For how we live.
The bestselling herbal for an enlarged prostate flopped in the trials: even at triple the usual dose it beat placebo by nothing. The hair-loss claim rests on a handful of small, weak studies rather than proof.
Nocturia is usually blamed on the prostate, but the commonest driver is the kidneys making too much urine overnight. In one trial, low-dose desmopressin trimmed nightly voids and bought about 40 extra minutes of sleep.
For the pelvic-pain syndrome that affects many men, Cochrane reviews find alpha-blockers, antibiotics and anti-inflammatories each help only a little. Acupuncture and shockwave therapy have the firmer support.
Alpha-blockers ease symptoms within weeks; 5-alpha-reductase inhibitors shrink the gland over months. In a 3,047-man trial, combining them cut progression risk by 66%. Newer office procedures spare sexual function.
Young men are starting hair-loss drugs early and stacking them with dermarolling and oral minoxidil. Two drugs have decades of evidence; the trend's framing runs ahead of it.
Cochrane pooled 47 randomised trials in 5,290 women. The drug most often named alongside minoxidil as first-line — spironolactone — had no randomised evidence, and the review asked for some.
A network meta-analysis of 24 randomised trials ranks oral dutasteride first on 24-week hair density. The adverse-effect literature behind these drugs is separately, and seriously, contested.