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In the studySymptom Management After Reducing TherapySMART-1327 patients with BPH were treated with the combination of an a1-blockertamsulosin0.4 mg/dplus a 5 a-reductase inhibitordutasteride0.5 mg/dOne arm of the study received combination therapy for 36 wkand the other arm combination therapy for 24 wkafter which placebo was substituted for tamsulosin for the remaining 12 wk of the studyOverall91of patients in the arm in which tamsulosin therapy was continued for 36 wk felt the same or better at week 30 as they did at week 24 compared with 77of patients who had tamsulosin withdrawn at week 24In patients with moderate symptomsIPSS 3 20the percentages were 86and 58These data suggest that tamsulosin can be withdrawn from a tamsulosin-dutasteride combination after 24 wk of therapybut that men with severe symptoms may need a longer period of combination treatment.

Bach et al57randomized 476 men 1:1 to placebo or a pumpkin extractTwo extracts have been tested against standard therapysaw palmetto against tamsulosin and a combination productsaw palmetto/stinging nettle rootagainst finasteride both trials revealed similar outcomes regarding symptomsQmaxand PVR between the plant extract and standard therapy.

Himplasia is a combination of herbs like Tribulus terrestrisCaesalpinia bonducellaAreca catechuAsparagus racemosus and Crataeva nurvalaIt acts by inhibiting the enzyme 5 alpha reductase that is responsible for the conversion of testosteroneThis helps to decrease the production of dihydrotestosterone or DHT that helps to reduce prostate sizeHimplasia also possesses alpha-receptor blocking activity thus improving urinary flow and maintaining bladder and prostate healthAs a daily supplement Himplasia helps to provide ongoing support for a healthy prostate.

Epristeridea novel 5 a-reductase inhibitoris an interesting drug in the treatment of BPHIt belongs to class of carboxy steroidIt has been shown to be an uncompetitive inhibitor against both testosterone and NADPHIts inhibitory action results from a preferential association to an enzyme binary complex containing NADP and henceincreases in testosterone concentration does not overcome its inhibitionIt is a specific inhibitor of type II 5 a-reductase generic atarax isoenzymeIt also attenuates the growth rate of some androgen responsive prostate cancers34]

Globe thistleSphaeranthus hirtusis very useful in enlargement of prostate.

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