The drug finasteride, which inhibits the metabolism of the male sex hormone testosterone and which has been shown to be effective in relieving the symptoms of benign prostatic hyperplasia (BPH), can also reduce the likelihood that otherwise healthy men will develop this condition. While the symptoms of BPH vary, the most common ones involve changes or problems with urination, such as a hesitant, interrupted, or weak stream; urgency and leaking or dribbling; and more frequent urination, especially at night.
Researchers examined patient data from over 9,000 men who were enrolled in the Prostate Cancer Prevention Trial, which collected information on men with BPH and related lower urinary tract symptoms, such as frequent urination, inability to urinate, and urinary tract infections. The average age of the men was 62 years. This retrospective analysis found that men who had received finasteride, a drug that blocks the conversion of testosterone to a more potent metabolite, had a 40 percent lower rate of BPH development than men who did not. The effect of finasteride did not vary significantly by age, race, diabetes, physical activity, or smoking, suggesting that these results could be applicable to a larger population. BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.
For many years, surgery was the only viable treatment option for BPH. In 2003, the NIDDK-supported Medical Therapy of Prostatic Symptoms (MTOPS) clinical trial conclusively demonstrated that combination therapy consisting of an α blocker, which relaxes smooth muscle, and finasteride was more effective than either drug alone in relieving the symptoms of BPH. The current study complements these findings, suggesting that finasteride may be an effective peventative therapy in men without overt symptoms of BPH.
Parsons JK, Schenk JM, Arnold KB, et al. Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. Eur Urol 62: 234-241, 2012.