Here’s one of the crucial questions facing a blogger: “Does anyone besides me care about how often I pee?” Well, how will I know unless I blog about it? And, if you don’t care, stop reading.
I suspect, though, that quite a few men of a certain age will find my subject fascinating.
For 50% of men over the age of 50 are said to have an enlarged prostate (90% over 80). In my “Female doctors do it better” post I noted that a prostate exam is the only time you don’t want to hear from a female who is inspecting your genital area that you’re larger than average.
That happened to me about fifteen months ago. At that time I started taking Flomax, a prescription drug that relieves the symptoms of BPH (Benign Prostatic Hyperplasia), which include going often, going urgently, having a weak stream, and frequently waking up at night to go.
All of which described how my 57 year old urinary system was operating. For some inexplicable reason that casts serious doubt on the existence of an intelligent designer, in men the uretha comes out of the bladder and passes through the prostate (which adds fluids to the semen to nourish and protect sperm cells).
When the prostate enlarges due to the effects of the male hormone dihydrotestosterone (DHT), the urethra gets squeezed. And the above-mentioned symptoms appear.
I’d been getting up at least two times a night to go to the bathroom. Recalling my youthful days, that wasn’t at all the case. Sleeping all the way to morning was the rule, not the exception. Then there was the flow thing.
At the athletic club where I work out, I generally use a side by side set of urinals (discreetly separated by a divider). One day I sidled up to pee at the same time as a twenty-something dude. I was struck by the difference in sound between us. One of us was imitating a small waterfall, the other a trickle tube.
You can guess which I was. But now I’m on my way to becoming a gusher again. And a much less frequent visitor to the bathroom, thanks to Avodart.
(Note: I have no financial interest in GlaxoSmithKline, which makes this drug. However, I'd like one. I’m entirely open to accepting cash and/or a free supply of Avodart from GSK if the company wants to express its appreciation for this marvelously positive free blog advertising. Or a Mini-Cooper S convertible, which would entitle GSK to a whole series of Avodart posts and really make me feel younger.)
When I went for my annual physical about three and a half months ago, my doctor told me that my prostate was still “generous.” I didn’t press for details. She said that while Flomax treats symptoms, it doesn’t shrink the prostate. Avodart does, by lowering the level of DHT. I was told that Flomax and Avodart can be taken at the same time, and that Avodart can take six months or so to have an effect.
Well, it seems to be working for me after just a bit over three months. I’m usually getting up to go just once a night now. And the frequency of bathroom trips is considerably less during the day.
Yesterday I peed at the athletic club around 4:30 pm, then went to my Tai Chi class. At 6:15 I drank a large Starbucks latte before beginning my weekly grocery shopping. Got home and took the dog for a walk. Peed again at about 8:00 pm. That’s three and a half hours between bathroom visits, even with a large latte coursing through my bladder.
Much improved from before. So I’m happy with Avodart.
It’s fairly spendy, but insurance is paying half the cost of my prescription. I haven’t noticed any side effects. That’s good, but I would like to experience the side effect of having hair regrow on my bald spot. Avodart is expected to work like Propecia, since it reduces the conversion of testosterone to DHT, one of the causes of hair loss.
I’ll be keeping an eye on the back of my head. Along with paying less attention to toilets.
Brian,
The word, "Pee" is a crude form of wordage.
The proper term should be, "Tinkle."
When I need to relieve myself, I properly communicate, "I need to take a Tinkle."
Not bragging, however, this does show a high level of sophistication on my part.
Posted by: Roger | January 26, 2007 at 08:51 AM
Roger, at least "pee" is above "wee-wee," don't you think? But I'll agree that "tinkle" is more sophisticated than either.
In this post I struggled with finding appropriate verbiage. I fell back on "go to the bathroom" when it seemed that I'd overdone "pee."
Yet "urinate" struck me as too clinical, and "number one" too mathematical.
I discovered this excellent Wikipedia compendium of toilet slang too late:
http://en.wikipedia.org/wiki/Wikipedia:Bad_Jokes_and_Other_Deleted_Nonsense/Toilet_Slang
Now I know about "point the pink pistol at the porcelain firing range" Certainly more vivid than a plain "pee."
Posted by: Brian | January 26, 2007 at 09:42 AM
Brian,
Thanks for the Wikipedia compendium of toilet slang. After an exhaustive analysis of the compendium and a thorough examination of the word, "Urination." I have decided to delete the "U" word from my daily communications to;
"pointing the Percy at the porcelain."
This is another classic example of my ability to change my usage of day-to-day standard words.
Posted by: Roger | January 26, 2007 at 11:39 AM
Whatchya complaining about?? Try having a baby and see how many times you wake to go pee. And it doesn't stop after the baby. Not to mention the sneeze induced tinkles. Anyhow, careful on the lattes, they are dehydrating so would have an impact on your pee-out-put.
Posted by: rach | January 30, 2007 at 09:03 PM
Brian, I am a 58 yr old male, and have been taking Flomax for 2 yrs. Now my doctor (and yes, female doctors definitely do it better) is switching me to Avodart, and there will be an overlap as you pointed out, until the Avodart kicks in later. Since my post is 6 months after yours, my question to you is: have you noticed any side effects from Avodart by now? I've noticed some occasional dizziness and nasal congestion from the Flomax and wonder what to expect from Avodart. A lot of men our age seem to be going this route, so i guess I'll go with the flow.
You may answer to my email if you want.
Posted by: Rick | July 11, 2007 at 09:52 AM
Rick, I'm still taking both: Flomax and Avodart. I haven't noticed any side effects from either. Some dizziness from Flomax only occurred the first time I took it. After that, I adjusted fine.
I'd say, go with both. I wish Avodart was cheaper, but that's the way our inefficient health care system works. On the plus side, I believe that Avodart has stimulated some hair growth in my bald spot.
I could be deluding myself, hoping to get more benefit bang for my Avodart bucks, but I really do think that this has been a beneficial side effect.
Posted by: Brian | July 11, 2007 at 11:17 AM
I am an athletic 73 year old and about to begin regimen of Avodart. I have been taking Flomax for some time and do experience light headedness. I am concerned about the effect of lower testosterone levels on my active life. Does it cause muscle weakness of any sort? Would be interested in hearing how it has affected others who work out regularly.
Posted by: Mike | February 29, 2008 at 08:38 AM
Mike, I'm no expert on this but a little Google research reveals that Avodart actually increases testosterone levels rather than reduce them.
This is what the Avodart official info. says (page 2):
http://us.gsk.com/products/assets/us_avodart.pdf
And it is also what this web page says:
http://www.mesomorphosis.com/steroid-profiles/avodart.htm
Makes sense. Avodart prevents the conversion of testosterone into DHT, so that leaves more of it as testosterone.
Posted by: Brian | February 29, 2008 at 11:06 AM
Wow, learn something totally inapplicable to you everyday! I thought that (until college) The reason a man had to hold his part was because, if let go while piddling it would go crazy, like the wand at a car wash. Now as if to erase any doubt, I see that some coming out in a fixed stream is a great thing. Quoting Elaine on Seinfield:"How do you guys live with those things?" Great, now I have to go whizzz, should have skipped this blog.
Posted by: Holly | March 05, 2008 at 01:40 PM
Just a comment about the sophisticated gentleman who doesn't like the word pee. My take on it is if you were born after 1960 you use the word pee. Aversion to the word clearly makes a statement of your age. Tinkle is the word my parents liked to use when I was a child--they were born in the 1940's. Anyone born after 1960 caught using the word tinkle after the age of 10 would have certainly been cast out by peers as a social misfit. Kind of like golly gee, neeto, swell, tally whacker, etc. If you really want to be proper and not disclose your age, use the word urinate, it makes you sound professional-not clinical. However, pointing the percy at the porcelain certainly will get you creativity points with the ladies and spark some interesting conversation. Since I don't have a percy, I will just have to continue my use of the word pee.
Posted by: nancy | November 04, 2008 at 07:28 AM
Does anyone including your Doctor know the difference between Avodart and Flomax with Phizer's Detrol LA and Toviz?
Posted by: Rich | April 13, 2009 at 03:36 PM
Rich, I don't know anything about those other medications. Sorry.
Posted by: Brian | April 13, 2009 at 06:17 PM
Patients who were on Avodart or Dutasteride should refrain from donating blood for 6 months since there is a possibility of the blood being transfused to a pregnant female who might be carrying a male fetus.
Posted by: プロペシア | May 01, 2009 at 03:56 AM
My experience with combined therapy:
great success with both drugs in combination for 6 months.
But, I tried dropping the Flomax a week ago and I'm ordering another refill today. For me, the Avodart hasn't fully kicked in. My doc says my prostrate is unusually large for a 52 year old, so we'll give it some more time. I'll try dropping it again in another couple of months.
For the active guy with questions ... I ran a 3:19 Boston Marathon after the combined therapy for a couple of months. It sure helped that I didn't need to wait inline at the porta-potties or find a tree along the road like so many others.
Posted by: RELB | October 05, 2009 at 12:22 PM
Brian" A little late but instead of Pee,wee-wee or tinkle. I jist suse the phrase " going to free Willy". Have not tried Avodart with Flomax but I don't like the idea of stopping flomaX BECAUSE OF ALL THE INCONVENIENCES THAT GO ALONG WITH IT, wILL ASK MY FEMALE DOCTOR IF TAKING aDVART WOULD INCREASE MY sexual activity. Excuse me Brian but I have to go free Willy.
Posted by: Herb | October 23, 2009 at 09:35 AM
hello friend excellent post about Avodart reduces my bathroom visits thanks for sharing!!
Posted by: Generic Viagra | November 30, 2009 at 07:40 AM
Interesting comments. I have just been put on Flomax and Avodart after 5 biopsies and 66 pieces of my prostate removed. I hope they work as good as everyone says. Can anyone top that many biopsies in a 5 year period ?
Posted by: william poole | December 10, 2009 at 02:49 PM
i actually quite prefer to " bleed my lizard" .. and with avodart sounds like a rather large bison pissing on a flat rock..
remember if you have an erection lasting more than 48 hours, don't call 911, call more hookers.. 77 years old and strong as ox..
Posted by: karl johnson | February 13, 2010 at 09:55 PM
I've been on avodart for about a year and it did work to reduce my trips to the bathroom. I was also taking flomax but decided to stop its use after a couple of months to cut down on the number of drugs I take. Recently noticed tender breast and some enlargement which is a known side affect. My doctor wants to run some tests to determine my testosterone. I may be facing a choice between larger breasts or smaller prostate.
Posted by: Paul Primmer | February 23, 2010 at 03:26 PM
Brian -
A useful post. Thanks. Pee...draining the lizard...whatever you want to call it, I'm OK with it as long as I can get some additional info. I've been on Flomax for about four years. It worked well initially, but I fear my next trip to the doc will indicate Avodart or surgery.
I have a couple questions about the Avodart:
1) Any change in sex drive? Any improvement in sexual function (i.e., solid erections?)
2) Tender breasts?
3) Any issue with retrograde ejaculation?
I've gone from getting through the night (initially) with one pee, now up to three times. Quite frankly, I need sleep and would really like to feel some relief from the constant need to pee.
BTW - Have you done any research on Green Laser surgery for BPH?
Thanks in advance for your help.
All the best!
Posted by: Lance | March 04, 2011 at 04:12 PM
Lance, I'm not familiar with BPH surgery. Personally, I'd be inclined to try out Avodart before getting a riskier surgical procedure.
Regarding Avodart, I haven't found any seriously negative side effects, such as the ones you mention. On the positive side, I might have gotten some hair regrowth on my bald spot, though I could be imagining this.
I've experienced the common side effect of less ejaculate volume, which I guess is the same or similar to your "retrograde ejaculation" question. See:
http://www.healthcentral.com/prostate/c/question/69576/31848
But I don't see this as a big deal, in contrast to several commenters on the above-linked post. If an orgasm feels the same, aside from what comes out fluid-wise, so what? And I'm done with having children.
I'd rather not have the BPH symptoms (needing to pee more frequently) than the ejaculate.
Posted by: Blogger Brian | March 05, 2011 at 11:12 AM
I have ALL the symptoms of BPH, but my M.D.(female) evaluated my prostate size and said it was normal?? She started me on Avodart just last week....Go figure??
Posted by: Gregorio | May 13, 2011 at 10:41 AM
I was on flomax and avodart. But stopped flomax because one is not available here. Avodart did grow hair on my bald spot but it is also giving pain in the testes. Anyone else experiencing this? I am only 42 ... not sure how the hell I got this. May be side effect of vitamins.
Posted by: Roger | June 24, 2011 at 11:17 AM
Sorry. I should have reviewed my comment before posting. I meant to say please Google the study from John Hopkins and its increased cancer risk.
Posted by: Lois | September 06, 2011 at 10:46 AM
Please Google John Hopkins study on Avodart. I stopped taking Avodart immediately after reading the study. It found Avodart increases cancer.
Posted by: Lois | September 08, 2011 at 06:18 AM
Posted by: Blogger Brian | September 08, 2011 at 11:45 AM
I recently started on flomax and I feel like a zombie.Its that groggy feeling of "just waking up" and it lasts all day.Im wondering if anyone else has experienced these symptoms.
Posted by: mark s | November 12, 2011 at 05:21 AM
mark, I felt mildly dizzy the first time I used Flomax. Since, I haven't detected any side effects. Consult your doctor, but I'd bet he/she would advise seeing how your body adjusts to Flomax over a couple of weeks or so.
There's always Avodart as an alternative. And daily Cialis has been approved by the FDA for treatment of an enlarged prostate, so, hey, you could get several bangs for your buck (so to speak). Canadian pharmacies offer generic daily Cialis, 5 mg, at a much cheaper price than the brand name.
Posted by: Blogger Brian | November 12, 2011 at 08:08 AM
The combo drug (FloMax & Avodart) is called Jalyn in the U.S. In the U.K. it is called Combodart.
Both are made by GlaxoSmithKline.
Combodart and other drugs can be bought from Canadian pharmacies. I get Combodart through JanDrugs (Canada) for a total of $65 per month, when I buy 2 months worth. It gets sent to me from London, England. It takes about two weeks to arrive.
You needn't worry about the legality of this as enforcement of any laws concerning Canadian drugs makes this a non-issue.
The drug I get is legit (non-counterfeit) and is approved by the appropriate EU agencies.
Posted by: Osvaldo | January 02, 2012 at 09:14 PM
Regarding a zombie, groggy like feeling, yes I experienced this when I first started using Flomax. It was not a very nice side affect! I had to reduce my doseage by 1/2 for a few weeks while my body adjusted to the drug, then I was ok to go back to full strength. Hope this helps
Posted by: Marty | March 11, 2012 at 02:16 PM
I buy Avodart from proscar.tictail.com. The guy that runs this store is an actual MD and is answering all the questions I ask him. The price is the lowest I have ever seen at about 40 dollars/month or lower if you buy 2 or 3 months supply. It's working great for me so if you want to save some money check it out
Posted by: Jim | February 24, 2014 at 02:46 PM
hi,
Was thinking about starting to use Avodart but the FDA comments scared me a tad.
i'm 64 and could use the help.
Have had the symptoms for over 15 years.
Are you still taking it and also what are your thoughts about what i said above.
Thanks.
John
Posted by: john | March 07, 2016 at 05:15 AM
John, I am indeed still taking Avodart, along with Tamsulosin. They are working well for me. My doctor tells me that my prostate is no longer "generous" in size, but pretty much normal. My bathroom-going frequency is much reduced.
I'm not sure which of the FDA possible side effects concern you. It's good to read about side effects, but every drug has them. And if you look for descriptions of how Avodart (or any other drug) has or hasn't helped people, usually the negative stories outweigh the positive ones -- because people are more inclined to complain about a problem than say "everything is going great."
All I can say is that Avodart and Tamsulosin have helped me. My doctor tells me that they work in different ways, so the combination can make sense for a patient. Also, you might look into low dosage daily Cialis (5 mg). It is recognized as a drug that can help with male urination frequency. And since it has a beneficial effect on another male organ, so much the better!
Posted by: Brian Hines | March 07, 2016 at 12:56 PM