I suspect that I might be prescribed Finasteride (Proscar, Propecia) in the future for my enlarged prostate. I think this is possible because the pills—the Tamsulosin (Flomax)—are working with limited success these days. They definitely help…but, I feel like I’m not happy with this urination situation really.

Tamsulosin lowers blood pressure and may cause dizziness or fainting, especially when you first start taking it, or when you start taking it again… You will also need to be checked for prostate cancer before and during treatment with tamsulosin.

I wasn’t checked—as far as I know—for prostate cancer. This is something that scares the hell out of me. I’m sure I have a lot of company in this regard. Probably millions of people. Who the hell isn’t scared of cancer? But, I know that I have to get this test done.

As far as who can’t use Finasteride?:

Finasteride is not suitable for some people. To make sure this medicine is safe for you, tell a doctor if you:

have had an allergic reaction to finasteride or any other medicines in the past
have severe bladder problems
have liver problems
are trying for a baby or have a pregnant partner – this medicine passes into semen and can affect an unborn baby

There are potential side effects of Finasteride. It would appear that they’re not so common. (reddit thread about Finasteride side effects.) Things like low sex drive, low ejaculation amount, erection problems, etc. You know how it is…research the side effects and talk to a doctor and make the decision that’s in your best interest…of course…that’s all pretty obvious, but I felt obligated to say it.

I think it’s also important to consider this info from Mayo Clinic:

This medicine will not prevent prostate cancer but may increase your risk of developing high-grade prostate cancer. This medicine may affect the results of the prostate specific antigen (PSA) test. Some men who use this medicine have become infertile (unable to have children). Talk with your doctor before using this medicine if you plan to have children.

Also from same Mayo Clinic page:

More common

cold sweats
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

Less common

Bloating or swelling of the face, arms, hands, lower legs, or feet
breast enlargement and tenderness
hives or welts, itching, skin rash
rapid weight gain
redness of the skin
swelling of the lips and face
tingling of the hands or feet
unusual weight gain or loss

One sort of happy side effect of Finasteride is that it helps a lot with male pattern baldness. (Anyone who’s interested for this reason, see I’m losing my hair, what do I do? I’ve been taking Propecia for 12 years, and you can AMA.) Apparently it’s used to treat baldness in addition to prostate stuff. It would appear that when being used for BPH the dose is around 5 mg and when used exclusively for hair loss stuff it’s in the vicinity of 1 mg. I notice there’s some controversy surrounding the dosage amount for baldness: with some people arguing that a small .25 mg daily dose is sufficient.

Here’s the Web MD symptoms of an enlarged prostate:

Symptoms of enlarged prostate can include:
A weak or slow urinary stream
A feeling of incomplete bladder emptying
Difficulty starting urination
Frequent urination
Urgency to urinate
Getting up frequently at night to urinate
A urinary stream that starts and stops
Straining to urinate
Continued dribbling of urine
Returning to urinate again minutes after finishing

If I’m being painfully honest, I have nine out of ten of those symptoms on the checklist. The only one that I don’t seem much afflicted by is the “continued dribbling of urine.”