My Penis Stuff

Why It Is Used

An antiandrogen is often added to luteinizing hormone-releasing hormone (LH-RH) agonist therapy to prevent a rise in testosterone at the beginning of LH-RH agonist therapy. (The rise in testosterone can cause a tumor flare with bone pain, urinary blockage, or other symptoms of rapid cancer growth. But this growth does shrink over time.)

Antiandrogens can be used along with surgery to remove the testicles (orchiectomy).

Antiandrogens are often used in combination with other hormone therapy to block the supply of testosterone. This is done to slow the growth of advanced prostate cancer and ease severe bone pain caused by the spread of cancer to the bones.

How Well It Works

Antiandrogen therapy is not an effective treatment for advanced prostate cancer by itself. But it does help other treatments work better.

Antiandrogen treatment after surgery to remove the prostate (radical prostatectomy) can slow the growth of cancer near the prostate and can increase survival.

Antiandrogen treatment for 2 to 3 years after radiation therapy increases survival for some men who have advanced prostate cancer.

Side Effects

Side effects from antiandrogen treatment may include:

• Nausea.
• Breast enlargement (gynecomastia).
• Diarrhea.
• Low red blood cell count (anemia).
• Decreased sex drive.
• Erection problems.
• Liver problems. Some cases of serious liver problems have been reported.

Long-term treatment with antiandrogens may cause osteoporosis, which causes bones to become brittle and break more easily. Your doctor may prescribe a bisphosphonate medicine. Zoledronic acid is specifically designed for people who are receiving treatment for metastatic cancer. In a clinical trial of men with metastatic prostate cancer, men who took zoledronic acid experienced far fewer bone fractures and less bone pain than those who did not take the drug.¹ For more information on prevention of and medication for bone thinning, see the topic Osteoporosis.

Why It Is Used

These medicines often are used by men who have moderate and bothersome symptoms of prostate enlargement and who want more than home treatment for their symptoms.

How Well It Works

Many men find a 4- to 6-point reduction in their American Urological Association (AUA) symptom index scores. Most men find this a significant improvement in their symptoms. Symptoms generally improve in 2 to 3 weeks.

Using a combination of an alpha-blocker with a 5-alpha reductase inhibitor may help your symptoms more than either medicine alone.

Side Effects

Side effects vary with the medicine and the individual. Common minor side effects of alpha-blockers include:

• Weakness or fatigue.
• Lightheadedness, dizziness, or fainting when you stand up suddenly after sitting or lying down. This may occur if your blood pressure becomes low when you stand up suddenly (postural or orthostatic hypotension).
• Headaches and nasal congestion.

Medicines used to treat erection problems, such as sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis), may make these side effects worse.

Alpha-blockers may cause ejaculation of semen into the bladder (retrograde ejaculation) instead of out through the penis. This is not harmful.

These side effects go away when the medicine is stopped.

Why It Is Used

These medications may be used to treat symptoms of chronic prostatitis/pelvic pain syndrome, noninflammatory, a type of prostatitis, when muscle tightness and spasms are suspected to be the cause of symptoms and pain. Muscle tightness and spasms may force urine into the prostate, causing irritation that leads to prostatitis.

These medicines are approved by the U.S. Food and Drug Administration (FDA) for treating symptoms of benign prostatic hyperplasia (BPH), which may be caused by muscle spasms in the bladder neck or in the prostate. Although these medicines have not been approved by the FDA for the treatment of prostatitis, your doctor may prescribe one of these medicines to treat your prostatitis.

How Well It Works

Most men who take alpha-blockers for prostatitis have fewer symptoms, but it takes awhile for the medicine to give results. Alpha-blockers work best in men who haven’t already tried many different kinds of medicines for prostatitis and who have moderate to severe symptoms.

Side Effects

Alpha-blockers can reduce blood pressure to less than normal. This can result in lightheadedness, especially when you stand up abruptly after sitting or lying down (postural hypotension).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)