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 weak urine stream
- Strong and sudden urge to urinate
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.
Learn about exercises (Kegel exercises) that strengthen the pelvic floor muscles. Doing these exercise may help with leaking or losing control of your urine. Once you have learned how to do these, you should perform them 3 times a day.
Medicines, Herbs, and Supplements
Your health care provider may have you take a medicine called alpha-1- blocker. Most people find that these drugs help their symptoms. Symptoms often get better soon after starting on the medicine. You must take this medicine every day.
- Common side effects include nasal stuffiness, headaches, lightheadedness when you stand up, and weakness. You may also notice less semen when you ejaculate.
- Ask your provider about taking Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) with alpha-1- blockers.
Other drugs such as finasteride and dutasteride may also be prescribed. These medicines help shrink the prostate over time and help with symptoms.
- You will need to take these drugs 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 drugs 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 drug.
- Other drugs that may worsen symptoms are certain antidepressants and drugs used to treat spasticity.
Many herbs and supplements have been tried for treating an enlarged prostate.
- Saw palmetto has been used by millions of 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 or herbal remedies and dietary supplements do not need approval from the FDA to sell their products.
When to Call the Doctor
Call your health care 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 call 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 doctor.
- You have taken tried self-care steps and your symptoms have not gotten better.
BPH - self-care; Benign prostatic hypertrophy - self-care; Benign prostatic hyperplasia - self-care
Kaplan SA. Benign prostatic hyperplasia and prostatis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 129.
McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011 May;185(5):1793-803. PMID: 21420124 www.ncbi.nlm.nih.gov/pubmed/21420124.
NcNicholas TA, Kirby RS, Lepor H. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 92.
Roehrborn CG. Male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Med Clin North Am. 2011 Jan;95(1):87-100. PMID: 21095413 www.ncbi.nlm.nih.gov/pubmed/21095413.
Tacklind J, Fink HA, Macdonald R, Rutks I, Wilt TJ. Finasteride for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2010 Oct 6;(10):CD006015. PMID: 20927745 www.ncbi.nlm.nih.gov/pubmed/20927745.
Review Date 8/31/2015
Updated by: Jennifer Sobol, DO, Urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.