Which medication is used to decrease the size of the prostate in elderly patients with BPH?

In the context of benign prostatic hyperplasia (BPH), the medication finasteride, marketed as Proscar, is specifically used to decrease the size of the prostate. It is classified as a 5-alpha-reductase inhibitor, which works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), a hormone that contributes to prostate growth. By reducing DHT levels, finasteride leads to a decrease in prostate size over time, which can alleviate symptoms associated with BPH, such as urinary retention and difficulty urinating.

This mechanism sets finasteride apart from other medications used for BPH treatment. For instance, while tamsulosin and terazosin are alpha-1 adrenergic antagonists that help relieve urinary symptoms by relaxing the muscles around the bladder and prostate, they do not actually decrease the size of the prostate. Similarly, dutasteride, although also a 5-alpha-reductase inhibitor like finasteride, is not the most recognized first-line treatment for reducing prostate size specifically in elderly patients, although it can still be considered in certain cases.

The choice of finasteride as the correct answer highlights its unique role in addressing the growth of the prostate in patients with BPH,