Try these techniques to relieve common urinary symptoms without medication

For frequent urination or urgency in men, these methods really work. And you can always switch to medication later.

If you are a man over age 50, chances are you know—or will soon—someone taking a medication for an overgrown prostate gland. Better known as benign prostatic hyperplasia (BPH), this condition can cause bothersome problems like frequent urination at night, difficulty completely emptying the bladder, and the urgent need to urinate at inconvenient times.

BPH triggers noticeable problems in a third of men in their 60s and nearly half of those in their 80s. Drug therapy relieves symptoms, and for severe problems, surgery may be considered. But for men with milder symptoms that don't interfere much with their daily lives, simple changes in behavior can help to take the edge off urinary symptoms.

This approach is broadly available to men who have lower urinary tract symptoms that have been attributed to BPH, but who are not bothered enough to take on the small but finite risks of treatment, such as drugs or surgery.

What is BPH?

In many men, the prostate gland may begin to grow larger over time. The urethra—the tube that conveys urine from the bladder to outside the body—passes right through the prostate, so it doesn't take much prostate growth to make urination difficult. As the bladder works against the restriction, its muscular walls thicken. This can cause problems like the need for more frequent visits to the bathroom and difficulty fully emptying the bladder.

For some men, the symptoms of BPH don't demand immediate treatment. The question that should drive that decision is this: How much do your symptoms bother you? Whether it is getting in the way of doing the things you want to do should be the primary driver of treatment.

How bothersome is it?

Doctors use the International Prostate Symptom Score (IPSS) to measure how frequent a man's symptoms are. It's a seven-item questionnaire about typical BPH symptoms that provides a score from 0 to 35. You can see the questionnaire at health.harvard.edu/IPSS.

Typically, men who score 8 and above are more likely to think their condition needs treatment, but it varies from man to man. Above a score of 8 there is actually a spectrum of bother. Two men can have the same symptom score, and one can tolerate it just fine but the other can't.

The IPSS test cuts through the subjectivity with this additional question: "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?" If the answer is, "I could live with it," then holding off on drug therapy or surgery might be best for you.

But not taking medication or having surgery doesn't mean "do nothing." It should include strategies to lessen symptoms or make them easier to cope with.

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