Alpha-Blockers are a class of prescription medications which relax muscles around small blood vessels.
By preventing the muscles from tightening, they can help improve blood flow and lower blood pressure.
Their muscle relaxing properties help improve lower urinary tract symptoms in men, often caused by benign prostatic hyperplasia (BPH).
You can obtain relief by relaxing the muscles around the bladder neck and the urethra. 1
Alpha-Blocker Medication
There are several medications available as alpha-blockers. These medications are:
- Tamsulosin (Flomax).
- Alfuzosin (Uroxatral).
- Doxazosin (Cardura).
- Prazosin (Minipress).
- Silodosin (Rapaflo).
- Terazosin (Hytrin).
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Beta vs. Alpha Blockers
Beta-blockers are a class of prescription medications that work by blocking the effects of the hormone called adrenaline.
They tend to slow the heart rate and cause the heart to beat with less force, thereby reducing blood pressure.
Beta-blockers and alpha-blockers are sometimes combined to help treat high blood pressure, especially in patients where beta-blockers alone are not entirely effective.
The muscle-relaxing ability of alpha-blockers can help improve blood flow and lower blood pressure.
However, alpha-blockers are rarely used alone to alleviate high blood pressure. While beta-blockers are not generally used to treat enlarged prostate in the absence of high blood pressure.
Risks, benefits and side effects of Alpha Blockers
The most prevalent BPH alpha blocker used in the US in men with BPH is tamsulosin, sold as Flomax.
The most common side effects are listed below:
- Delayed or disrupted orgasm or ejaculation.
- Loss of Libido.
- Erectile dysfunction.
- Lowers blood pressure/ Sudden drops in blood pressure on standing.
- Headaches or nausea.
- Swollen legs or ankles.
- Gynecomastia (enlargement of male breasts).
- Weakness or feeling lethargic.
- Sleep disturbances.
There is very little research on medication-induced sexual dysfunction.
However, in recent years, as the use of these drugs has become more prevalent, effects involving sexual disruption have moved closer to the top of the known side effects.
These effects were likely under-reported in the past by pharmaceutical companies, to promote the drugs.
Flomax side effects
Flomax (tamsulosin), for example, has many side effects. The most common and well-known are:
- A reduction in (or loss of) libido.
- Delayed or disrupted ejaculation.
Further side effects
The side effects of alpha-blockers vary. Flomax or tamsulosin is frequently used for the control of BPH symptoms.
A review of the current literature suggests several adverse sexual side effects common to this medication.
However, the chief adverse sexual side effects, especially erectile dysfunction and disturbed or missing ejaculation, are psychologically enough to lead many men to stop taking the drug.
These adverse effects of BPH medications have only recently begun to surface and can be rather debilitating to an older man.
Many men consider a change from normal to abnormal ejaculations sacrosanct and will eliminate drug therapy as soon as they discover the drug is causing the effect.
A rare side effect of alpha-blocker medications is a vision problem called Amblyopia.
In this condition, vision in one eye reduces because the eye and the brain are not properly coordinating muscle responses. This is due to the muscle-relaxing properties of the drug.
Typically, the brain is favoring one eye over the other. This condition is also sometimes called a lazy eye and may resolve when the medication is discontinued.
Further, some research suggests long-term use of alpha-blockers may increase the risk of heart failure.
Recent studies have suggested drugs such as Finasteride can reduce the risk of getting prostate cancer while resolving symptoms of BPH. Some doctors have been prescribing Finasteride for this purpose.
However, the prevention aspect is dulled by the under-reported detail that Finasteride may also increase the risk of developing aggressive and potentially fatal prostate cancer. 2 Other studies have shown that 5-ARIs and control patients have the same risk of suffering aggressive prostate cancer, which is why these results are still debatable
Other drugs for treating BPH
There are three classes of drugs in common use today to treat BPH. They are:
- Alpha-blockers, which we discuss in this article.
- 5-Alpha Reductase inhibitors (5-ARIs), which help reduce the activity of the enzyme that converts testosterone to estrogen.
- Phosphodiesterase-5 (PDE-5) inhibitors, which help reduce the activity of one of a family of enzymes that act to prevent an erection.
The excess circulating estrogen hormone in the male body contributes to prostate growth or BPH.
By preventing the excess conversion of testosterone to estrogen, 5-ARIs help increases free testosterone levels while reducing excess estrogen.
This often can prevent further prostate growth. This class of drugs seems to be most helpful to men with very large prostates.
There are two main 5-ARI drugs in use today: Finasteride (Propecia, Proscar) and Dutasteride (Avodart).
Unwanted side effects
While these drugs may help with symptoms, they also carry some unwanted side effects.
- Cause or exacerbate erectile dysfunction.
- Lower or eliminate sex drive (libido).
- Cause retrograde ejaculation. A condition whereby a man′s ejaculate directs into the bladder instead of out of the penis.
It can take several months for the full effects of 5-ARIs to take effect, and they must be continued regularly to maintain improvements.
Cautions: Pregnant women should not be exposed to 5-ARI medications. Several reports have found that Finasteride can be absorbed through the skin. It can cause birth defects in unborn male children if the mother comes in contact with it while pregnant.
Side effects of several 5-ARI medications may be permanent and persist after the drug is stopped.
Phosphodiesterase-5 Inhibitors (PDE-5Is) are a class of medicines used to treat erectile dysfunction. They work by inhibiting the effect of the PDE-5 enzymes on the smooth muscle cells lining the blood vessels and erectile chambers of the penis.
A high PDE-5 level can quickly degrade an erection.
There are several kinds of PDE-5 inhibitors, and the FDA has approved Tadalafil (Cialis) used daily as a treatment for BPH.
Safety and effectiveness of Alpha Blockers
Alpha-blocker medications are generally safe and well-tolerated. They are quite effective when used for improving urine flow in older men with BPH.
However, herbal and nutritional items (see below) are often as effective and have fewer side effects.
Alpha-blockers sometimes have a severe side effect that results in a reduction of normal blood pressure.
This can result in dizziness, especially when rising from a prone or sitting position. This effect is generally short term, and moderates on regular usage as the body adapts to the medication.
However, sudden syncope or fainting induced by an alpha-blocker may result in injury. Therefore, most doctors prescribe taking an alpha-blocker at night just before sleep.
Some alpha-blockers might have what is called a “first-dose effect”. When an alpha-blocker meditation is first used, it can cause a drop in blood pressure under certain conditions.
This can cause syncope or fainting on rising from a sitting or lying position. As a result, the first dose is often prescribed to be taken at bedtime.
The alpha-blockers mentioned above are all prescription medications. Like all prescription medications, they are made from synthetic substances and chemicals that alter certain body functionality.
Natural alternatives to resolve BPH symptoms
Many medications mimic the effects that certain plant nutrients (phytonutrients) have on the body.
Rye Flower Pollen
Several phytonutrients have similar effects to alpha-blockers on the body. The most commonly used product to mimic alpha-blocker medication is Flower Pollen.
One of the advantages of flower pollen is that, as a nutritional item, it has nutritional value and virtually no side effects.
Flower Pollen powder consists of multiple micro-nutrients. These include :
- minerals
- vitamins
- enzymes
- essential fatty acids
- antioxidants
- plant sterols
- and all essential amino acids needed by the human body.
It is typically produced from common Ryegrass.
Studies show its effect on smooth muscle relaxation is similar to alpha-blocker medication.
This includes statistical improvements in:
- urinary flow.
- intermittent voiding.
- dribbling.
- the number of times one wakes up at night to urinate (nocturia).
- urinary retention.
Flower pollen is available under names like Graminex, Cernilton, and Swedish Flower Pollen. 3, 4
Pygeum africanum
Pygeum africanum is a tree that grows in Africa. Its bark is used to make an extract that can be used for treating symptoms of BPH.
Its most prevalent use in the US is to help with the treatment of BPH and to increase sexual desire.
Pygeum has many medicinal uses worldwide. It is an anti-inflammatory herb that can reduce inflammation, making it useful for many conditions.
Men often use pygeum africanum to help with lower urinary tract symptoms consistent with BPH.
A meta-analysis looked at eighteen randomized, controlled trials using extracts of pygeum.
These trials included a total of 1562 men with BPH. 5 The review concluded that pygeum improved urinary symptoms of BPH with few side effects.
Men using pygeum were more than twice as likely to report improvement in overall symptoms.
Stinging nettle
Urtica dioica, also known as stinging nettle, is a plant that grows in various climates worldwide.
Many cultures have successfully used its root to treat the urinary symptoms from BPH.
It also has numerous medicinal properties and is often used for joint problems, as a diuretic, and as an astringent.
Studies have shown it can help improve symptoms of BPH, including those of the lower urinary tract.
A 2005 double-blind, placebo-controlled, randomized trial of 620 men with BPH found that treatment of BPH over six months with an extract of Urtica dioica induced a significant improvement in International Prostate Symptom Score (IPSS), compared to placebo.
These improvements were maintained 18 months after treatment was stopped indicating that a healing effect might have also occurred. 6
Saw palmetto
Saw Palmetto (Serenoa repens) is a dwarf palm tree that grows prolifically in the US in South Florida.
Extracts of its berries saw palmetto is commonly used to treat BPH.
Native Americans utilized saw palmetto to treat prostate gland swelling and inflammation, testicular atrophy, and erectile dysfunction in Florida in the early 1700s. References to its use also turned up in 15th-century Egyptian literature.
Medical practitioners worldwide have historically used the plant for urological conditions. Saw palmetto berries were officially listed in the United States Pharmacopoeia in the first half of the 20th century.
Many studies and meta-analyses have evaluated extracts of the saw palmetto berry for its safety and efficacy in the treatment of BPH.
Saw palmetto berries contain more than 100 known chemical compounds or phytonutrients. The active ingredients in saw palmetto appear to be contained in the fat-soluble extract of the berry.
Moreover, the exact mechanism of action for saw palmetto is unknown. Various studies have isolated proposed mechanisms, but none have been conclusively established.
However, the herb is known to have properties that inhibit 5-alpha-reductase (similar to beta-blockers drugs), and relaxation of lower urinary tract smooth muscle (similar to alpha-blockers drugs).
It has also shown a tendency to increase circulating testosterone by decreasing available sex hormone-binding globulin, an element that binds to testosterone, making it unavailable to the body. 7
Synergy
Synergy is the result of two or more substances acting together to produce a greater effect.
In nature, you never find nutrients in isolation. Purifying a single chemical component of an herb for medicinal purposes is akin to producing a pharmaceutical drug and sometimes results in unintended consequences.
Most herbal preparations use extracts of the complete plant to avoid losing potential benefits of any single nutrient.
Herbalists know that the chemical constituents of many herbs and foods often have a greater benefit when used together.
The synergy between herbs is significant and is what makes herbal combinations much more powerful.
There is significant evidence that a properly formulated herbal combination of Pygeum, Saw Palmetto, and Urtica dioica is highly effective in relieving lower urinary tract symptoms associated with BPH.
Many supplement manufacturers provide products combining saw palmetto extract with pygeum, nettle, pumpkin seed oil (a food high in zinc), and other ingredients.
Synergy is one of nature’s most potent effects, but it is not always easy to study, though it has recently gained more attention. 8
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Conclusion
There are many medications as well as herbal and nutritional supplements that can help relieve the symptoms of BPH.
Medical professionals often use alpha-blockers to alleviate the effects BPH has on a man′s normal ability to urinate. However, like other medications, they carry a long list of side effects.
Alpha-blocker medications are proven to be effective. But many men discontinue their use due to intolerance of their side effects. Herbal and nutritional supplements can often provide similar symptom relief without such side effects.
Many herbals used for BPH also influence the health and function of the prostate gland positively, a characteristic not found in prescription medications.
Some medications that treat BPH, specifically the family of 5-ARIs, have side effects that do not resolve after stopping the medication.
Further, many young men that have used high-dose Finasteride for thinning hair have discovered that some undesired sexual effects persist for life.
Natural substances often have nutritional elements that enhance symptom relief.
So, this added benefit makes herbal and nutritional products the more logical place to begin treatment of BPH.
Especially since most sufferers are older men with other conditions that might be affected by medications.
Reputable manufacturers often do extensive research to formulate products for maximum efficacy.
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