By Howard LeWine, M.D.
Q: I have an enlarged prostate. Over the last few months, I have a more frequent urge to urinate, especially at night. And my urine flow is so slow. I would prefer not to start medication. Any suggestions?
A: Doctors call this condition benign prostatic hyperplasia (BPH). In most men, BPH progresses slowly. They can decide for themselves when and if they should be treated.
It’s very reasonable to start with some simple adjustments in lifestyle to reduce the daily nuisance-factor of BPH.
–Reduce your intake of fluids, particularly after dinner.
–Limit your intake of alcohol and caffeine, and avoid them after mid-afternoon.
–Avoid medications that stimulate muscles in the bladder neck and prostate, such as pseudoephedrine and other decongestants.
–Avoid medications with anticholinergic properties that weaken bladder contractions. Antihistamines such as diphenhydramine are the most common offenders. Various antidepressants and antispasmodics have similar properties.
–If you are taking diuretics for high blood pressure or heart problems, take it in the morning when you first wake up. Also ask your doctor if you can reduce the diuretic dose.
–Never pass up a chance to use the bathroom, even if your bladder does not feel full. Take your time, so you empty your bladder as much as possible.
–When you are in new surroundings, learn the location of the bathroom before you really need it.
–Make your night-time trips to the bathroom easy and safe. Be sure there is enough light to see where you’re going. Avoid bright light that jolts you awake, making it hard for you to get back to sleep. Be sure there are no electrical cords, telephone wires, loose rugs or stray objects that might trip you up.
If you can live comfortably with BPH, do it. But if your symptoms are too bothersome, taking medication might be your best option.
(Howard LeWine, M.D. is an internist at Brigham and Women’s Hospital and assistant professor of medicine at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)