Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate , a male reproductive gland that rests at the base of the bladder and surrounds the urethra (a tube that carries urine from the bladder to the outside of the body). The condition is very common in older men. An enlarged prostate can cause a variety of urinary symptoms including frequent urination (particularly at night), a weak urine stream, and an urgent need to urinate. Previous studies have found that the use of NSAIDs, or nonsteroidal anti-inflammatory drugs (such as aspirin, ibuprofen, and naproxen), may be associated with a decreased risk of prostate cancer . However, the relationship between NSAIDs and BPH remains unclear.

Now, in a study to be published in the American Journal of Epidemiology , researchers report that men who used NSAIDs every day had a substantially lower risk of developing an enlarged prostate or developing moderate to severe urinary symptoms than men who were not regular NSAID users.

About the Study

The researchers studied data from 2,447 Caucasian men, ages 40-79 years, enrolled in a urinary health study. At the beginning of the study, and then every two years, the subjects reported on the presence and severity of lower urinary tract symptoms and researchers measured their peak urinary flow rates. They also recorded the names and dosage of all medications taken on a daily basis. A subset of 634 men underwent additional testing including the measurement of prostate-specific antigen (PSA) levels (a common screening test for prostate cancer), a digital rectal exam, and an ultrasound examination of the prostate. The men were followed from 1990-2002, or until BPH symptoms emerged.

After taking age and other BPH risk factors, such as diabetes and hypertension , into consideration, daily NSAID users had a 36% reduced risk for moderate or severe urinary symptoms, a 54% reduced risk for the onset of low urine flow rates, a 54% reduced risk for increased prostate volume, and a 52% reduced risk for elevated PSA levels compared to non-daily NSAID users. Results were similar for men taking aspirin or non-aspirin NSAIDs.

One major weakness of this study was its observational design, which can only be used to investigate an association between NSAIDs and BPH. A clinical trial, on the other hand, would more reliably establish a cause and effect relationship between the two. In addition, the study only looked at Caucasian men, so the results may not apply to men of other races and ethnicities.

How Does This Affect You?

This study found that daily NSAID users had a reduced risk of benign prostatic hyperplasia compared to men who did not take an NSAID every day. However, more studies are needed to determine whether NSAIDs are actually responsible for the decreased BPH risk and, if so, what dosage is needed to achieve this protective effect.

Many middle-aged men take a daily NSAID to help prevent heart disease or control arthritis symptoms. This study suggests that these men may enjoy an additional benefit of prostate health.

However, NSAIDs carry risks of their own including heartburn and stomach ulcers , even at low doses. Given these risks and the unanswered questions about the link between NSAIDs and BPH, it seems safest not to start taking NSAIDs for the sole purpose of prostate health, at least for now.