 [ Symptoms ] how can i know if my prostate is enlarged [ Disease ] the symptoms of prostate enlargement really are manifest by two different factors one is the actual size as the gland gets bigger it is harder to push the urine through the other cause for symptoms for men with signs of prostate enlargement is not really the size of the gland but the fact that the gland and surrounding tissues are involved with smooth muscle it is part of the normal architecture that those muscles squeeze down so as they squeeze the urethra they block the flow as well and that is another whole category of medications called alpha blockers that relax those muscles the advantage to the alpha blockers is that they work very quickly men have remarkable improvement in their urinating symptoms almost within days and often avoid the need for any surgical intervention the problem with the alpha blockers is they might not last as long so maybe after a year or two or three the symptoms might start to come back that is where the 5 alpha reductase inhibitors come into play the avodart and the proscar and that they actually shrink the gland and sometimes the combination of the two is what has the most success for some men sl what are the side effects the avodart and the proscar have a very low incidence of side effects that are sexual the main ones are sometimes an increase in sex drive sometimes a decrease in sexual ability and for many men a decrease in volume of ejaculate because you are shrinking the glandular structure for the alpha blockers their main side effect is that they relax the smooth muscle so depending on whether you are using a new one or an old one some men can have problems with blood pressure and also retrograde ejaculation where because the bladder neck is relaxed when the man ejaculates the semen goes backwards into the bladder sl that does not sound very good it is retrograde ejaculation is generally it is painless men though become very obsessed with how things should be and when there is changes such as reduced volume they become upset with that and want to restore it