Prostate Drugs: Flomax & Saw Palmetto Compared

Before we compare the action of Flomax and Saw Palmetto, let’s just look at the drugs commonly used for the treatment of urinary problems due to prostate enlargement. These are frequent urination, feelings of urgency, incomplete voiding (emptying of the bladder), night time urination – many times a night. Saw Palmetto is a natural supplement and Flomax is a drug prescribed by doctors.

Conventional Drugs Used For Prostate Health Treatment

I recommend trying natural prostate supplements, but so that you are fully informed about the drug options available from the medical profession, here’s a list of the usual drugs prescribed to men with BPH (Benign Prostatic Hyperplasia). Unfortunately many of these drugs reduce the force of your ejaculation and therefore also reduce the feeling of pleasure which a man gets during sexual release.


This drug shrinks an enlarged prostate in cases of BPH. It lowers the amount of dihydrotestosterone in prostate tissue, which slows its growth. This reduces urinary blockage and improves flow.

Cardura XL

This drug is also used to treat BPH. It is a category of drug called an alpha blocker and it relaxes smooth muscles in the bladder neck and prostate. This leads to a reduction in symptoms of BPH, including the need to urinate frequently or having to go urgently, a weak urine stream, difficulty in beginning to urinate, and the need to urinate in the night.


This prostate drug again treats BPH. The active ingredient, Tamsulosin, is another alpha-blocker that relaxes muscles in the bladder neck and prostate. This helps to reduce the sense of needing to urinate frequently or urgently, weak urine stream, and mild or moderate difficulty in beginning the flow of urine, as well as reducing any need to urinate during the night.


This contains Finasteride, which helps to shrink an enlarged prostate in cases of benign prostatic hyperplasia. It may be used alone or taken with other drugs to reduce symptoms of BPH.


This drug is yet another used in cases of enlarged prostate. The active ingredient, Silodosin, is an alpha-blocker that relaxes muscles in the bladder neck and prostate. While it does not shrink the prostate, it can reduce the need to urinate frequently or urgently, improve a weak stream, and aid beginning the flow of urine, while reducing the need to urinate frequently at night. Silodosin does not shrink the prostate.

Saw Palmetto and Flomax Compared

Flomax is a drug that is often prescribed to help men who are having difficulty urinating because of an enlarged prostate (technically known as benign prostatic hyperplasia or BPH). The active compound in the drug is known as tamsulosin. It’s actually a very useful drug, as I’ve experienced myself, and as one man emailed me:

“I’ve been developing benign prostatic hyperplasia for two or three years now, and it hasn’t really been much of a problem until the last few weeks. What I find is that the difficulty I have urinating is very variable. Sometimes it’s actually quite easy to urinate, at other times, particularly when I am feeling slightly anxious, I have very little or no flow at all. What I discovered is that tamsulosin will really relax things so that I can pee without difficulty.”

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This effective natural supplement for prostate health acts to reduce benign enlargement of the prostate. In tests it worked for 95% of men, who showed improvements in urinary function after only 6 weeks: these improvements continued for up to a year as the prostate continued to shrink.

The benefits of tamsulosin are an experience common to many men, and I’ve been asked a few times how tamsulosin actually works and whether there are side-effects. As a man ages, it’s quite common for his prostate to enlarge, and the consequence of this is that muscle cells inside the prostate and around the neck of the bladder tighten up. And the flow of urine through the neck of the bladder and prostate gland becomes much slower.

It’s a combination of enlargement and muscle tightening that is compressing your urethra and causing difficulty with urination. Now of course muscles don’t act independently of the nervous system: the nerve cells that supply these muscles are called the alpha adrenergic nerves, and they cause the muscle cells to tighten by releasing adrenaline.

Tamsulosin intervenes so that adrenaline has no impact, or rather less impact, on the muscle cells, thereby causing them to relax, allowing more urine to flow.

Tamsulosin is rather specific to the prostate and bladder; other variations of alpha adrenergic blockers include minipres, terazosin, and alfuzosin, which are prescribed for conditions like high blood pressure or heart problems. Tamsulosin has less effect on alpha adrenergic nerves elsewhere in the body, and therefore has fewer side effects including minimal impact on blood pressure.

Tamulosin is more effective when it is taken on an empty stomach, because more of medication is absorbed, however this could potentially cause a slight drop in blood pressure. It’s also important to note that it interacts with erythromycin, ketoconazole, paroxetine, cimetidine and retonavir.

It’s also important to know that Levitra, Viagra, and Cialis enhance the capacity of tamsulosin to lower blood pressure; together, these drugs may cause severe blood pressure loss. Presumably you’ll be taking this medication only under medical supervision, and you should therefore be informed by your healthcare practitioner of the side-effects.

Tamsulosin is certainly a very worthwhile and important medication for the control of urinary difficulties in men due to prostate enlargement. Even so, there have been reports of other side-effects, some of them serious: and while that’s inevitable with any medication, it may well be preferable for you to take a natural prostate health supplement that has the same effects. This is your decision.

Certainly you can experiment; to avoid prostate surgery, which has a massive impact on ejaculation and possibly on urinary incontinence, you may well feel that any drug is a good drug. But since all decisions about whether to take medication are a balancing act between the risk and reward, and prostate drugs are no exception to this general rule, please ensure you are well-informed. Get information on the side effects here.

So I suppose the question is whether or not you believe that the risks of tamsulosin are worth the rewards, or whether you will be better off using an alternative such as saw palmetto.

One of the ways that you can make this decision, or at least be slightly more informed about it, is to look on the Internet for accounts of its effects from people who have actually tried it.

Some studies have suggested that saw palmetto is ineffective, but as one of the commentators on the link above observes, meta-analysis is only as good as the research that it’s based on. It’s certainly true that European doctors have prescribed saw palmetto for many years. There are some interesting reviews on, stating that saw palmetto tablets can be a very effective way to cure urinary retention.

Out of 34 reviews for one particular saw palmetto product, 19 men gave it five stars, and 6 men gave it four stars, the average being 4.5 stars. Comments included:

  • Saw palmetto saved me from the discomfort the urologist wanted to put me through … for two decades.
  • This works extremely well, and almost immediately.
  • I have had many problems with my urinary system because of my enlarged prostate… I had to urinate every half an hour… thanks to these magic pills I’m back to my usual lifestyle.
  • I do not have to get a to use the bathroom as often at night.

And so it goes on: one reviewer actually makes the observation that even when he was prescribed flomax he still had to get up to go to the bathroom at night. When he took two or three saw palmetto pills, he started sleeping through the night. One reviewer made the observation that through trial and error he had found tablets containing 160 mg of saw palmetto extract per capsule seemed to be the most effective dose for him, and taking three capsules a day resulted in his urinary flow increasing substantially.

Now, of course all this is anecdotal, but it does mean something; when a body of evidence comes together in sufficient weight, with sufficient reviews, there is actually some substance to it. As always, the variability of the human body means that the only way to really find out is to try taking these tablets for yourself and seeing what happens.

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