A recent study reported in the Harvard Men’s Health Watch, has shown that although taking common painkillers, such as nonsteroidal anti-inflammatory drugs (NSAID), may lower the risk of developing an enlarged prostate, it may worsen urinary symptoms in men who already have the condition.

Benign prostatic hyperplasia is a condition that occurs where the prostate gland to becomes enlarged as a man ages.

As a man matures, the prostate goes through two main periods of growth, the first occurring early in puberty, when the prostate doubles in size, and the second around the age of 25, when the gland begins to grow again. This second growth phase is the one that often results, years later, in BPH.

Though the prostate continues to grow during most of a man’s life, the enlargement doesn’t usually cause problems until late in life. BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.

When the prostate enlarges, the layer of tissue surrounding it stops it from expanding, thereby causing the gland to press against the urethra.  Thus, the bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so some of the urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH.

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 is known that certain medications, most commonly cold and allergy remedies, can make BPH symptoms worse.

The Harvard publication, reporting on a large study done in the Netherlands, recently implicated NSAIDs as another cause of worsening BPH.  Approximately 5,900 men age 45 and older, who were using NSAIDs were twice as likely as non-users to develop acute urinary retention, a sudden inability to empty the bladder.

In men who already have BPH, the painkillers may worsen urinary symptoms because they block production of chemicals called prostaglandins which is produced by the bladder to enhance contractions of surrounding muscles.  When this process is blocked, it makes it even harder for men with BPH to empty their bladders.

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.