Q. Because of an enlarged prostate gland I have to get up at night to pee. Initially it was once or twice. Now it is three or four times. Getting back to sleep is challenging. My primary care physician recently prescribed tamsulosin (Flomax). I can’t say it made a huge difference in my bathroom trips, but I think it gave me a terrible case of sinusitis.

A week or so after I started the drug my sinuses were totally blocked. My head felt like a beach ball. When that happens I can’t focus on work or anything else for that matter.

How can a drug for my prostate mess up sinuses?

What other side effects should I be aware of regarding tamsulosin? I can more or less deal with the peeing problem. Sinus congestion, on the other hand, makes me feel like a zombie.

Is there anything else that might work for BPH?

A. It is understandable that you would be confused about the sinusitis side effect. Physicians and pharmacists may consider nasal congestion, stuffy nose, runny nose or sinusitis a “minor side effect.” For those suffering, however, it can have a major impact on their quality of life. All these nasal symptoms are linked to tamsulosin (Flomax). And we completely get your confusion. Why would a drug that is supposed to make urination easier affect the nose?

Tamsulosin is considered an alpha-blocker (also known as an alpha-adrenergic antagonist). That means it binds to alpha receptors in smooth muscles found in blood vessels, prostate and bladder and relaxes them. The result of this action is vasodilation and lower blood pressure as well as better urine flow. Other drugs in the category include:

  • Alfuzosin (Uroxatral)
  • Doxazosin (Cardura)
  • Prazosin (Minipress)
  • Silodosin (Rapaflo)
  • Tamsulosin (Flomax)
  • Terazosin (Hytrin)

Not surprisingly, some of these medications (prazosin, terazosin) are used to treat high blood pressure. Others, like tamsulosin, are prescribed more often for prostate problems.

But here’s the catch. Vasodilation can cause nasal congestion (stuffy nose or even sinusitis). Consider for a moment that nasal decongestants work by causing vasoconstriction or narrowing of blood vessels. Since these drugs work in the opposite direction, the side effects actually make sense. They include:

SIDE EFFECTS OF ALPHA-BLOCKERS:

  • Dizziness (especially upon standing suddenly), vertigo, lightheadedness, fainting
  • Heart palpitations
  • Nasal congestion, stuffiness, sinusitis, runny nose, sore throat, cough, infection
  • Headache, drowsiness, fatigue, weakness
  • Fluid retention, edema, swollen hands or feet
  • Urinary incontinence
  • Back pain
  • Digestive distress, heartburn, nausea, diarrhea
  • Lower libido, abnormal ejaculation (reduced semen or retrograde ejaculation into the bladder)
  • Prolonged and/or painful penile erections (priapism)
  • Intraoperative Floppy Iris Syndrome (IFIS) [this can cause problems during cataract surgery!], blurred vision
  • Rash, itching or hives [notify your doctor immediately!]

Such side effects quickly overwhelm you, especially if the voice-over announcer on a television commercial is reading them quickly while the video is showing happy people doing fun things. Here are some stories from visitors to our website to help you understand what it is like to experience some of these complications.

“Flomax has played havoc with my sex life. The doctor has advised for me to skip a dose when I believe the chance may arise.

“I really do not like stopping medication and it does cause me urinary problems while I am missing that dose and getting it back in my system.

“On top of Flomax being expensive and me on Medicare the donut hole comes up and makes the medical cost unbearable.” John


“I had a cataract surgery while I was taking tamsulosin for urinary problems. The surgery went bad and in time it lead to me losing the sight in my right eye. At that time there was NO warning of the problems with Flomax and cataract surgery.” Ralph


“I have just been put on tamsulosin because of difficulty peeing. I wake up with a painful erection which can only be relieved by peeing. My GP prescribed the drug over the phone without any warning of this. This has only started since I started on the drug.

“I do not want to cause permanent damage.  I wonder if there are there alternatives?” Richard


“I am 52 and wake up 3-4 times a night with these uncomfortable erections. I’m convinced I would have them for hours if I don’t get up and walk around, have a pee, etc, as this is the only way they go away.  Unfortunately, even after it goes away, it seems in another hour or so, it comes back. I’ll be seeing the urologist next week, but I don’t expect much sleep until then. Hoping for an answer…” J.M.


“I am 60 years old and take lisinopril and Flomax, alternating each day. I used to take each med before I went to bed. The nights I took the Flomax – about 4-6 hours afterward – I would wake up to very persistent, full erections. This would disrupt my sleep, and although sometimes getting up to urinate would alleviate the problem, I would often soon reawaken to another erection. If I did not need to urinate, masturbation and ejaculating would make my erection subside, as normal. Of course, that could wake me up even more (and sometimes my wife as well), but usually I’d get back to sleep. But then an hour later – another very stiff erection.

“Because of the lack of sleep I was experiencing from this, I began taking the Flomax and lisinopril in the morning. I get fewer, less persistent erections at night – or at least the ones I get are easier to sleep through or go back to sleep without urinating.

“If you are taking Flomax at night and are having problems with persistent, uncomfortable, annoying, sleep-disrupting, very stiff erections, try taking it in the mornings instead – if that is an option.” B.B.


So, what can a man do to deal with benign prostate enlargement (BPH) besides take an alpha blocker? Interestingly, the erectile dysfunction drug Cialis (tadalafil) has received approval from the FDA to treat BPH. It too has side effects including nasal congestion. Other possible adverse reactions include headache, heartburn, muscle pain, flushing and back pain. Priapism (prolonged erections) are another potential complication of Cialis, along with vision or hearing loss.

Research into saw palmetto has produced disappointing results. Nevertheless, some readers maintain that it too helps with BPH symptoms.

“I also have heard that saw palmetto does not work, but I have a different experience with it. I have an enlarged prostate and about 10 years ago I went to an urologist.  He wrote a prescription for Flomax but told me to try saw palmetto first. He said that many of his patients had had a lot of success with it and because Flomax had so many side affects that if I wanted to I could give it a try.

“I tried saw palmetto and gave it about 2 weeks to work {the doctor said it might take some time to help} and I have had great results. I have used it for all these years and the only time I have problems is when I run out and don’t get any for a few days. Then I have to start over. The only other time it is less effective is when I take the wrong kind of cold tablet.

“Just because a study says one thing does not make it so, the drug companies in the USA have a lot of power because we let them have power. Take control of your own health, exercise and eating right and watching what you put in your body.” Lloyd


One final natural product worth consideration is the herb stinging nettle (Urtica dioica). It has been used in Europe to relieve allergy symptoms and improve urinary flow in cases of benign prostate enlargement.

Please share your own story with treatments for BPH. Have the alpha-blockers worked for you? Did you experience any side effects such as nasal stuffiness? Did anything else help ease symptoms without unpleasant side effects? Let others know about your experience.

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  1. j
    az
    Reply

    I’ve tried them all. Flomax gives the best, fastest results for prostate-related issues (i.e. flow, pain, irritability, painful ejaculation, etc). However, it also gives the WORST side effects of all the medications I’ve tried. The stuffy head/nose/sinus problems are so bad that sleep is next to impossible, and I am in a fog throughout the entire next day. I’ve also noticed a decrease in, or even “dry,” ejaculations with the drug. We can put a man on the moon but we can’t develop a better drug for the prostate than this? Of all the drugs, uroxatral was probably the best but took the longest to work. Rapaflo seemed like a step down from Flomax (less intense, but less benefit). Prazosin and Terazosin were probably a step down from the Rapaflo.
    Although I think I need the Flomax daily, I simply cannot bear the inability to breathe throughout the day and night.

    So, is there any other option unrelated to holistic medicine?

  2. TB
    Arizona
    Reply

    Hmmm, interesting remarks about Flomax. Was recently prescribed it in addition to the anti-hypertensive drugs metoprolol and lisinopril and the anti-cholesterol drug simvastatin, the latter of which also gets mixed reviews. Had been using saw palmetto, just one cap every two to three weeks, which worked well for a weak urine stream, but with recent diagnosis of hypertension, it just wasn’t doing the trick anymore. The first night after taking Flomax, I got the stuffy nose in our stuffy bedroom in the middle of a typically hot desert summer. The next morning when I went to urinate, I felt a little nauseous and slightly faint while walking to the john. The urine stream, however, was very strong, as good as it was many years ago, and this was the first pee of the day, which usually dribbles out. It also cleaned out my intestines pretty effectively. But I had to lay down across the couch until the effects began to wear off.

    Although my mind was strangely clear, it’s a strong drug, so the next night after dinner I halved the dose by taking the capsule apart and discarding some of it before putting the cap back together, despite a warning not to do that on the paperwork that came from the pharmacy (I talked it over with the pharmacist first, who advised other options, like taking it less often or earlier in the day). No stuffiness, no problem the next morning, but I could tell the positive effects weren’t as strong either. The third night, I took only about a quarter of the drug out of the cap and had stuffiness and some anxiety. I think I’ll reserve this drug for occasional use, as needed, like I did with saw palmetto.

  3. Michael
    Santa Fe, NM
    Reply

    I am a 48 yr old male who has had prostate issues as long as I can recall with regard to cold meds really messing things up downstairs. In the last 8 years I have experienced a HUGE increase in prostate enlargement and difficulty urinating.

    I tried Flomax sample and liked the results. I asked for an Rx and got half the dose of the sample plus the additional Rx of finasteride and the results have been – Meh. If I forget a day or two it’s back to camping on the toilet until urine begins to flow and frequent bathroom visits.

    Most troubling is that I have noticed issues with less intense and sometimes disappearing ejaculations/orgasms. I’m not sure if this is a prostate issue or a Flomax issue. I also feel sooo much more tired and often take at least one nap a day and sometimes two. I’m not sure if the fatigue is a side effect of the drug in my case but its interesting to note.

    I suppose going cold turkey could answer some of these questions but the idea of camping on the toilet and standing for an embarrassingly long time at a urinal is not too appealing.
    There is no way in HELL I want to risk having dribbling the rest of my life so unless its the very last option surgery is out of the question.
    Has anyone tried that surgery where they use a multi-needle prod to electrically “burn” prostate tissue away? This seems highly uncontrollable.

  4. Stephen
    USA
    Reply

    I’m suffering from Kidney stones and was prescribed Tamsulosin to help pass them.
    It sure did increase the strength and frequency of passing urine but the nasal congestion I’m suffering with has kept me awake for 2 days straight. It’s that bad.
    Had to stop using it, have to find an alternative when next I visit the urologist.

  5. Eric
    coos bay oregon
    Reply

    After only 1 week I have terrible headaches and total congestion of my sinusis so bad I cant sleep . Plus a strange depression has came over me -I cant take that and function right so the Flomax gets 86″d starting today ……~Eric in Coos Bay ,Or

  6. Gerhard O.
    Hawaii
    Reply

    I needed to take flomax to prevent urine retention in preparation for TURP. One capsule every evening caused no major side effects, but the last 12 days before the surgery I had to double the dose to prevent complete blockage of the urethra. The result was Muscle pain on the left side of my chest and the left muscles of the groin.

    After the TURP I am unable to put any weight on my left leg. And have to use a wheel chair and crutches to get around. Hopefully this condition is a withdrawal symptom and will pass soon.

  7. Eric
    Hickory, NC
    Reply

    No comment. I am already subscribed. I would like to be notified of follow-up comments.

    Thank you!

  8. patty
    Reply

    CAN STOPPING FLOMAX CAUSE HEARING LOSS??
    Hi my name is patty I’m 40 years old and might be the only woman on here. I had brain surgery almost a month ago and from the surgery I lost most of my hearing I was already deaf on my left side they were operating on the right side this time time.
    I have Neurofibromatos type 2 and get brain tumors on the nerves that control hearing, and other places too. I did not lose all my hearing and I had a little left. After surgery, probably from the anesthesia I had a lot of trouble peeing. For a few days in the hospital they have to come put a catheter in to help me go. The doctor put me on flomax.
    I was supposed to take it until I saw the surgeon again but I won’t see him for another 3 weeks and I really figured I did not need it. I had a similar problem after having outpatient gall bladder surgery and got through it with no medicine and I got really tired of taking unnecessary medicine, was also on a food thickener for 3 weeks I’m pretty sure I didn’t need it not for that long anyway.
    So about a week after stopping flomax, I woke up barely hearing at all. This could be some swelling in the area of surgery and not have anything to do with flomax. I also finished my after surgery steriods that stop brain swelling about a week ago.
    My husband called the doctor for me since I can’t and he is starting me on more steroids I started yesterday. This has helped a lot of people with sudden hearing loss, surgery or not.
    I know this is getting long but my question is this, Can stopping flomax cause hearing loss? Did I do this to myself? Should I get back on? No that one I won’t do without talking to a doctor. It’s labor day today but I”ll email all these questions to the doctor and surgeon tomorrow. Thanks for listening gentlemen, sorry it got long, any opinions or experiences are greatly appreciated, I don’t know how often people come to this site. Thanks again, Patty

    • TX.stents
      TX
      Reply

      I don’t know about the hearing thing. But I’m a 43 year old woman taking flomax. Was put on it for stents I have and kidney problems. You’re not the only female on it. I haven’t yet had any problem with hearing but only been taking it several months. Best of luck to you Patty.

  9. Greyfox
    Reply

    I have been on JALYN for 3 years (dutasteride+tamsolusin) for 3 years, For 2 1/2 years the effects were not great, up 2-3 times a night with halting stream. Then 3 months ago everything changed, up 1 once a night with normal stream go about 9-10 times every 24 hours. Sex life for a 76 old is good. Erections available when needed, not much output though. Don’t know what caused the change, I did change supplier from UK to USA, starting taking 30 minutes after dinner. Dropped my metformin and cut my Lipitor in half. Reluctant to try alternative medicine when I am happy with the current results. I pay $80 for 90 day supply plus $20/month for drug plan, Get other meds for $0

  10. steve
    Reply

    I add them to my oatmeal. probably about a table spoon or two. they taste good. thanks

  11. Torence
    Reply

    Hi Steve: What amount of pumpkin seeds are you using? I bought some but am unaware of how much to take. Please let me know how much you take that worked for you. Thank you.

  12. Bevis L
    Reply

    To Steve W comments 11/6/2013 and 3/12/2014.
    Hi steve if you are keeping across this site. could you please supply at what amounts you are using the products you listed. I realize we are all different but at least it gives me a starting point.
    Thanks.

  13. steve w
    Reply

    update from 11/6/2013
    I am still getting good results. if I get up in the night it is only once. No urgency and I can finally see a movie all the way through. I have a relative who got the surgery. He drips constantly. Has no control. So no surgery for me. It’s much better to experiment with natural cures. I’m telling you this worked for me. NAC, Milk thistle and cranberry extract. But there are a lot of other supplements to be tried. I’m done with most doctors, unless it is life or death. they just want to give you some RX and walk away. Flomax is full of side effects.

  14. PJH
    Reply

    I recently experienced a weak urine stream and my doctor put me on flow max. It definitely helped improve the stream, but I was getting up 4 to 5 times a night to urinate. I was taking it after dinner, so I switched to mornings, that helped for a while. I have now stopped taking it as I can not stand to get up all night. I have had prostate removed for cancer, am on hormone therapy after they found elevated PSA, had radiation that did not help. Currently the hormones are working.

  15. JIM
    Reply

    I’ve scheduled holep surgery for bph in late Jan. I’d appreciate some feedback on your surgery. Jim

  16. MS
    Reply

    If you want something that is completely safe, natural and side-effect-free, try the herb angelica, which is found in “Saga Pro,” a product by Europharma. My husband has taken 1-2 at bedtime for a few months now, and it has made the biggest difference! What’s even better is that both men and women can use it, since it strengthens the bladder. For years my husband thought it was his prostate, but if it was, why would this work so well??

  17. steve w.
    Reply

    WHAT WORKS FOR ME.
    OK, at 62 I have been suffering with this for years. 4, 5 6, times a night. sleeping was a luxury. I was tired all the time. I had it so bad that I would go to the bathroom and then almost immediately felt I had to go again. I have tried several remedies, with very little success. I have heard horror stories about the surgery. Imagine dribbling for the rest of your life.
    I was listening to this Doctor on the local radio. he said to try several things
    1. NAC also known as : N-Acetyl-Cysteine only could find this online
    2. Cranberry Extract. most drug stores have this.
    3. Milk Thistle most drug stores have this.
    additionally I take
    4. Curcumin(500 MG) which is concentrated form of Turmeric. (I mostly take this to prevent restless leg syndrome)
    5. Vit D3 2000 to 4000 units depending on how much sun I get daily.
    6. I eat lots of shelled Pumpkin Seeds. I find them at whole foods unsalted. they are tasty.
    I also stopped drinking beer. there are reports beer has yeast still in it that causes a yeast build up in the prostate. Dark beers are supposedly worse. I didn’t notice a big change immediately from stopping the beer. I do occasionally consume one once in a while.
    RESULTS:
    I get 5 to 6 hours a night before I have to get up. but I go right back to sleep. believe me this is heaven compared to the way it was before.
    Recently I stopped taking the NAC and my condition came back. In fact if I stop eating the pumpkin seeds my condition also deteriorates. Of course sometimes I drink a lot of water too late in the evening. but most nights even this isn’t a problem.
    I have no idea what NAC is but I’m sure I will not stop.
    you have to find what works for you, but if I were you I would try this.

  18. B.R.A.
    Reply

    Thank you for sharing your info on the surgery and the results.

  19. B.R.A.
    Reply

    Please tell me what you did for you to get better rest via sleep. It wasn’t clear what you did for helping with the problem of an enlarged prostate gland. Thank you.

  20. DaB
    Reply

    I feel a need to share some info on prostate surgery. Mine was enlarged some, enough to keep “crystalized minerals” (bladder stones) from passing while they were small. My urologist suggested a surgical procedure called a “TURP” for short. Full name: transectional urethral resectioning of the prostate, I believe. If anyone suggests this surgery to you, run for at least a second opinion, and learn ALL about it before agreeing to the procedure! It has a horrible effect on your ejaculation/orgasms. Beware!

  21. Jeff
    Reply

    I used Saw Palmetto for a couple of years. It seemed to help a little at first, but as the problem with BPH increased I tried pygeum, stinging nettle, beta sitosterol, rye pollen and pumpkin seed oil. Any help was negligible and urination became often painful, frequent, and I seldom felt like I was emptying. To make matters worse I would frequently wake at night wet (this would even happen during the day with a 5-10 minute nap).
    I was prescribed Tamsulosin and I quickly got relief, along with a stuffy nose, sleepiness, weakness, and body aches. Since I prefer not to live in this condition indefinitely I looked into surgery, and I am scheduled for HolEP (Holmium Enucleation of the Prostate) laser surgery in a few days.

  22. Torrence
    Reply

    I am on tamsulosin and was going the have cataract surgery. I had no idea it could cause blindness. I need to talk with the doctor and ask how long I have to get off the meds before surgery. BUT, I am going out and find the two other meds offered and see if they do the trick. As the witch said in “The Wizard of OZ”, “What a world, What a world!” The doctors give out meds WITHOUT ANY OFFERINGS OF THE SIDE EFFECTS. I THOUGHT IT WAS THEIR JOB TO TAKE CARE OF US? WRONG AGAIN!!!!!!

  23. M
    Reply

    For my experience, Alpha Blocker NO.& NO. Main reason for me side effect & increase my BP.
    Please try Flax seeds pill AM/PM. Exact time for me is spoon of flax seeds in my cereal & Pill at 3PM.
    Please let me know, if some one find a good urologist with experience of Botox. I might give a try.
    Thank you.

  24. Rick
    Reply

    Quite a problem and I am trying to understand more about this.

  25. eb
    Reply

    Some cases of excessive trips to urinate at night are resolved when the person is found to have sleep apnea and begins using a CPAP machine while sleeping. The apnea can trigger excessive kidney functioning at night. My spouse went from 6-8 trips/night down to one or none.
    It’s worth a sleep study–amazing how many folks develop that problem, but don’t know it.

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