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There are two kinds of prescription pills, known as alpha blockers and 5-alpha reductase inhibitors. They can be taken either alone or as combination therapy, which may result in greater effectiveness and symptom relief. Pills may require several weeks to 6 months to take effect. They also may have side effects, and their long-term effectiveness can be limited. Over the long run, the continual use of pills can be costly.

Alpha Blockers

These pills are often prescribed for mild to moderate BPH symptoms. Alpha blockers relax the muscle tissue of the prostate and the bladder neck, allowing urine to flow from the bladder more easily.
These pills include:

  • Hytrin® (terazosin hydrochloride)
  • Cardura® (doxazosin mesylate)
  • Flomax® (tamsulosin hydrochloride)
  • Minipress® (prazosin hydrochloride)
  • Uroxatral® (alfuzosin hydrochloride)

Alpha blockers relieve symptoms within a few weeks, but do not stop the process of prostate enlargement. Side effects vary with each individual and medication.

Common side effects of alpha blockers include:

  • Weakness or fatigue
  • Headaches
  • Nasal congestion
  • Dizziness

Sexual side effects include:

  • Failure to ejaculate,
  • Retrograde (or internal) ejaculation,
  • Less semen to be ejaculated.

Side effects disappear once the medication is stopped.


5-Alpha Reductase Inhibitors

These medications work best with men who have significantly enlarged prostates (BPH). Men with smaller prostates see less benefit. 5-alpha reductase inhibitors inhibit the effect of certain male hormones, which slows the rate of prostate enlargement. In some cases, they even shrink the size of the prostate.

Two medications in this category are:

  • Proscar® (finasteride)
  • Avodart® (dutasteride)

5-alpha reductase inhibitors may take from 3 to 6 months before symptom improvements are noticed.

While 5-alpha reductase inhibitors are generally considered safe and well tolerated, common side effects include:

  • Less semen to be ejaculated
  • The inability to get an erection (impotence).



Sexual Function and BPH

Dr. Shore is a clinical urologist and principle investigator of the Prolieve® System, who specializes in prostate disease and has performed more than 200 office-based minimally invasive treatments for the symptoms of BPH. This article is based on Dr. Shore’s clinical experiences and opinions. Dr. Shore is a paid consultant of Boston Scientific.



1. Avodart® and Proscar® prescribing information.

The information presented on this page has been adapted in part from Benign Prostatic Hyperplasia (BPH): A Patient’s Guide from the American Urological Association, and from Benign Prostatic Hyperplasia (BPH) from WebMD Inc.

Hytrin is a trademark of Abbott Laboratories; Cardura is a trademark of Pfizer Inc.; Flomax is a trademark of Yamanouchi Pharmaceutical Co., Ltd.; Minipress is a trademark of Pfizer Inc.; Uroxatral is a trademark of Sanofi-Synthelabo; Proscar is a trademark of Merck & Co., Inc.; and Avodart is a trademark of GlaxoSmithKline.

Disclaimer: This material is provided for information purposes only and is not a substitute for a consultation. You should talk with a urologist regarding your specific symptoms or medical condition.


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