Benign prostatic hyperplasia (BPH) is a condition that affects the prostate gland, which is part of a man’s reproductive system. BPH can cause uncomfortable urinary symptoms, like a frequent or urgent need to go. This can occur in the middle of the night sometimes.
BPH is common among older men. It affects up to
Treatment for BPH has come a long way in the last two decades. Today, several medicines are available to relieve urinary symptoms. Tadalafil (Cialis) and tamsulosin (Flomax) are just two of the drugs prescribed for BPH. Here’s a deeper look at what BPH is, how these medicines work, and their possible side effects.
Normally, the prostate adds fluid to semen. As you age, the gland can start to grow, which may cause problems.
The urethra, which is the tube urine travels through on its way out of the bladder, runs right through the prostate. Over time, the prostate can grow large enough to press down on and squeeze the urethra. This pressure narrows the exit.
This can make it more difficult for the bladder to release urine. Eventually, the bladder may become so weak that it can’t release urine normally.
This can lead to symptoms such as:
- a constant need to urinate
- an urgent need to urinate
- a weak urine stream
- dribbling after urination
You can treat these symptoms with:
- lifestyle changes, such as training the bladder to reduce bathroom trips or drinking fewer alcoholic and caffeinated beverages to reduce the urge to go
- medicines that relax the muscles of the prostate and bladder
- procedures to remove excess prostate tissue
Cialis was originally developed to treat erectile dysfunction (ED), which is difficulty getting an erection. Researchers then discovered that the drug also helps relieve BPH symptoms. In 2011, the U.S. Food and Drug Administration approved Cialis for men who have both BPH and ED.
In ED, Cialis works by increasing the levels of a chemical called cyclic guanosine monophosphate, or cGMP. This chemical increases blood flow to the penis. The chemical also relaxes muscle cells in the bladder and prostate. This may be why it eases the urinary symptoms of BPH.
Cialis was approved for BPH after studies had found men who took 5 milligrams per day had improvements in both BPH and ED symptoms.
Most side effects from Cialis are mild. These can include:
- nausea
- diarrhea
- a headache
- indigestion
- back pain
- muscle pain
- a stuffy nose
- flushing of the face
Because Cialis widens your arteries to let more blood flow to the penis, it can cause your blood pressure to drop. That’s why the drug isn’t recommended for men who already take drugs that lower blood pressure such as nitrates or alpha-blockers. Consuming alcohol can also increase this risk.
In rare cases, men have suddenly lost vision or hearing after taking Cialis and other drugs in its class. If you experience hearing or vision loss, you should tell your doctor right away.
Cialis is available in generic form, which can cost less than the brand name version.
Tamsulosin (Flomax) was one of the first drugs available to treat the urinary symptoms of BPH. It’s been around since the late 1990s.
Flomax is part of a drug class called alpha-blockers. These drugs work by relaxing smooth muscles in the prostate and bladder neck to let urine flow more freely.
Flomax, or another alpha-blocker, is usually the first drug prescribed for men with mild to moderate urinary symptoms from BPH.
Because Flomax also affects blood pressure, you shouldn’t use it if you already have low blood pressure. Since its effects on blood pressure are brief and somewhat unpredictable, it’s not a good choice to treat high blood pressure.
Side effects from Flomax are usually mild. These can include:
- an infection
- a stuffed nose
- pain
- a sore throat
- abnormal ejaculation
Rarely, men have developed more serious side effects, such as:
- dizziness or lightheadedness when standing or sitting up, which can be due to low blood pressure
- fainting
- chest pain
- prostate cancer
- a heart attack
- an allergic reaction
Talk to your doctor before taking Flomax if you’ve had a severe allergic reaction to sulfa drugs. You may be at an increased risk for an allergic reaction to Flomax.
This drug can also affect your eyes, and it may interfere with cataract or glaucoma surgery. If you’re planning to have eye surgery, you should tell your doctor before starting Flomax.
Talk to your doctor before taking Flomax if you also take an ED drug or blood pressure medication. When combined with Flomax, these can lower your blood pressure too much and increase symptoms like lightheadedness or fainting.
Like Cialis, Flomax is available in generic form, which can cost less than the brand name version.
Cialis and Flomax are just two of many drugs that are approved to treat BPH. Whenever you’re considering any new medicine, it’s important to discuss all of your options with your doctor. Find out how these drugs can help your symptoms and what side effects they might cause. Choose the drug that offers the best relief with the fewest risks.
Which drug you choose may also depend on what other health conditions you have. Cialis is a good option for men with both BPH and ED. Flomax is primarily for BPH. Both of these drugs can cause a drop in blood pressure and wouldn’t be a good choice for you if you already have low blood pressure or if your blood pressure varies.