The prostate, a walnut sized gland that surrounds the urethra, often enlarges as men age, decreasing the flow of urine through the urethra and causing symptoms ranging from frequent nocturnal urination and reduced, hesitant urine stream to complete inability to urinate. Causes of prostate enlargement include benign prostatic hypertrophy, prostatitis, inflammation of the prostate and prostate cancer. Several medications are commonly used to improve urine flow and decrease symptoms.
5-Alpha Reductase Inhibitors
Proscar and Avodart, 5-alpha reductase inhibitors, shrink the prostate by inhibiting production a DHT, a hormone necessary for prostate enlargement. According to MayoClinic.com, it may take week or even months before improvement occurs. Possible side effects include decreased libido, impotence and retrograde ejaculation whereby sperm flow into the bladder instead of being ejaculated from the penis.
Alpha Blockers
Alpha blockers relax smooth muscle around the bladder neck and in the prostate, making it easier for urine to flow in cases of prostate enlargement. Unlike 5-alpha reductase inhibitors, alpha blockers work quickly, often improving urinary symptoms of prostate obstruction within a day or two, according to MayoClinic.com. Commonly used brand name alpha blockers include Cardura, Flomax, Rapaflo and Uroxatral. Alpha blockers can also cause retrograde ejaculation.
Combination Therapy
According to the National Kidney and Urologic Disease Information Clearinghouse, using alpha blockers in conjunction with 5-alpha reductase inhibitors reduces symptoms more effectively than using either drug class alone, reducing benign prostatic hyperplasia by 67 percent as compared with 39 percent for a smooth muscle relaxant alone, or 34 percent for a 5-alpha reductase inhibitor alone.
Testosterone Suppression
Prostate cancer can be treated with medications injected monthly that stop production of testosterone, the dominant male hormone. Lupron and Zoladex are commonly used medications. Side effects include loss of libido and impotence, along with hot flashes, the University of California San Francisco reports. Oral medications that block the uptake of testosterone into the prostate may also be given: Casodex, Eulexin and Nilandron are brand names commonly prescribed. Long term use of medications that stop testosterone production include a risk for developing osteoporosis, a loss of bone density.
Antibiotics
If prostatitis, inflammation of the prostate caused by bacterial infection is present, antibiotics help clear the infection and reduce swelling of the prostate. Antibiotics may also help with symptoms in cases of non-bacterial prostatitis, the Merck Manual reports.
