Prostate: BPH May Leave You Out in the Cold
During cold and flu season, health professionals are warning men who have an enlarged prostate to avoid common medications containing antihistamines and decongestants.
Men with prostate trouble should avoid certain cold medicines!
“It’s very important that men with an enlarged prostate avoid cold medicines with pseudoephedrine or phenylephrine. Those are ingredients in decongestants and they constrict the prostatic capsule” and can lead to urine retention, said Dr. Gregory T. Bales, a urologist at the University of Chicago Medical Center. “Antihistamines aren’t quite as bad, because they work more on the bladder muscle, but they can cause bladder contractility.”
Enlargement of the prostate, formally known as benign prostate hyperplasia (BPH), results from increased cell growth in and around the prostate gland. The increased growth can constrict the urethra (the tube that carries urine out from the bladder) and decrease urine flow. Men with the progressive disease often have difficulty urinating and the urge to go more frequently.
BPH is common in older men. By age 60, more than half of men have BPH. By age 85, about 90 percent of men have BPH, but only 30 percent of men will be bothered by their symptoms.
Dr. Bales has treated hundreds of patients struggling with BPH, and he warns against waiting too long to visit a doctor during complete retention. Severe retention can cause kidney damage and other serious issues.
“If a man is already having a little difficulty and his stream is already slow, and then you make it worse it by adding one of these medicines, it’s the recipe for causing retention. All it takes is one dose,” Bales told Reuters Health. “If you haven’t urinated in six hours or so, you have to go to the hospital and get a catheter put in to drain that liquid. Then we wait a couple days to let the medicine get out of his system and then do a urine test. It’s painful.”
Cold remedies that are inhaled, such as a nasal corticosteroid, will not have the same side effects as an oral agent, Bales added. Mentholated ointments are a safer alternative to decongestants.
“If men notice problems with urination after taking certain medicines, they may need to weigh the risks and benefits,” Dr. Dan R. Gralnek, a urologist with the University of Wisconsin School of Medicine and Public Health, told Reuters Health. Nearly 15 percent of his patients have complications associated with BPH.
Dr. Matthew Johnson, a urologist with Aurora Health Care in Milwaukee, Wisconsin, urges men to carefully read over-the-counter drug labels.
“You have to be aware of what a medication’s potential side-effects are. Unfortunately, the package insert for most medications is quite lengthy,” he told Reuters Health. “Men need to have a relationship with a provider who can monitor these things and individualize their care.”
Also, men who are taking diuretics, which increase urination, may want to talk to their doctor about reducing the dosage or switching to another drug. These are important drugs for many people with high blood pressure, with a proven track record of saving lives. No one should go off these medications without medical supervision.
The causes of BPH are not completely understood. No definitive information on potential risk factors exists. It has long been known that BPH occurs mainly in older men and that it does not develop in men whose testes were removed prior to puberty. Because of this, researchers believe that factors related to aging and the testes may spur the development of BPH.
Men produce both the male hormone testosterone and smaller amounts of the female hormone estrogen. As you age, the level of testosterone in your blood decreases, resulting in a higher proportion of estrogen. Animal studies have suggested that BPH may occur due to the higher levels of estrogen within the gland. This increases the activity of certain substances that promote cell growth.
Early symptoms of BPH may take many years to become bigger problems. In most cases, these symptoms may point to an enlarged prostate, but they may also be a sign that other, more serious conditions that require prompt attention. If you are experiencing these early symptoms, it is a good time to see your doctor.
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