BPH

Enlarged Prostate and Sex : What Does It Mean For My Sex Life?

Having an enlarged prostate can complicate your sex life in many ways. And instead of curing them, the conventional methods of treating prostate disease like surgery and drugs make your sexual problems worse.

BPH is a condition when your prostate becomes enlarged. As a result, it blocks the flow of urine through the urethra. This is the tube that carries urine from the bladder out through your penis.

An enlarged prostate can cause problems with urination. Symptoms of BPH include difficulty starting to urinate, slow flow, dribbling, the inability to urinate, and frequent urination are all common problems.

If left untreated, an enlarged prostate can result in further complications, such as urinary retention,  urinary tract infections, bladder, and kidney damage.

ED, on the other hand, is the inability to get or maintain an erection. Failing to have an erection for a week after going through intense emotional stress, or after a night of heaving drinking, is not erectile dysfunction.

A quick point to note: ED does not cause BPH. But…BPH can cause ED depending on how you treat it.

For more information on BPH (Benign Prostatic Hyperplasia) click here.

What are the available treatments for BPH?

As men get older, their prostates tend to become enlarged. This is usually from a lifetime of bad habits. However, prostate enlargement does not equate to prostate cancer. Having an enlarged prostate does not inevitably mean you will get cancer.

Once diagnosed, doctors usually recommend medication. It is essential you know that some of the drugs used to treat BPH have side-effects. Some of these include Erectile Dysfunction and a diminished sex drive.

Men who take alpha-blockers (Tamsulosin, Flomax, ) and alpha reductase (Finasteride, Dutasteride) are prone to develop erectile dysfunction.

Studies show that approximately 3% of men who took Dutasteride and 6.4% of men who took Finasteride experienced a loss of libido.

The active component of the prostate plays a crucial role in generating libido and sustaining erectile rigidity. Therefore, it is not uncommon for men to experience flagging sexual desire and compromised erectile after initiation of treatment.

Recent scientific research has pointed out that medicine such as blue pills (PDE5-I) will also have a relaxing effect on the prostate.

30% of men facing BPH will encounter compromised sexual function. One-third of men suffering ED have troubling symptoms related to the prostate.

5 side effects of an enlarged prostate on your sex life

1) Retrograde Ejaculation    

BPH can cause bladder problems, and some men who experience these symptoms undergo a surgery called transurethral resection of the prostate (TURP). While this procedure treats bladder problems, it has one major sexual side effect: retrograde ejaculation.

This adverse effect is also called dry orgasm, in which the semen released during orgasm enters the bladder rather than exit the penis.

A 2011 newsletter published in Harvard Men’s Health Watch claims that as many as 50 to 75% of men who receive TURP experience this side effect.

How long this problem lasts depends on the cause. Note that if your retrograde ejaculation is caused by severe nerve or muscle damage from TURP, the condition may be permanent.

2) Decreased Libido

Diminished libido is a potential side effect of BPH medicines called 5-alpha reductase inhibitors (5-ARIs).

These drugs are supposed to decrease the prostate size by reducing the levels of active forms of testosterone in the blood. But doing so also lowers one’s sex drive.

A 2014 study explored the dark side of 5-ARIs on sexual health. It found that 5-ARIs have certain isoforms that are widely spread in the central nervous system and inhibits enzymes that are needed to make several key hormones and neuroactive steroids to maintain healthy libido.

Experts claim that about 3% of men who take Dutasteride experienced a drop in libido. And those who take Finasteride Proscar experience a 6.4% drop in sex drive. A diminished libido can affect the quality of your relationships, so keep this in mind.

3) Reduced Sexual Satisfaction

Treatments for a prostate enlargement have many potential side effects that can reduce your overall satisfaction with your sex life. In most cases, enlarged or inflamed prostate causes painful ejaculation that diminishes the pleasure you get from sex.

According to one review, the more severe your urinary problems are with BPH, the more likely you’ll be dissatisfied with sex. Another study claims that lower urinary tract symptoms spoil the sex lives of men in as much as 46% of men with an enlarged prostate.

These studies stress that reduced sexual satisfaction is a big concern to men with prostate problems, and should be taken into account when managing their conditions.

4) Erectile Dysfunction

If you have an enlarged prostate, chances are you’re prescribed with 5-ARIs like Avodart or Proscar to treat the disease.

These drugs have a major side effect: they cause erection problems. And the FDA has already put warning labels on them about their sexual side effects.

A recent study published in PeerJ explored this link. The research team looked at data on more than 12,000 men who had been prescribed one of the drugs at least once from 1992 to 2013.

The results show that about 1.4% who took these 5-ARIs developed erection problems. And for some of them, the adverse effect lasted for about three and a half years after they stopped taking the drug.

5) Low Sperm Count

Men who take prostate drugs also experience lower sperm count, decreased sperm volume, and lower sperm movement.

One randomized double-blind placebo-controlled study looked at the effects of 5-ARIs on semen.

After 26 weeks of treatment, the study found that men taking these drugs had a 34.3% reduction in sperm count, a 21.1% decrease in semen volume, and a 21.5% decrease in sperm concentration.

After 52 weeks of treatment and 24 weeks of follow-up, the reduction of all the three semen parameters was no longer significant.

Regardless, the research team recommended that 5-ARIs should be evaluated further as potential causes of infertility in men.

For more information on prostate supplements click here.

A Chicken and Egg Situation

Sadly, this is a “chicken and egg” situation. For men facing lower urinary tract symptoms of frequency, urgency, slow flow, and dribbling, the first line treatment are alpha-blockers. They are known to relax the prostate to ease urine flow.

If medications do not work, doctors will usually then promote surgical procedures to cut, slice, or remove the prostate altogether.

This is known as radical prostatectomy. Transurethral resection of the prostate (or prostate TURP) is a surgical procedure that is known to relieve symptoms of BPH(Benign Prostatic Hyperplasia).

Men who have this procedure often experience sexual side-effects after surgery. According to the Harvard Medical School, between 50 to 75% of men who underwent TURP experienced retrograde and dry ejaculation.

Most men will experience relief of urinary problems. Some even experience improved in blood pressure.

One of the complaints encountered by sufferers is retrograde ejaculation. This is caused by the easing of the prostatic sphincter, resulting in the semen going backward.

The operation to correct the BPH can either be carried out with TURP or laser done by simply coring out a cavity to allow better flow of urine with minimal resistance.

The adverse effect of retrograde ejaculation is both undeniable and unavoidable. But the degree of compromise on erectile rigidity is still unclear and hotly debated.

It is rarely possible to achieve maximum efficacy of treatment without compromised libido, erectile function, or backward shoot of the semen.


For more information on prostate surgery click here.


Conclusion

An enlarged prostate, along with its treatment, results in many side effects that can affect your sex life. Because drugs are harmful, you may want to look for a natural solution to support your prostate health and improve your urination problems.  

An enlarged prostate can be treated naturally with the right diet, exercise, and supplements that maintain a healthy prostate.

Natural prostate supplements come from plants and food sources, so they don’t produce the negative side effects that prostate drugs cause.

Sources

  1. Kiguradze T, Temps WH, Yarnold PR, et al. Persistent erectile dysfunction in men exposed to the 5α-reductase inhibitors, finasteride, or dutasteride. PeerJ. 2017;5:e3020. Published 2017 Mar 9. doi:10.7717/peerj.3020
  2. Bruskewitz RC. Quality of life and sexual function in patients with benign prostatic hyperplasia. Rev Urol. 2003;5(2):72–80.
  3. https://www.health.harvard.edu/blog/sex-and-the-prostate-overcoming-erectile-dysfunction-when-you-have-prostate-disease-20090331100
  4. Traish AM, Mulgaonkar A, Giordano N. The dark side of 5α-reductase inhibitors’ therapy: sexual dysfunction, high Gleason grade prostate cancer and depression. Korean J Urol. 2014;55(6):367–379. doi:10.4111/kju.2014.55.6.367
  5. Frankel SJ1, Donovan JL, Peters TI, Abrams P, Dabhoiwala NF, Osawa D, Lin AT.. (8). Sexual dysfunction in men with lower urinary tract symptoms.. Journal of Clinical Epidemology. 51 (1998), p:677-685.
  6. Kiguradze et al. (2017), Persistent erectile dysfunction in men exposed to the 5a-reductase inhibitors, finasteride,
    or dutasteride. PeerJ 5:e3020; DOI 10.7717/peerj.3020
  7. Amory JK1, Wang C, Swerdloff RS, Anawalt BD, Matsumoto AM, Bremner WJ, Walker SE, Haberer LJ, Clark RV.. (2007). The effect of 5alpha-reductase inhibition with dutasteride and finasteride on semen parameters and serum hormones in healthy men.. The Journal of Clinical Endocrinology & Metabolism. 92 (5), p1659–1665.

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