Benign prostatic hyperplasia (BPH) is non-cancerous prostate enlargement that affects up to 50% of men over 60 and 80% of men over 80. Symptoms include weak stream, hesitancy, intermittency, nocturia, and incomplete emptying — collectively called lower urinary tract symptoms (LUTS). Modern medical management uses three drug classes alone or in combination, with the addition of tadalafil 5 mg daily for men with both BPH and erectile dysfunction. All MedsBase BPH products are supplied by WHO-GMP certified manufacturers.
Alpha-blockers — first-line for symptom relief. Selective alpha-1 antagonists relax smooth muscle in the prostate, bladder neck, and urethra to improve flow and reduce obstructive symptoms within 1–2 weeks. They do not reduce prostate volume or change long-term progression — they relieve symptoms. Tamsulosin 0.4 mg (the most prostate-selective, lowest BP-related side-effects) is stocked as Urimax, Urimax Capsule, Tamsuheal, and the combination forms Urimax-D (with dutasteride) and Urimax-F (with finasteride). Alfuzosin extended-release 10 mg as Monolosin. Silodosin 8 mg (most uroselective, fewest BP effects, but highest retrograde-ejaculation rate) as Temsunol, Temsunol Capsule, and combinations Temsunol-F and Temsunol-D. Side-effects across the class: dizziness on standing (especially first dose), retrograde ejaculation, nasal congestion. Important: warn anaesthetist before cataract surgery (intraoperative floppy iris syndrome).
5-alpha-reductase inhibitors — for prostate-volume reduction. Finasteride 5 mg and dutasteride 0.5 mg block conversion of testosterone to dihydrotestosterone, reducing prostate volume by ~20–25% over 6–12 months. They reduce risk of acute urinary retention and need for surgery. Slower symptom relief than alpha-blockers (3–6 months) but address underlying biology. Finasteride 5 mg (the original 5-ARI from MERCK) is stocked as Proscar and Proscalpin. Dutasteride 0.5 mg as Dutanol and the combination Dutas T (with tamsulosin). Finasteride 1 mg formulations are listed in our Hair Loss Treatment for Men category — same molecule, different dose. Side-effects: reduced libido (~3–5%), erectile dysfunction (~3–5%), decreased ejaculate volume, gynaecomastia (rare). Some men report persistent post-finasteride syndrome — discuss risks before starting.
PDE-5 inhibitors for combined BPH + ED. Tadalafil 5 mg once daily is FDA-approved for BPH-LUTS (alone or in combination with alpha-blocker). It improves both LUTS and erectile function in men with both conditions — a single-pill solution for two problems. We stock low-dose tadalafil under multiple brands listed in our Tadalafil catalogue, and combinations such as Tadalista and Vidalista. Higher-strength tadalafil and other PDE-5 inhibitors live in our broader ED Medication catalogue.
How to choose. Mild symptoms (IPSS < 8) → lifestyle measures + watchful waiting. Moderate symptoms (IPSS 8–19) → alpha-blocker monotherapy first-line; add 5-ARI if prostate volume > 30 mL or PSA > 1.4 ng/mL (risk markers for progression). Severe symptoms (IPSS > 19) or recurrent retention → combination alpha-blocker + 5-ARI ± referral for surgical options (TURP, HoLEP, PVP, prostatic urethral lift, water-vapour ablation). Concomitant ED → consider tadalafil 5 mg daily as monotherapy or combination.
Important. Acute urinary retention (sudden complete inability to void with painful bladder distension) is a urological emergency — go to A&E. New haematuria, perineal pain, weight loss, or PSA rise above expected age range warrants prompt urology referral to exclude prostate cancer. PSA testing is a separate decision discussed with your GP — BPH treatment with 5-ARIs lowers PSA by ~50%, factor this into surveillance interpretation. Avoid alpha-blockers in patients on PDE-5 inhibitors at full doses without dose review (additive hypotension risk).
All MedsBase BPH products ship from WHO-GMP certified manufacturers with discreet packaging and are covered by our Reshipment Assurance Policy.