Prostate Health

Key points

• NIDDK explains that an enlarged prostate is not itself caused by cancer, even though some urinary symptoms can overlap with other prostate problems.
• NIDDK describes alpha blockers as relaxing the muscles of the bladder neck and prostate, and 5-alpha reductase inhibitors as shrinking the prostate over time.
• NICE’s guidance on lower urinary tract symptoms in men covers assessment, conservative management, medicines and surgery.

Alpha blockers for urinary symptoms

Flomax contains tamsulosin, Cardura contains doxazosin, Hytrin contains terazosin and Uroxatral contains alfuzosin; all four relax muscle around the bladder neck and prostate to ease urinary symptoms from an enlarged prostate. Cardura and Hytrin are also used for high blood pressure. Minipress contains prazosin, the same type of medicine, but here it is used only for high blood pressure.

Medicines that shrink the prostate

Finpecia contains finasteride and Avodart contains dutasteride; both reduce prostate size over time rather than relaxing muscle. Jalyn combines dutasteride with tamsulosin in a single capsule, joining both approaches together.

Xtandi treats prostate cancer, not enlargement

Xtandi contains enzalutamide and is used across several stages of prostate cancer, including metastatic disease, sometimes together with androgen deprivation therapy. It has no role in benign prostatic hyperplasia and is kept apart from the medicines above for that reason.

Further reading

• Enlarged Prostate (Benign Prostatic Hyperplasia)
• Lower urinary tract symptoms in men: management