What is really the safest way to reduce prostate enlargement?

Medication.: The only sure way to reduce the size of the prostate without surgery is to use a medication called a 5-alpha-reductase inhibitor. Examples are Finasteride and dutasteride. Most over-the-counter and herbal remedies have not been validated as effective treatments. Even with an enlarged prostate, you may not need any treatment unless you become bothered by symptoms. Seek a urologist for guidance.