Proscar (Finasteride) Medication for Enlarged Prostate and Urinary Problems: What You Need to Know

by Alex Shteynshlyuger MD

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Urolift system for Enlarged Prostate

Urolift for Treatment of BPH

Finasteride (Proscar) is an Effective Treatment for BPH Symptoms

 Proscar, generically known as finasteride, shrinks the prostate by as much as 50% which helps to improve urinary symptoms in men.  The benefits of Proscar are not immediate.  He takes 3-6 months to see the benefits of using finasteride.  In addition to shrinking the prostate, finasteride also decreases the rate of growth of the prostate. 

Proscar Works Best in Combination with Alpha-Blockers  to Improve Slow Urine Stream

Finasteride (Proscar) is effective in improving urinary flow. It can help men to wake up less at night to urinate.  When used in combination with medication such as Flomax or Uroxatral, the effectiveness of using 2 medications together is greater than using either one alone.

Cost of Finasteride (Proscar) Pills

Proscar or generic finasteride is fairly inexpensive with a monthly cost of less than $20-$30.  Buying medications at a neighborhood pharmacy or pharmacies at Costco or Walmart are usually much less expensive and buying them at CVS or Rite-Aid.

Proscar (finasteride) Side Effects and What to Do If You Get Them

Side effects of finasteride are not common.  Most men take them without any noticeable side effects.  Taking finasteride for a prolonged period of time can lead to gynecomastia or increased breast size.  Some men taking Proscar experience problems with sexual interest (libido) and erections.  Typically, there is a decrease in ejaculate volume;  patients planning to have children should not be using finasteride. 

Medications such as finasteride have been implicated in what is called post-finasteride syndrome which can result in depression, anxiety and other symptoms, typically in younger males taking finasteride for hair loss.

Alternatives to Finasteride: Treatment Options for Enlarged Prostate

If someone cannot tolerate finasteride, Avodart is a similar medication within the same class of alpha-reductase inhibitors, that can be used as an alternative to finasteride.

Medications such as Flomax and Uroxatral (alfuzosin) can be used as an alternative to Proscar or in addition to Proscar with treating symptoms of enlarged prostate and BPH such as frequent urination, incomplete bladder emptying and slow urine stream.

Treatment Options if Proscar (Finasteride) Does Not Help

 Most commonly finasteride is used when alpha-blockers are not helpful or cannot be tolerated.  Finasteride is also used in addition to alpha-blockers to maximize the benefit of medical treatment.

When finasteride in combination with Flomax does not provide sufficient relief of symptoms of an enlarged prostate, other options should be considered.  Depending on patient anatomy and severity of symptoms, either an office procedure such as the Urolift procedure for enlarged prostate or Rezum in-office procedure can be performed. 

For very large prostate or severe symptoms such as urinary retention or incomplete bladder emptying, laser enucleation of the prostate, Greenlight laser and Bipolar TURP can be performed.

PSA and Finasteride: What You Must Know

Medications such as finasteride (Proscar) and Avodart can lower the level of PSA (prostate-specific antigen) but is much as 50%.  Takes about 3-6 months to get the full effect on PSA lowering.  The effect on PSA is an artificial effect and typically we double the PSA to account for use of medications such as finasteride and Avodart (dutasteride).

Because PSA levels are used to predict men who are at risk for prostate cancer, it is important to let your doctor know that you are taking or have been taking finasteride or dutasteride recently.


Why Choose New York Urology Specialists for Treatment of Enlarged Prostate (BPH) with Prostate Enucleation?

  • All treatment is performed by a Board-certified urologist experienced in treating men with symptoms of BPH using medical therapy, minimally invasive therapies, lasers and open surgery.
  • We are one of the few practices in the region to offer a full range of options for treatment of BPH.
  • We offer BPH treatment options under local anesthesia which avoids the risks, costs, and recovery from general anesthesia. Most men are able to return to office work and other normal activities the next day.
  • Extensive Experience: Hundreds of men treated successfully using medical therapy, Urolift, lasers for BPH (Holmium, Thulium, Evolve, Greenlight lasers), Bipolar TURP, traditional TURP, open suprapubic prostatectomy, robotic suprapubic prostatectomy for BPH.
  • We treat men with BPH who have heart problems (hypertension, CAD, CHF), renal failure (ESRD) on hemodialysis, men on blood thinners such as aspirin, Lovenox, Coumadin (Warfarin), apixaban, rivaroxaban (Xarelto).

Excellence-Urology_Care VasectomyWhen it comes to experience and innovation – New York Urology Specialists are a step ahead.  Better Science Means Better Care.  We specialize in minimally invasive highly effective treatment for symptoms of enlarged prostate and BPH. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4044


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Schedule an Appointment with Dr. Shteynshlyuger:

Call today: 646-663-4044 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of urinary problems in men.  He uses modern effective and proven treatment methods including Urolift for BPH.  He is highly recommended by top primary care physicians in the New York area.

He has successfully performed hundreds of prostate procedures in adults. Urolift procedures are performed in the office under local anesthesia, in a surgical center and affiliated hospitals under anesthesia.

If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to Contact Us with any questions.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: (646) 663-4044

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend, and evening office hours.