AboutStephen W. Leslie, MD Expertise Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.
Experience Full time practicing urologist with 20 years experience. Assistant Clinical Professor of Urology at the Medical College of Ohio. Editor in Chief of eMedicine Urology internet textbook. Author of only book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.
Organizations American Urological Association, Ohio State Medical Association, Sexual Medicine Society
Publications Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.
Education/Credentials Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison
Awards and Honors Thirlby Award of the American Urological Association.
Question I've been on Flomax for 3 years now for BPH. It seems to work with two problems: 1) I get very sleepy after taking it so I take before bed with a cracker to wash it down. Most nights I'm up only once. And 2 - it seems to be affecting my sex drive. (I'm 61 and while not that active before, there are very few erections now.).
After seeing the ads for Avodart, I started to research it. It seems that most sources I found on the Internet for knowledge explain that it is different than Flomax and takes 6 months to start working. The adds say it doesn't affect sexual drive and doesn't mention drowsiness. Based on what I read - including an answer here - I can't find a reason why anyone would find Avodart useful.
Is there something I should look for as an alternate to Flomax (which is not generic)? Or is that my best hope outside of surgery?
Thanks!
Answer There is no evidence that any of the alpha blockers (Flomax type medicines) work better than any others so it's unlikely that switching medicines within this class will alleviate symptoms. Uroxatral is another alpha blocker that is less likely to have side effects than Flomax and this may be worth a try.
Avodart does not take 6 months to start working. It takes six months for the shrinkage of the prostate produced by the Avodart to make a clinically noticeable difference.
Why is Avodart useful? It is a 5 alpha reductase inhibitor which blocks the effects of testosterone on the prostate. This effect causes the prostate to shrink. It also decreases the blood supply to the prostate which is helpful in some situations. Flomax and similar meds do not ultimately stop the prostate from growing, only Avodart type meds can do this. If the prostate is very large, the Avodart type meds are most useful. Finally, only the Avodart type meds have been proven to reduce the likelihood of eventual need for surgery, by about 50%. The Flomax type don't.
One more thing. In a case like yours where Flomax alone may not be adequate, Avodart can be added and may resolve your problem without surgery. That's why Avodart is useful in many cases.
