When the prostate gland gets big, it can make it harder to urinate. Men with benign prostate hypertrophy (BPH) often complain that they have to get up three or four times a night to pee. Medications called alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), silodosin (Rapaflo), tamsulosin (Flomax) or terazosin (Hytrin) are often prescribed to make it easier to urinate.
These drugs work by relaxing smooth muscle throughout the body. Because they also relax the muscles around the prostate and bladder, they are supposed to improve urinary flow. Sometimes men experience side effects that are not easy to discuss with a health professional.
Q. You’ve written about the side effects of tamsulosin, prescribed for frequent nighttime urination. You said nothing about sexual problems.
I have been using drugs for erectile dysfunction for several years. When one ED drug stopped working, my doctor switched me to another but it didn’t help.
I thought perhaps the problem is a side effect of another drug I am taking. When I researched this online, I found these side effects listed for tamsulosin: lack of interest in sex, difficulty getting or keeping an erection and abnormal ejaculation. I stopped taking tamsulosin for a week and my sexual problems weren’t as bad. I’ll discuss this with my doctor soon.
A. Tamsulosin (Flomax) and similar drugs are prescribed for men with enlarged prostate glands. They make urination easier.
Side effects of these alpha blockers can include sexual difficulties such as the ones you have mentioned. There are other complications that people should be aware of:
Alpha Blocker Side Effects:
- Dizziness (upon standing up suddenly), lightheadedness, vertigo, losing consciousness temporarily
- Irregular heart rhythms
- Stuffy nose, congestion, sinusitis, runny nose
- Sore throat, cough, infection
- Drowsiness, tiredness, fatigue
- Swollen feet, ankles or hands; fluid retention, edema
- Urinary incontinence
- Back pain
- Digestive upset, indigestion, 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!]
Other Readers Report Pee Pill Problems:
Michael in Santa Fe, New Mexico complained:
“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 a 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.”
J in Arizona says:
“I’ve tried them all. Flomax gives the best, fastest results for prostate-related issues (i.e. flow, pain, irritability). 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?”
Steve came up with a strategy the says works for him:
“OK, at 62 I have been suffering with this for years. I had to get up four to six times a night to pee. 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 a doctor on my local radio station. He said to try several things
1. NAC also known as: N-Acetyl-Cysteine. I found this dietary supplement online.
2. Cranberry Extract. Most pharmacies or health food stores have this.
3. Milk Thistle. Health food 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./strong>
6. I eat lots of shelled Pumpkin Seeds. I find them at Whole Foods unsalted. They are tasty.
“I also stopped drinking beer. 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 prefer natural approaches when possible. NAC, Milk thistle and cranberry extract worked for me.”
What Other Medicines might work for BPH?
Please discuss your concerns with your doctor. Tadalafil (Cialis) has been approved for both urinary problems and erectile dysfunction. The downside is that the drug is pricey and many insurance companies will not pay for “recreational” drug use. They perceive sexual satisfaction as a non-critical health problem. The fact that the drug is also effective for BPH does not seem to interest them. You may need to ask your doctor to negotiate on your behalf.
Are There any Home Remedies for Nighttime Urination?
To our amazement we have heard from a lot of people that a handful of raisins in the evening can help with nighttime urination. Here are just a few links with stories from people who found this remedy helpful:
Do Raisins Really Control Nighttime Urination – Nocturia
Can Raisins at Bedtime Reduce Nighttime Bathroom Visits?
Solving Nighttime Urinary Problems with Beets