Urinary and Prostate Symptom Medicines
Urinary and prostate symptom medicines are commonly used to manage lower urinary tract symptoms (LUTS), particularly in men as they get older.
Symptoms may include:
- weak urinary stream
- hesitancy
- urgency
- increased frequency
- nocturia
- incomplete bladder emptying
In many cases, these symptoms are related to benign prostate enlargement (also called benign prostatic hyperplasia, BPH). However, other causes such as infection, neurological conditions, or prostate cancer must be considered.
Medication choice depends on symptom pattern, prostate size, PSA testing where appropriate, and overall health.when symptoms may signal underlying cardiovascular or endocrine conditions.
These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.
Understanding Lower Urinary Tract Symptoms (LUTS)
LUTS can be divided into:
Voiding symptoms
- weak stream
- straining
- intermittency
- incomplete emptying
Storage symptoms
- urgency
- frequency
- nocturia
- urge incontinence
Different medicines target different symptom patterns.
Read more here: Lower urinary tract symptoms (LUTS)
Alpha Blockers
Alpha blockers relax smooth muscle in the prostate and bladder neck, helping urine flow more easily.
Common examples include:
- tamsulosin
- alfuzosin
- doxazosin
What to expect
- Often work within days to weeks
- Improve urinary flow
- Do not reduce prostate size
Common side effects
- dizziness
- light-headedness
- postural hypotension
- ejaculatory changes
Blood pressure review may be appropriate in some individuals.
5-Alpha Reductase Inhibitors
These medicines reduce the size of the prostate over time by blocking conversion of testosterone to dihydrotestosterone.
Common examples include:
- finasteride
- dutasteride
What to expect
- May take several months to show effect
- Most useful in men with larger prostate volumes
- May reduce risk of urinary retention over time
Important considerations
- Can reduce PSA levels by approximately half
- May affect libido or erectile function
- Ongoing monitoring may be required
PSA interpretation must take medication use into account.
You can read more in: PSA blood testing
Combination Therapy
In some cases, an alpha blocker and a 5-alpha reductase inhibitor may be used together.
This may be considered when:
- symptoms are moderate to severe
- prostate enlargement is significant
- long-term progression risk is higher
Treatment decisions are individualised.
Medicines for Storage Symptoms
If urgency and frequency dominate, additional medicines may be considered.
These include:
Antimuscarinic medicines
Used cautiously where incomplete bladder emptying is not significant.
Beta-3 agonists
May help bladder overactivity.
Assessment of post-void residual volume may be required before prescribing certain agents.
💡 Why assessment matters for urinary symptoms
Urinary symptoms can signal different conditions requiring different treatments:
- Benign prostate enlargement vs prostate cancer
- Bladder dysfunction vs incomplete emptying
- Medication side effects vs disease progression
- When referral to urology is appropriate
Proper assessment including symptom review, examination where needed, and PSA testing consideration ensures safe prescribing.
When Medication Is Not Enough
Medication may not be sufficient if:
- urinary retention develops
- infections are recurrent
- kidney function is affected
- symptoms remain severe
In such cases, referral for urology assessment may be required.
PSA Testing and Prostate Monitoring
PSA testing may be considered in men with urinary symptoms depending on age, risk factors, and shared decision-making.
Important points:
- PSA can be influenced by prostate size
- PSA is reduced by finasteride and dutasteride
- PSA is not a diagnostic test on its own
You can read more in: PSA blood test guidance
Red Flags Requiring Urgent Assessment
Seek urgent medical review if you develop:
- inability to pass urine
- severe lower abdominal pain
- visible blood in urine
- unexplained weight loss
- bone pain
- progressive weakness
Acute urinary retention is a medical emergency.
Urinary Medicines in Remote GP Care
Many urinary symptom discussions can begin remotely.
However, in-person assessment may be required if:
- abdominal examination is needed
- post-void residual measurement is indicated
- neurological symptoms are present
- red flags exist
Safety assessment is prioritised over convenience.
Frequently Asked Questions
1. Does tamsulosin shrink the prostate?
No. Tamsulosin relaxes muscle around the prostate to improve urine flow but does not reduce prostate size.
2. Does finasteride affect PSA results?
Yes. Finasteride typically lowers PSA levels. PSA results should be interpreted with this in mind.
3. Can urinary medicines cause erectile dysfunction?
Some medicines, particularly 5-alpha reductase inhibitors, may affect sexual function in some individuals. Risks and benefits should be discussed before starting treatment.
When to contact a GP
You should consider contacting a GP if:
- urinary symptoms worsen
- medication causes dizziness or sexual side effects
- you notice blood in urine
- you develop urinary retention
- you are unsure whether monitoring is due
Sudden inability to pass urine requires urgent medical attention.
Further Reading and Hub Links
Visit our Medication and Prescribing hub or browse more health topics in the AccessGP Knowledge Base.
If you are concerned about urinary symptoms, prostate health, or medication side effects, a GP can help guide you on the safest next step.
Last reviewed by Dr Zamiel Hussain, GMC registered GP
Updated: 14 February 2026