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Medications for erectile dysfunction may also help treat enlarged prostate, from Harvard Men’s Health Watch

Although both erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) become much more common as men age, they are very different problems. But according to an article in the September 2011 Harvard Men’s Health Watch, research suggests that the most popular and effective drugs for ED may substantially reduce the symptoms of BPH.

Starting in middle age, the prostate gland in men begins to enlarge and can make urination difficult. By age 80, about 25% of all men have BPH that is bothersome enough to require treatment. In such cases, doctors can prescribe medications or recommend surgery.

But current BPH treatments are far from perfect. Doctors continue to work on new approaches to current treatments and, although ED pills would seem unlikely candidates to treat BPH, studies suggest they may help.

The first ED pill, sildenafil (Viagra), revolutionized the treatment of ED — but it took four years for researchers to report that the little blue pill also appeared to reduce symptoms of BPH. And even now, only a handful of studies have examined the possible role of ED pills in BPH.

Despite the lag, the studies are favorable. In randomized clinical trials, sildenafil, vardenafil (Levitra), and tadalafil (Cialis) all appear to reduce lower urinary tract symptoms in men with BPH. The trials were brief, lasting 8 to 12 weeks, but several studies enrolled over 1,000 men. Men with both moderate and severe lower urinary tract symptoms improved. BPH symptoms improved to a similar degree both in men with ED and in those with normal sexual function; obesity did not interfere with the benefits.

The ED pills are not currently approved to treat BPH. Indeed, more research is needed to evaluate long-term efficacy and safety. It will also be important to conduct head-to-head comparisons between ED pills and medications already approved for BPH. Scientists should also evaluate combination therapy, particularly since doctors worry that ED pills may excessively lower blood pressure in men taking alpha blockers for BPH. And because the ED pills are much more expensive than BPH medications, cost is a factor in long-term therapy, especially since insurance does not cover ED pills for BPH.

Older men may be impatient for research results to flow in. But since many older gents have both ED and BPH, they may already be getting dual benefit from ED pills.

Read the full-length article: "ED pills and benign prostatic hyperplasia"

Also in this issue of the Harvard Men's Health Watch

  • The crucial, controversial carotid artery Part II: Treatment
  • ED pills and benign prostatic hyperplasia
  • On call: Electronic cigarettes
  • On call: More dietary advice

More Harvard Health News »

About Harvard Health Publications

Harvard Health Publications publishes four monthly newsletters--Harvard Health Letter, Harvard Women's Health Watch, Harvard Men's Health Watch, and Harvard Heart Letter--as well as more than 50 special health reports and books drawing on the expertise of the 8,000 faculty physicians at Harvard Medical School and its world-famous affiliated hospitals.