How to prevent Benign Prostatic Hyperplasia (BPH)?

From the Guidelines

To prevent BPH, the most effective approach is to consider the use of 5 alpha-reductase inhibitors, such as finasteride, in men with demonstrable prostatic enlargement, as they have been shown to reduce the risk of acute urinary retention and the need for BPH-related surgery. This is based on the American Urological Association (AUA) guideline on the management of benign prostatic hyperplasia 1. The guideline suggests that 5 alpha-reductase inhibitors are appropriate and effective treatments for patients with lower urinary tract symptoms (LUTS) associated with prostatic enlargement.

Some key points to consider when using 5 alpha-reductase inhibitors for BPH prevention include:

• They are most effective in men with symptomatic prostatic enlargement
• They can reduce the size of the prostate, increase peak urinary flow rate, and reduce BPH symptoms
• They can reduce the risk of acute urinary retention and the need for BPH-related surgery
• However, they may have side effects such as sexual dysfunction, and the need for long-term daily therapy should be discussed with the patient

In addition to medical therapy, maintaining a healthy lifestyle through regular exercise, weight management, and a balanced diet can also help reduce the risk of BPH. Limiting alcohol and caffeine consumption, staying hydrated, and managing stress through relaxation techniques can also help minimize urinary symptoms. Regular prostate screenings after age 50 (or earlier with risk factors) can help detect BPH early, allowing for timely intervention.

It is essential to note that while these strategies may help delay the onset or reduce the severity of BPH symptoms, they may not completely prevent the development of BPH, especially in men with a strong family history or other risk factors. Therefore, a comprehensive approach that includes medical therapy, lifestyle modifications, and regular monitoring is recommended for men at high risk of developing BPH 1.

From the FDA Drug Label

The data from these studies, showing improvement in BPH-related symptoms, reduction in treatment failure (BPH-related urological events), increased maximum urinary flow rates, and decreasing prostate volume, suggest that finasteride tablets arrests the disease process of BPH in men with an enlarged prostate. Finasteride tablets are indicated for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate to:

• Improve symptoms
• Reduce the risk of acute urinary retention
• Reduce the risk of the need for surgery including transurethral resection of the prostate (TURP) and prostatectomy. The use of finasteride may help prevent the progression of BPH by reducing the risk of acute urinary retention and the need for BPH-related surgery. Key points to consider:

• Finasteride reduces the risk of symptomatic progression of BPH.
• Finasteride decreases prostate volume and increases maximum urinary flow rates.
• Finasteride is indicated for the treatment of symptomatic BPH in men with an enlarged prostate. However, it is essential to note that finasteride is not approved for the prevention of prostate cancer 2.

From the Research

Prevention of BPH

To prevent Benign Prostatic Hyperplasia (BPH), several lifestyle changes and dietary modifications can be considered.

• Weight loss: Reducing weight can help decrease the risk of developing BPH 3.
• Regular physical activity: Engaging in regular exercise can help prevent BPH 3, 4.
• Dietary changes: Consuming a heart-healthy diet, including vegetables and moderate alcohol intake, may reduce the risk of BPH 5, 4.
• Avoiding certain foods: Reducing or avoiding starches, red meats, and fatty foods may help prevent BPH 5, 3.
• Supplements: Certain supplements like saw palmetto, zinc, and beta-sitosterol may have beneficial effects on BPH symptoms, although more research is needed to confirm their effectiveness 5, 6.

Medical Prevention

Some medical treatments may also help prevent BPH or reduce its symptoms.

• 5α-reductase inhibitors: These medications, such as finasteride, can help reduce the size of the prostate and prevent symptom progression 7, 3.
• Alpha 1 blockers: Medications like terazosin, doxazosin, and tamsulosin can help improve urinary symptoms by relaxing the muscles in the prostate and bladder neck 7, 3.