If you’re dealing with frequent nighttime bathroom trips, a weak urine stream, or difficulty emptying your bladder completely, you’re not alone. An enlarged prostate, medically known as benign prostatic hyperplasia (BPH), affects millions of men as they age. The good news? You have more options than ever to reduce prostate size and reclaim your quality of life.
Understanding what actually works—and what doesn’t—can help you make informed decisions about your urinary health. Let’s explore the evidence-based approaches to prostate size reduction, from lifestyle modifications to cutting-edge medical procedures.
Understanding Prostate Enlargement
Your prostate naturally grows throughout your lifetime, and by age 60, about half of all men experience some degree of BPH. By age 85, that number jumps to 90%. This growth occurs in the transition zone of the prostate, which surrounds the urethra. As the prostate expands, it can squeeze the urethra and block urine flow, leading to those frustrating symptoms that disrupt your daily life.
The key question most men ask: Can I shrink my prostate, and if so, how?
Natural Approaches: Lifestyle Modifications That Help
While lifestyle changes alone won’t dramatically shrink an enlarged prostate, they can help manage symptoms and potentially slow progression.
Dietary Adjustments
Research suggests certain dietary patterns may support prostate health. Foods rich in zinc, omega-3 fatty acids, and antioxidants appear beneficial. Consider incorporating more of these into your diet:
- Fatty fish like salmon and mackerel
- Nuts and seeds, particularly pumpkin seeds
- Tomatoes, rich in lycopene
- Green tea
- Vegetables from the cruciferous family, like broccoli and cauliflower
Conversely, limiting caffeine, alcohol, and spicy foods may reduce urinary urgency and frequency, even if they don’t shrink the prostate itself.
Exercise and Weight Management
Maintaining a healthy weight through regular exercise correlates with better prostate health. Studies show that men who are physically active experience fewer severe BPH symptoms. Even moderate exercise like brisk walking for 30 minutes daily can make a difference.
Obesity, particularly abdominal obesity, is associated with prostate growth and worsening symptoms. Losing excess weight may help slow BPH progression.
Bladder Training and Fluid Management
Strategic fluid intake—drinking adequate water during the day but limiting fluids two hours before bedtime—can reduce nighttime urination. Bladder training exercises, which involve gradually increasing the time between bathroom visits, can also improve bladder control.
The Reality Check
While these lifestyle modifications are valuable for overall health and symptom management, they typically won’t significantly reduce an already enlarged prostate. For men with moderate to severe symptoms, medical intervention becomes necessary.
Medical Treatments: Medications That Shrink the Prostate
When natural approaches aren’t enough, medications offer the next line of defense. Two main classes of drugs treat BPH, and they work in different ways.
Alpha Blockers
Medications like tamsulosin (Flomax), alfuzosin, and doxazosin relax the muscles around the prostate and bladder neck, improving urine flow. However, alpha blockers don’t actually shrink the prostate—they simply make it easier for urine to pass through.
Benefits include relatively fast symptom relief, often within days to weeks. The downside? Side effects can include dizziness, fatigue, and retrograde ejaculation.
5-Alpha Reductase Inhibitors
This is where actual prostate shrinkage happens with medication. Drugs like finasteride (Proscar) and dutasteride (Avodart) block the conversion of testosterone to dihydrotestosterone (DHT), the hormone that fuels prostate growth.
These medications can reduce prostate size by 20-30% over six to twelve months. The catch? It takes patience—you won’t see results for at least three to six months. Side effects may include reduced libido, erectile dysfunction, and decreased ejaculate volume.
Combination Therapy
For men with larger prostates (over 40 grams), doctors often prescribe both an alpha blocker and a 5-alpha reductase inhibitor. This combination addresses symptoms immediately while working to shrink the prostate over time.
Minimally Invasive Procedures: Modern Alternatives to Surgery
When medications aren’t effective or cause intolerable side effects, you don’t have to jump straight to traditional surgery. Several minimally invasive procedures now offer effective prostate reduction with less downtime and fewer complications.
Prostate Artery Embolization (PAE)
PAE or Prostate Artery Embolization represents one of the most innovative approaches to prostate size reduction. This outpatient procedure works by reducing blood flow to the prostate, causing it to shrink naturally over time.
During PAE, an interventional radiologist makes a tiny incision in your wrist or groin—just a few millimeters—and guides a thin catheter through your blood vessels to the arteries feeding your prostate. Microscopic particles are then injected to block blood flow to the enlarged tissue.
What makes PAE appealing? There are no incisions in the genital area, you go home the same day, and recovery is typically mild. Most men notice significant symptom improvement within one month, with the prostate continuing to shrink over the following months. Studies show prostate volume reductions of 20-40% at one year, with symptom improvements lasting for years.
PAE is particularly attractive for men who want to avoid the sexual side effects associated with traditional surgery, as it has a very low risk of causing erectile dysfunction or ejaculation problems.
UroLift
This procedure uses small implants to hold the prostate tissue away from the urethra, like pulling back curtains to open a window. UroLift doesn’t remove or destroy prostate tissue—it simply moves it out of the way. The procedure preserves sexual function and has minimal recovery time, though it’s most effective for smaller prostates without a middle lobe.
Rezūm Water Vapor Therapy
Rezūm uses steam to destroy excess prostate tissue. During the five-minute procedure, sterile water vapor is injected into the prostate, causing cell death. Over the following months, your body naturally absorbs the dead tissue, and the prostate shrinks.
Recovery can involve urinary symptoms for a few weeks, but sexual function is typically preserved. Symptom improvement appears within two weeks to three months.
Laser Procedures
Various laser technologies (GreenLight, HoLEP, ThuLEP) vaporize or remove prostate tissue. These procedures are more invasive than PAE or Rezūm but less so than traditional surgery. They offer immediate symptom relief and significant prostate reduction but may carry higher risks of sexual side effects.
Surgical Options: When More Aggressive Treatment Is Needed
For very large prostates or when other treatments fail, surgical removal of prostate tissue remains an option.
TURP (Transurethral Resection of the Prostate)
Long considered the gold standard, TURP involves inserting an instrument through the urethra to cut away excess prostate tissue. It’s highly effective at reducing prostate size and improving symptoms, but it requires anesthesia, a hospital stay, and carries risks including bleeding, infection, retrograde ejaculation, and erectile dysfunction.
Simple Prostatectomy
For prostates larger than 80-100 grams, surgical removal through an abdominal incision may be recommended. This is major surgery with significant recovery time and the highest risk of complications.
How to Choose the Right Approach
Selecting the best treatment depends on several factors:
- Prostate size: Larger prostates may require more aggressive treatment
- Symptom severity: How much are your symptoms affecting your quality of life?
- Overall health: Your age, medical conditions, and fitness for surgery matter
- Priorities: How important is preserving sexual function? How much downtime can you afford?
- Previous treatments: What have you already tried?
Most specialists recommend starting with lifestyle modifications and medications, then progressing to minimally invasive procedures before considering surgery. However, every case is unique.
What to Expect: Treatment Timelines
Understanding how quickly different approaches work can help set realistic expectations:
- Lifestyle changes: Ongoing management; may slow progression but won’t shrink prostate
- Alpha blockers: Symptom relief in days to weeks; no prostate shrinkage
- 5-alpha reductase inhibitors: 3-6 months for noticeable shrinkage; 6-12 months for maximum effect
- PAE: Symptom improvement within 2-4 weeks; continued shrinkage over 3-12 months
- Rezūm: 2 weeks to 3 months for improvement
- UroLift: Immediate to 2 weeks
- Surgery: Immediate improvement once healed (2-6 weeks recovery)
The Bottom Line
Reducing prostate size is absolutely achievable with today’s treatment options. The best approach depends on your individual situation, preferences, and goals.
If you’re experiencing bothersome urinary symptoms, don’t suffer in silence or assume surgery is your only option. Start by consulting with a urologist or interventional radiologist who can assess your prostate size, discuss your symptoms, and present all available options.
Many men find that minimally invasive procedures like prostate artery embolization offer the sweet spot between effectiveness and minimal disruption to their lives. With same-day outpatient treatment, quick recovery, and excellent preservation of sexual function, PAE and similar procedures are changing the landscape of BPH treatment.
Your enlarged prostate doesn’t have to control your life. Take the first step by scheduling a consultation to explore which prostate reduction method is right for you. Whether you start with lifestyle modifications and medications or move directly to a minimally invasive procedure, relief is within reach.
Learn more about Prostate Artery Embolization (PAE) or request a consultation. Colorado Advanced Endovascular is based in Lakewood, Colorado, and serves Denver and the Front Range.