Professionals, BPH Treatment Options, Medical Management

Medical Management

Medical management may be effective for patients with mild to moderate symptoms of BPH.  Several different types of medications are available to treat the symptoms of enlarged prostate and generally fall into these categories:

  • Alpha Blocker
  • 5 Alpha Reductase Inhibitor (5-ARI)
  • PDE 5 Inhibitor

In many practices medication is still the primary treatment option offered to patients due to its simplicity but, unfortunately, medication is not effective for all men with a reported 48% of patients not showing clinically significant symptom improvement.1


  • Simple to use
  • Do not require surgery or a hospital stay
  • Fast symptom relief

Side Effects2,3

  • Fatigue
  • Headache
  • Dizziness
  • Impotence
  • Chronic sinus congestion
  • Low blood pressure
  • Loss of sex drive
In the 2007 Prostate Research Study (Harris Interactive), only half of the patients surveyed were satisfied with their current BPH medication.6

Alpha blockers are intended to relax the muscles around the neck of the bladder and urethra making it easier to urinate. Common side effects include reduced semen released during ejaculation, low blood pressure, dizziness, headache, stomach or intestinal irritation, and a stuffy or runny nose.2 There is also a risk of floppy iris syndrome which can cause surgical complications in the event of cataract surgery in anyone who has ever taken an alpha blocker5

5Alpha-reductase inhibitors are intended to help shrink the prostate gland. Common side effects include erectile dysfunction, decreased libido, and reduced semen during ejaculation4

Clinical Results

The figure below, published in the AUA clinical guidance document, shows the impact of medical management on patient bother as measured by symptom score, peak flow rate, QoL score, and BPH impact Index.7

Note: The data for BPH Medications, Cooled ThermoTherapyTM, and PROSTIVA® were not collected in a head-to-head study. Direct comparisons cannot be made.

1Wel, et al, High Rates for Continued BPH Medical Therapy Among Non-Responders, Abstract 498, AUA Annual Meeting, 2009. 2Flomax®, Tamsulosin hydrochloride, Patient Information About Flomax Capsules, Table 3, Treatment Emergent Adverse Events Occurring in ≥2% of Flomax (tamsulosin hydrochloride) capsules or placebo patients in the U.S. short-term placebo-controlled clinical studies, Page 14, July 17, 2006. 3Proscar Labeling 9631304, www.fda.gov. 4Prostate gland enlargement. MayoClinic.com tools for healthier lives. Original Article: www.mayoclinic.com/health/prostate-gland-enlargement/DS00027/DSECTION=2. Accessed March 11, 2008. 5Flomax (tamsulosin hydrochloride) prescribing information, Boehringer Ingelheim Pharmaceuticals. 6Data from online survey conducted by Harris Interactive, August 2007 sponsored by Medtronic, Inc. Survey included 206 qualified respondents. 7AUA Clinical Guidelines on the Management of BPH (Revised, 2010)