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What's the best treatment for your enlarged prostate?

Treatment for enlarged prostate, also called benign prostatic hyperplasia or BPH, will depend on the severity of the symptoms, and how they are affecting a man's life.

In some cases, a patient and doctor will agree on a plan to not treat enlarged prostate after diagnosis, but to carry out what's called watchful waiting.

Watchful waiting for an enlarged prostate

If you choose watchful waiting, there are things you can do to reduce your symptoms:

Make simple changes in your habits, like drinking fewer liquids before bedtime - and drinking less caffeine and alcohol generally.

Don’t take over-the-counter cold and sinus medicines with decongestants, which can make a prostate problem worse.

Talk to your doctor before taking herbal supplements to try to improve the symptoms of BPH. Saw palmetto is registered with the medicines regulator MHRA as a traditional herbal remedy used to relieve the symptoms of urinary tract discomfort in men with an enlarged prostate or BPH. Unlike licensing for mainstream medicines, registration doesn't mean a herbal remedy has been tested and proven to actually work. It does mean the MHRA is satisfied the product is made to good quality standards with appropriate labelling and a product information leaflet. It also means the herb has been used in traditional remedies for more than 30 years.

Watchful waiting is the least invasive treatment for an enlarged prostate. You avoid the risks of medications, procedures, and surgery. For some men, mild BPH symptoms improve with time. If symptoms become worse, it’s time to talk to your doctor about treatment.

An enlarged prostate and prescription drugs

When enlarged prostate symptoms become more troublesome, drugs may help provide relief. Two types of medications are available to treat moderate BPH. Each works differently in the body, and each has its own side effects.

The two classes of drugs for an enlarged prostate are:

  • Alpha blockers, which relax muscles of the prostate to relieve symptoms.
  • 5-alpha reductase inhibitors, which help shrink the prostate and prevent additional growth.

Men with very enlarged prostates may take both types of drugs, called combination therapy, to reduce the need for surgery. However, men taking combination therapy may experience the side effects of both drugs.

How to decide on your enlarged prostate treatment

The choice between watchful waiting and taking medications for your enlarged prostate is something to be discussed with your doctor. Together, you must weigh the risks and benefits of each.

Ask yourself about each treatment option:

  • How much is my quality of life affected right now?
  • How much will it improve?
  • How long will the effects last?
  • Is there a risk that the treatment will cause problems?

Points to consider in treating an enlarged prostate

Reasons to consider using medication for an enlarged prostate:

  • You have moderate, troublesome BPH symptoms.
  • You have tried watchful waiting, but symptoms are still troublesome.
  • You’ve tried making lifestyle changes, like drinking fewer liquids, but symptoms remain troublesome.
  • You are at risk for complications related to BPH, like urinary retention.

Reasons to try watchful waiting for an enlarged prostate:

  • Your BPH symptoms are mild and not troublesome.
  • You don’t want the side effects of medications.
  • Some men with mild BPH symptoms find that symptoms improve without treatment.
  • You may have to take medication indefinitely to control BPH symptoms.
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