics may want to talk to their provider about reducing the dosage or switching to another type of medicine.
Other medicines that may worsen symptoms are certain antidepressants and medicines used to treat spasticity.
Many herbs and supplements have been tried for treating an enlarged prostate.
Saw palmetto has been used by many men to ease BPH symptoms. It is unclear whether this herb is effective in relieving the signs and symptoms of BPH.
Talk with your provider about any herbs or supplements you are taking.
Often, makers of herbal remedies and dietary supplements do not need approval from the FDA to sell their products, and thus, their studies may be less rigorous.
When to Call the Doctor
Contact your provider right away if you have:
Less urine than usual
Fever or chills
Back, side, or abdominal pain
Blood or pus in your urine
Also contact if:
Your bladder does not feel completely empty after you urinate.
You take medicines that may cause urinary problems. These may include diuretics, antihistamines, antidepressants, or sedatives. Do not stop or change your medicines without first talking to your provider.
You have taken self-care steps and your symptoms have not gotten better.
References
Andersson KE, Wein AJ. Pharmacologic management of lower urinary tract storage and emptying failure. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 120.
Capogrosso P, Salonia A, Montorsi F. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 145.
Kaplan SA. Benign prostatic hyperplasia and prostatitis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 114.
McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793-1803. PMID: 21420124 pubmed.ncbi.nlm.nih.gov/21420124/.
Samarinas M, Gravas S. The relationship between inflammation and LUTS/BPH. In: Morgia G, ed. Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia. Cambridge, MA: Elsevier Academic Press; 2018:chap 3.
Review Date:
7/1/2023
Reviewed By:
Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
