What is best meds for BPH and how long do they take to work?

[Keepfit1]

I recently increased my T dose to around 20mg day, mix of enanthate and some topical gel, about half and half, in the space of about 3 months I notice my BPH symptoms are worse, ie smaller pee volume and more frequent, I have read about Tadalafil and other meds and wondered how much difference to symptoms have people noticed on them and how long it took to make a noticable difference, also slightly wary of sides?
I had Rezum a few years back and it was good until I increased my T dose, maybe my prostrate doesnt like the Gel?

 

[broker]

The gel will increase DHT a lot and that increases prostate size.
1)did Rexum work well? Increase the force of urine stream?
2) did you maintain ejaculation?
3) any pain during the procedure or after?

i use flomax and get decent results. my friend uses flomax at night and tadalifil during the day With good results. synergistic effect.

 

[madman]

I recently increased my T dose to around 20mg day, mix of enanthate and some topical gel, about half and half, in the space of about 3 months I notice my BPH symptoms are worse, ie smaller pee volume and more frequent, I have read about Tadalafil and other meds and wondered how much difference to symptoms have people noticed on them and how long it took to make a noticable difference, also slightly wary of sides?
I had Rezum a few years back and it was good until I increased my T dose, maybe my prostrate doesnt like the Gel?

Canadian Urological Association guideline: MLUTS/BPH

UPDATE – Canadian Urological Association guideline: Male lower urinary tract symptoms/ benign prostatic hyperplasia (2022) Dean Elterman, Mélanie Aubé-Peterkin, Howard Evans, Hazem Elmansy, Malek Meskawi, Kevin C. Zorn, Naeem Bhojani Introduction The current document summarizes the...

www.excelmale.com

I would tread lightly when it comes to the use of 5-ARIs (finasteride/dutasteride)!


2.3 Medical therapy

2.3.1. Alpha-blockers
We recommend alpha-blockers as an excellent first-line therapeutic option for men with symptomatic bother due to BPH who desire treatment (strong recommendation, evidence level A).


2.3.2. 5-ARIs
We recommend 5-ARIs (dutasteride and finasteride) as an appropriate and effective treatment for patients with LUTS associated with a demonstrable prostatic enlargement (strong recommendation, evidence level A)


2.3.3. Combination therapy (alpha-blocker and 5-ARI)
We recommend the combination of an alpha-adrenergic receptor blocker and a 5-ARI as an appropriate and effective treatment strategy for patients with symptomatic LUTS associated with prostatic enlargement (>30 ccs) (strong recommendation, evidence level B)

It may be appropriate to consider discontinuing the alpha-blockers in patients successfully managed with combination therapy after 6–9 months of combination therapy.32,33

We suggest that patients successfully treated with combination therapy may be given the option of discontinuing the alpha-blocker. If symptoms recur, the alpha-blocker should be restarted (conditional recommendation, evidence level B).


2.3.4. Antimuscarinic and beta-3 agonist medications
We suggest that antimuscarinics or beta-3 agonists may be useful in predominately storage symptoms and BPH, and used with caution in those with significant BOO and/or an elevated PVR (conditional recommendation, evidence level C).


2.3.5. Antimuscarinic or beta-3 agonists in combination with alpha-blockers
We suggest that an alpha-blocker combined with an antimuscarinic or beta-3 agonist may be useful to treat LUTS/ BPH in men with both voiding and storage symptoms and failure of alpha-blocker monotherapy (conditional recommendation, evidence level B).


2.3.6. Phosphodiesterase inhibitors
We recommend long-acting PDE5Is as monotherapy for men with LUTS/BPH, particularly in men with both LUTS and erectile dysfunction (strong recommendation, evidence level B).


2.3.7. Desmopressin
We recommend desmopressin as a therapeutic option in men with LUTS/BPH with nocturia as a result of NP (conditional recommendation, evidence level B).


2.3.8. Phytotherapies
We do not recommend phytotherapies as standard treatment for MLUTS/BPH (strong recommendation, evidence level B).



post #10

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

www.excelmale.com

BPH/LUTS

*There is no evidence that TTh either increases the risk of BPH or contributes to the worsening of LUTS

*At present, there is no evidence that TTh either increases the risk of BPH or contributes to the worsening of LUTS

Is Dihydrotestosterone DHT Good or Bad for Men?

In this issue of Endocrine Reviews, Swerdloff et al. (5) review the human and animal data regarding the physiological and clinical implications of elevated blood concentrations of DHT in men and women. All exogenous testosterone formulations increase serum DHT concentrations above...

www.excelmale.com

In this issue of Endocrine Reviews, Swerdloff et al. (5) review the human and animal data regarding the physiological and clinical implications of elevated blood concentrations of DHT in men and women. All exogenous testosterone formulations increase serum DHT concentrations above physiologically normal serum concentrations. Because testosterone therapy is commonly prescribed to men, understanding the physiological effects (beneficial and adverse) of supranormal DHT concentrations is clinically important (6, 7). Although the focus of their review is on the physiological and clinical effects of supraphysiological serum DHT concentrations, they also review the effects of pharmacological suppression of DHT

*Collectively, these data indicate that the prostate self-regulates DHT concentrations independently of serum DHT concentrations. Within a broad range from low to high-normal serum testosterone concentrations, prostatic DHT concentrations remain stable

* DHT acts as a paracrine independently of circulating DHT concentrations for the two principal target organs in adults: prostate and skin

*The review by Swerdloff et al. (5) demonstrates that DHT is principally a paracrine hormone. Circulating DHT concentrations have little relationship to prostatic and skin DHT concentrations. In addition, within a broad range of serum testosterone concentrations, raising or lowering serum testosterone concentrations has little effect on prostatic DHT concentrations

 

[madman]

Using Cialis to Treat BPH: Two Doctors Discuss

PCRI's resident moderator, Mark Moyad, MD, MPH, sits down with urologist Steven Gange, MD, FACS, to discuss the use of Cialis to treat lower urinary tract symptoms, bladder control drugs, and the use of supplements to treat benign prostatic hyperplasia (BPH, or prostate enlargement). Dr...

www.excelmale.com

 

[madman]

Benign Prostatic Hyperplasia BPH Treatments

Medical Treatment of Benign Prostatic Hyperplasia (2022) Alexander Plochocki, MD, MPH, Benjamin King, MD* INTRODUCTION Benign prostatic hyperplasia (BPH) and its associated is one of the most common diagnoses seen by the urologist, with previous studies estimating greater than half of the...

www.excelmale.com

 

[Keepfit1]

The gel will increase DHT a lot and that increases prostate size.
1)did Rexum work well? Increase the force of urine stream?
2) did you maintain ejaculation?
3) any pain during the procedure or after?

i use flomax and get decent results. my friend uses flomax at night and tadalifil during the day With good results. synergistic effect.

Rezum worked pretty well for me, I chose it because it has low to zero sides, my erections and ejac are unchanged, the flow doubled and the volume doubled, I was unconscious, only hassle is I had a a catheter for a week, no cycling 6 weeks, it took about 2-3 months to get max benefits but had mcuh improvement from day 1 , before I was peeing about 100ml a time , sometimes struggling to pee at all, post op I was getting up to 300-400ml max, more recently itbs been about 200 to 300 max, I had a bit more urgency for about 6 weeks post op. I researched the options to death and for me Rezum came out top. Since then Aquablation seems to be getting some press, I havnt dug in to the details yet.

 

[Keepfit1]

Canadian Urological Association guideline: MLUTS/BPH

UPDATE – Canadian Urological Association guideline: Male lower urinary tract symptoms/ benign prostatic hyperplasia (2022) Dean Elterman, Mélanie Aubé-Peterkin, Howard Evans, Hazem Elmansy, Malek Meskawi, Kevin C. Zorn, Naeem Bhojani Introduction The current document summarizes the...

www.excelmale.com

I would tread lightly when it comes to the use of 5-ARIs (finasteride/dutasteride)!


2.3 Medical therapy

2.3.1. Alpha-blockers
We recommend alpha-blockers as an excellent first-line therapeutic option for men with symptomatic bother due to BPH who desire treatment (strong recommendation, evidence level A).


2.3.2. 5-ARIs
We recommend 5-ARIs (dutasteride and finasteride) as an appropriate and effective treatment for patients with LUTS associated with a demonstrable prostatic enlargement (strong recommendation, evidence level A)


2.3.3. Combination therapy (alpha-blocker and 5-ARI)
We recommend the combination of an alpha-adrenergic receptor blocker and a 5-ARI as an appropriate and effective treatment strategy for patients with symptomatic LUTS associated with prostatic enlargement (>30 ccs) (strong recommendation, evidence level B)

It may be appropriate to consider discontinuing the alpha-blockers in patients successfully managed with combination therapy after 6–9 months of combination therapy.32,33

We suggest that patients successfully treated with combination therapy may be given the option of discontinuing the alpha-blocker. If symptoms recur, the alpha-blocker should be restarted (conditional recommendation, evidence level B).


2.3.4. Antimuscarinic and beta-3 agonist medications
We suggest that antimuscarinics or beta-3 agonists may be useful in predominately storage symptoms and BPH, and used with caution in those with significant BOO and/or an elevated PVR (conditional recommendation, evidence level C).


2.3.5. Antimuscarinic or beta-3 agonists in combination with alpha-blockers
We suggest that an alpha-blocker combined with an antimuscarinic or beta-3 agonist may be useful to treat LUTS/ BPH in men with both voiding and storage symptoms and failure of alpha-blocker monotherapy (conditional recommendation, evidence level B).


2.3.6. Phosphodiesterase inhibitors
We recommend long-acting PDE5Is as monotherapy for men with LUTS/BPH, particularly in men with both LUTS and erectile dysfunction (strong recommendation, evidence level B).


2.3.7. Desmopressin
We recommend desmopressin as a therapeutic option in men with LUTS/BPH with nocturia as a result of NP (conditional recommendation, evidence level B).


2.3.8. Phytotherapies
We do not recommend phytotherapies as standard treatment for MLUTS/BPH (strong recommendation, evidence level B).



post #10

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

www.excelmale.com

BPH/LUTS

*There is no evidence that TTh either increases the risk of BPH or contributes to the worsening of LUTS

*At present, there is no evidence that TTh either increases the risk of BPH or contributes to the worsening of LUTS

Is Dihydrotestosterone DHT Good or Bad for Men?

In this issue of Endocrine Reviews, Swerdloff et al. (5) review the human and animal data regarding the physiological and clinical implications of elevated blood concentrations of DHT in men and women. All exogenous testosterone formulations increase serum DHT concentrations above...

www.excelmale.com

In this issue of Endocrine Reviews, Swerdloff et al. (5) review the human and animal data regarding the physiological and clinical implications of elevated blood concentrations of DHT in men and women. All exogenous testosterone formulations increase serum DHT concentrations above physiologically normal serum concentrations. Because testosterone therapy is commonly prescribed to men, understanding the physiological effects (beneficial and adverse) of supranormal DHT concentrations is clinically important (6, 7). Although the focus of their review is on the physiological and clinical effects of supraphysiological serum DHT concentrations, they also review the effects of pharmacological suppression of DHT

*Collectively, these data indicate that the prostate self-regulates DHT concentrations independently of serum DHT concentrations. Within a broad range from low to high-normal serum testosterone concentrations, prostatic DHT concentrations remain stable

* DHT acts as a paracrine independently of circulating DHT concentrations for the two principal target organs in adults: prostate and skin

*The review by Swerdloff et al. (5) demonstrates that DHT is principally a paracrine hormone. Circulating DHT concentrations have little relationship to prostatic and skin DHT concentrations. In addition, within a broad range of serum testosterone concentrations, raising or lowering serum testosterone concentrations has little effect on prostatic DHT concentrations

thanks for all the info, I will have a read. I have looked in to the DHT blockers mentioned and any hormone doc I have listened to apart from Hertoghe says to stay a million miles from Propeia etc

 

[Jed Dorsey]

The gel will increase DHT a lot and that increases prostate size.
1)did Rexum work well? Increase the force of urine stream?
2) did you maintain ejaculation?
3) any pain during the procedure or after?

i use flomax and get decent results. my friend uses flomax at night and tadalifil during the day With good results. synergistic effect.

I’ve stayed away from Flowmax I’ve read it has a negative side effect of ED. Did it effect you??

 

[jobshopper]

I’ve stayed away from Flowmax I’ve read it has a negative side effect of ED. Did it effect you??

I used Flomax for a couple of years and it almost rendered me impotent. I finally asked my doctor to let me try 5mg of tadalafil daily instead of Flomax. It worked ok and my doctor added 4mg of terazosin. The combination of those two drugs have helped me a lot. At 69 years old I still experience some issues but at least I can enjoy sex again... no more ED or orgasm issues. I imagine that before long I will be trying find a urologist to talk to about getting the Rezum procedure done.