A urologist recommended me to take Tamsulosin to relieve and treat frequent urination. Any thoughts?


#1

He said that it’s an alpha blocker, which I replied that it concerned me since some of you have mentioned not to take those, and finasteride is an alpha reductase inhibitor.

From WebMD: "Tamsulosin is used by men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH). It does not shrink the prostate, but it works by relaxing the muscles in the prostate and the bladder. This helps to relieve symptoms of BPH such as difficulty in beginning the flow of urine, weak stream, and the need to urinate often or urgently (including during the middle of the night).

Tamsulosin belongs to a class of drugs known as alpha blockers.

Do not use this medication to treat high blood pressure."

So any thoughts on it? He said it would help relieve the muscles in my bladder and the area involved with urination, but we decided to hold off on it until the test results come back. Given that it’s an alpha blocker I’d rather not take it.


#2

Tamsulosin blocks alpha adrenergic receptors. It specifically targets a type of alpha adrenergic receptor (alpha1A receptors) that are more prevalent in the prostate. Adrenergic receptors are all over the body and have multiple different roles. In this case, the action of Tamsulosin causes relaxation of smooth muscle in the prostate and can help to relieve lower urinary tract symptoms.

Finasteride inhibits 5 alpha reductase which is an enzyme that is primarily known to convert testosterone to DHT. It is also found in multiple locations in the body, primarily the prostate. 5 alpha reductase is not at all related to the alpha adrenergic receptors in the prostate.

I think it would be interesting to experiment with Tamsulosin to see if it had any benefit in PFS. Has any one on this forum had experience with Tamsulosin or Flomax? It sort of makes sense to me that relaxation of smooth muscle in the prostate might improve blood flow to nerves/nerve function considering the nerves that control erections run in and around the prostate.


#3

Interesting to follow…


#4

All prostate drugs are dangerous. If you google Tamsulosin (Flomax) and side effects you’ll see it has almost all the same as finasteride. Insomnia, libido, erectyle dysfunction. And they can be permanent.

Look into the UroLift procedure if you’re going to do anything to your prostate. Otherwise leave it alone and deal with the frequent urination.

Urolift is still risky, but it’s the safest prostate treatment there is. After that maybe Vitamin B12 pills. Then Cialis (which also relaxes the muscles and causes no libido issues, but it could make you blind forever so keep that in mind).

But Tamsulosin, Finasteride, and all other prostate drugs are androgen inhibitors and should only be used as a last resort.


#5

I wonder if that’s an argument for gentle exercise such as walking. It will have a prostate massaging effect and could aid bloodflow.


#6

Yeah you might as well just exercise a lot if you want better blood flow and less inflammation. If you go out for a run and take a piss right after you’ll notice it’s a lot easier to do.


#7

This isn’t something I can live with. Hopefully the results will show something but if not, I may try the medication. I’m not getting a uro lift because there’s nothing to suggest I have BPH.


#8

Oh, you might want to get an MRI to be sure, but I guess vitamin B pills or Cialis are your best options treating it then.


#9

Tamsulosin may produce sexual adverse effects in some people, and that makes sense. If you inhibit smooth muscle contraction of the prostate, that it is going to have an effect on ejaculation. I’m not aware that Tamsulosin has any activity at all at androgen receptors. If you have read any studies that suggest that this is the case, please share.

That being said, I hope that anyone on this forum that has actually taken Tamsulosin will post their experience. It’s useful to add to our collective knowledge. It’s always possible that we will stumble upon something that helps alleviate some of our symptoms. I mean, we probably won’t, haha, but it’s still worth a try.


#10

Alpha blockers probably interact with androgen receptors because they cause all the same side effects. They’re all connected.


#11

That is not an informed statement. There are multiple etiologies of male sexual dysfunction: endocrine, psychogenic, neurological, vascular, pharmacologic, etc. The mechanisms in one case or another may or may not overlap. An individual with a complete spinal cord injury will probably have erectile dysfunction, but they will still have functional androgen receptors. In the same way, drugs can cause sexual dysfunction in different ways. Cimetidine literally antagonizes androgen receptors. GnRH agonists (e.g. Leuprolide) overstimulate the HPA axis and ultimately produce downregulation of the GnRH receptors in the pituitary. SSRIs cause sexual dysfunction… somehow, haha. I don’t really know exactly why they cause sexual dysfunction, but it is most likely related to the increase in Serotonin (+/- other neurotransmitters) considering that is their known mechanism of action. I’m not trying to argue— I just think it is important for us to be as precise as possible.