NSAID's may worsen enlarged prostate


Pain meds may worsen symptoms of enlarged prostate
Fri Sep 21, 4:25 PM ET

Common painkillers like ibuprofen and naproxen may act as a double-edged
sword when it comes to men's prostate function, according to a report in the
Harvard Men's Health Watch.

Recent evidence suggests that drugs such as these, called nonsteroidal
anti-inflammatory drugs (NSAID), may lower the risk of developing an
enlarged prostate and worsen urinary symptoms in men who already have the
condition.

Prostate enlargement, known as benign prostatic hyperplasia (BPH), is common
among older men. The condition is unrelated to prostate cancer, but it does
cause bothersome symptoms such as frequent urination and difficulty with
emptying the bladder completely.

It's known that certain medications, most commonly cold and allergy
remedies, can make BPH symptoms worse. Now, a large study in the Netherlands
recently implicated NSAIDs as another cause of worsening BPH, according to
the Harvard publication.

Using data from 5,900 men age 45 and older, researchers found that men using
NSAIDs were twice as likely as non-users to develop acute urinary retention,
a sudden inability to empty the bladder.

The findings stand in contrast with those from a recent U.S. study of more
than 2,400 men with no history of urological problems. Those who regularly
used NSAIDs were less likely to develop BPH.

The seemingly conflicting results may reflect two different actions of
NSAIDs, according to the report.

In men who already have BPH, the painkillers may worsen urinary symptoms
because they block production of chemicals called prostaglandins; the
bladder produces prostaglandins to enhance contractions of surrounding
muscles, and blocking this process may make it even harder for men with BPH
to empty their bladders.

On the other hand, there's evidence that inflammation contributes to the
development of BPH, so NSAIDs may help prevent the condition.

However, younger men should not start popping painkillers to the lower their
risk of BPH, according to the Harvard publication. All men should use NSAIDs
carefully, following the label directions unless a doctor tells them
otherwise.

Men with BPH should pay attention to whether their symptoms increase when
taking an NSAID. If this does happen, they should tell their doctor, and
possibly switch to acetaminophen (Tylenol) for pain relief.

SOURCE: Harvard Men's Health Watch, September 2007.




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