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 when you have the chance, 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 doctor about taking Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) with alpha-1- blockers.
Finasteride and dutasteride may also be prescribed.
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 doctor 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 doctor 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 your doctor 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.
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. Epub 2011 Mar 21.
Roehrborn CG. Male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Med Clin North Am. 2011 Jan;95(1):87-100.
Tacklind J, Fink HA, Macdonald R, Rutks I, Wilt TJ. Finasteride for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2010 Oct 6;(10):CD006015.
Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.