Pharmacotherapy and herbal treatment of benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is the most common tumor in aging men, and is associated with lower urinary tract symptoms (LUTS). Treatment options include watchful waiting, life-style modification, pharmacologic treatment, and surgery. Alpha-adrenergic receptor blockers (alpha-blockers) decrease LUTS and increase urinary flow rates in men with symptomatic BPH. 5-Alpha-reductase inhibitors (5-ARIs) decrease the production of dihydrotestosterone within the prostate, which results in decreased prostate volume. For patients with moderate to severe symptoms and a large prostate, combination therapy with a-blockers and 5-ARIs can further improve clinical efficacy of treatment. Numerous plant-based products (phytomedicines) are increasingly used as an alternative or complement the conventional medication. For some patients, phosphodiesterase-5 inhibitors (PDE5-Is) or antimuscarinic agents may be added. Here, we discuss the current pharmacotherapy of BPH.