Proscar (finasteride) – Effective BPH symptom improvement
Since its approval in 1992, Proscar (finasteride) has helped countless numbers of men worldwide to tackle the symptoms of Benign Prostate Hyperplasia (BPH) (sometimes referred to as Enlarging Prostate). BPH is an extremely common age-related condition affecting an estimated 50% of men over the age of 50. This figure rises to 90% of men over the age of 80. Whilst for many men BPH does not cause any them any problems at all (around half of men with BPH are symptom free), for others the symptoms can become particularly distressing and embarrassing and can have a huge impact on their quality of life in general.
The prostate gland is a walnut-shaped gland that sits at the base of the bladder. It forms part of the male reproductive system playing an important part in male sexual function and reproduction. Its role is to store and secrete a slightly alkaline, milky-looking fluid that usually constitutes 25-30% of the volume of a man’s semen. This fluid helps to nourish and protect sperm during ejaculation. The urethra (the thin tube that allows urine and semen to leave the male body via the penis) passes through the prostate enabling the prostatic fluid to become part of a man’s semen.
The prostate gland is unusual in that it has a number of growth phases throughout a man’s life. At birth the prostate weighs on average around 1.5 grams but following growth phases during puberty and again in the mid-20s, the prostate grows to around 18 grams. Most men experience yet another growth phase which appears to begin in their late 40’s-50’s so that by the time a man has reached his 70’s his prostate may weigh as much as 31 grams or around 21 times birth weight. It is this later growth phase that causes the problems associated with BPH.
Because of the prostate’s position within the male body, an enlarging prostate puts pressure on the urethra which can lead to a number of urinary problems developing. If left untreated, not only will symptoms become worse as the prostate continues to grow, but surgery may also be required (surgery is necessary in 4 out of every 100 cases of untreated BPH). As it takes time for the prostate to grow to such a point that it is causing problems, the onset of symptoms is usually gradual. The first symptoms usually manifest themselves as mild urinary problems which many men simply put down to growing older. Signs that there may be a problem include:
• Slowness in starting urinating
• Weak urine stream
• Dribbling at the end of passing urine
• Getting up more than once or twice a night to urinate
• Blood in the urine
• Urinary leakage when coughing or sneezing
• Difficulty in getting to the toilet in time when the urge to urinate occurs
• Complete stoppage of urine
As these symptoms progressively worsen, they can have a significant and detrimental impact on a man’s life.
It is not yet fully understood why a man’s prostate continues to grow in the way that it does. Theories centre around changing hormonal patterns and in particular the testosterone derivative dihydrotestosterone (usually referred to as DHT) which is needed for prostate gland growth.
This prostate growth requires the conversion of testosterone into DHT in the presence of a specific enzyme called ‘5-alpha reductase’. The active ingredient in Proscar (finasteride), finasteride, belongs to a class of drugs known as ‘5-alpha reductase inhibitors’. Proscar (finasteride) specifically inhibits type II 5-alpha-reductase which in turn reduces the amount of DHT available in the body. By doing this, Proscar (finasteride) can help to improve the symptoms of BPH. It provides benefits such as:
• A decreased urge to urinate
• Better urine flow with less straining
• Less of a feeling that the bladder is not completely emptied
• Decreased night time urination
But Proscar (finasteride) also acts to reduce the risk of the need for surgery including transurethral resection of the prostate (usually referred to as TURP - a procedure whereby an endoscopic instrument is passed up through the opening of the penis and the centre of the prostate gland is removed) and prostatectomy (the surgical removal of the prostate gland).
Proscar (finasteride) also helps to reduce the risk of acute urinary retention (AUR) developing. Both men and women can experience AUR, but with increasing age men tend to be affected more as a result of BPH. AUR produces severe lower abdominal pain, a distended abdomen, and/or the sudden inability to pass urine. It requires immediate medical attention if further complications such as bladder damage and chronic kidney failure are to be avoided.
It should be remembered that Proscar (finasteride) shrinks the prostate gland slowly. Therefore, Proscar (finasteride) may need to be taken for 6 months or longer to see whether it is beneficial. If Proscar (finasteride) treatment is helpful in easing the symptoms of BPH, it may need to taken every day because the prostate gland is likely to grow again if treatment is discontinued.
It should be noted that BPH is not forerunner to prostate cancer.
Dosage
The recommended dose is 5 mg orally once a day. Proscar (finasteride) should be taken with a glass of water.
Side effects
Proscar (finasteride) is generally well tolerated in most men but, as with all medicines, taking Proscar (finasteride) may cause unwanted side effects in a few people. The more common side effects include:
• Impotence (the inability to get an erection)
• Decreased libido
• Changes or problems with ejaculation, such as a decreased amount of semen being released during sex (this does not appear to interfere with normal sexual function)
If the above side effects are experienced, they are usually mild in nature and may disappear even though Proscar (finasteride) medication is continued. If symptoms persisted, they are usually resolved on stopping the tablets.
In rare cases more serious side effects may occur and should be immediately reported to a patient’s doctor:
• Breast swelling and/or tenderness
• Breast lumps, pain or discharge from the nipples
• Skin rash, itchiness
• Hives or nettlerash (pinkish, itchy swellings on the skin)
• Testicle pain
Immediate, urgent medical assistance must be sought if there is any swelling of the face or lips as this would indicate a serious allergic reaction which may affect breathing or swallowing.
Warnings
Proscar (finasteride) has not been shown to interfere with other medicines.
Proscar (finasteride) is for use by men only and should not be given to women or children. It is rated ‘Category X’ for pregnancy - this means that it is known to cause birth defects. It may cause male babies to be born with abnormalities of the sex organs. Women who are pregnant or may be pregnant must not take Proscar (finasteride) nor must they touch crushed or broken tablets because finasteride (the active ingredient in Proscar (finasteride)) can be absorbed through the skin.
Proscar (finasteride) tablets are coated and this coating prevents contact with finasteride during normal handling, provided the tablets are not broken or crushed. If a pregnant woman swallows Proscar (finasteride) or handles crushed or broken tablets, her doctor must be consulted immediately.
Whilst finasteride is not, in itself, a performance-enhancing substance, it is known to be a "masking agent" for a number of performance-enhancing anabolic androgenic steroids that are banned by World Athletics Doping Agency.