From the Research
Finasteride should be taken once daily for urinary retention associated with benign prostatic hyperplasia (BPH), with the standard dosage being 5 mg taken orally at approximately the same time each day, with or without food, as supported by the most recent and highest quality study 1. The medication works by inhibiting the enzyme 5-alpha reductase, which converts testosterone to dihydrotestosterone (DHT), thereby reducing prostate size over time. This mechanism means that symptom improvement may take 3-6 months of regular use to become noticeable. It's essential to continue taking finasteride even after symptoms improve, as stopping the medication will allow the prostate to begin growing again. Some key points to consider when taking finasteride include:
- Consistency in timing helps maintain stable blood levels of the medication
- Patients should be aware that finasteride can affect PSA levels, potentially masking prostate cancer detection, so regular prostate exams are still necessary
- Side effects may include decreased libido, erectile dysfunction, and ejaculation disorders, which should be discussed with a healthcare provider if they occur
- The use of 5-alpha reductase inhibitors, such as finasteride, has been demonstrated to decrease prostate volume, improve lower urinary tract symptoms (LUTS) and urinary flow rates, and ultimately reduce the risk of acute urinary retention (AUR) and BPH-related surgery 1. Additionally, a study from 2018 highlights the importance of proper evaluation and management of urinary retention, including the use of alpha blockers and voiding trials 2. However, the most critical aspect of finasteride treatment is its ability to reduce the risk of AUR and BPH-related surgery, as shown in a study from 2000 3. Overall, finasteride is a valuable treatment option for urinary retention associated with BPH, and its use should be considered in conjunction with other management strategies.