The prostate gland, located at the base of the penis, commonly enlarges as men age. This can lead to a noncancerous condition known as benign prostatic hyperplasia (BPH), which causes men to urinate more frequently and urgently, and may lead to a weak or diminished urine stream.
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When symptoms are bothersome, medications may be used to shrink prostate size or reduce urinary symptoms. For moderate to severe symptoms, minimally invasive procedures or surgery can be used to restore urine flow and improve quality of life.
Step 1: Medications
If your BPH symptoms are bothersome, talk to your doctor about your treatment options. Drugs that reduce prostate size include 5 alpha-reductase inhibitors (finasteride and dutasteride). These medications work to reduce the production of DHT, a hormone that can cause the prostate to enlarge.
Other drugs used in BPH management include terazosin, doxazosin, alfuzosin and tamsulosin, which relax the smooth muscle around the prostate and improve urinary symptoms. Your doctor may also recommend combining more than one class of drugs, as this can be more effective at reducing symptoms and improving urine flow.
Step 2: Procedures and Surgery
If your symptoms are moderate to severe, certain minimally invasive procedures or surgery may be advised. Most of these do not necessarily reduce the size of the prostate.
Rather, they remove or destroy enlarged prostate tissue or widen the urethra to allow a normal urine flow. Surgery may be recommended when medications and minor procedures are ineffective at controlling symptoms.
Step 3: Lifestyle Changes
While there are no known lifestyle changes that reduce prostate size, there are some steps you can take to ease symptoms. To minimize nighttime or excessive urination, avoid or limit caffeine or alcohol, particularly after dinner, and limit excess liquids before bed.
Getting regular physical activity and including several servings of fruits and vegetables each day have been associated with fewer BPH symptoms — although the mechanism of action is not clear. Natural therapies, such as saw palmetto, are commonly used by men with BPH.
However, due to lack of supportive evidence, the American Urological Association#x2513) does not endorse any dietary supplement for managing BPH.
Reviewed by Kay Peck, MPH, RD