Increased Adrenergic Response May Cause Ed And Luts/bph
Both urinary function and erection can be affected by changes in the smooth muscle tonus caused by increased adrenergic response. Unilateral sympathectomy in rats led to homolateral increase in prostate . Transgenic rats that are spontaneously hypertensive due to greater adrenergic tonus presented urodynamic characteristics similar to those of males with LUTS . Furthermore, the rats presented a deficient erectile response to electrical stimulus of the cavernous nerve .
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Medications For Prostate Enlargement
Typical medications used to treat prostate issues are Finasteride , dutasteride , and tamsulosin . Finasteride and dutasteride are 5-alpha reductase inhibitors that reduce the amount of the 5-alpha reductase enzyme in the blood. This enzyme converts testosterone in the blood into estrogen. High levels of estrogen exacerbate prostate growth and can result in BPH.
Men with high estrogen levels also tend to develop breast enlargement . Any man who spends a lot of time at the gym has probably noticed older men with enlarged breasts due to a high estrogen level. Enlarged male breasts are an outward indicator, but BPH is most likely also present inwardly.
Tamsulosin is an alpha-blocker that works by relaxing the prostate and bladder muscles so that urine flows easier.
Each of these drugs has a profile of severe sexual side effects. Alpha-blockers can lead to difficulty ejaculating, and 5-alpha reductase inhibitors can destroy libido as well as alter the sensation of orgasm or interfere with erections. For example, in several studies, Finasteride has been shown to increase the risk for men with BPH to develop erectile dysfunction.
What To Expect After Surgery
The patient should make arrangements to have a family member drive him home following surgery. The patient may experience some discomfort within the first 24 hours. If necessary, the urologist will prescribe pain medication. The patient should avoid any heavy lifting or vigorous exercise for 24-48 hours following surgery. To protect the incision, do not bath or shower for the first 24 hours following surgery. Sexual activity with birth control protection can be resumed within one week.
After the vasectomy, it is necessary to continue to use some form of birth control until all stored sperm are cleared from your system. This usually takes at least 8-10 weeks. Two separate semen specimens should be taken to the urologists office to confirm that the specimens are free from sperm.
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What Is Bph And Its Effects
Benign Prostatic Hyperplasia happens in many men as they get older. The enlarged prostate for these men can cause problems while urinating. Some of the specific issues with urinating include:
- Constant urge to urinate
- Difficulty beginning or stopping urination
- Weak urine stream
- Feeling like your bladder is not empty
- Higher frequency of urinating
If trouble urinating were a one-time thing, it would be bad enough, but as an on-going condition, BPH can impact the quality of a mans life.
Issues with your prostate can also lead to sexual problems. Some sexual problems of men with BPH include:
- Reduced sexual satisfaction
What Is Benign Prostatic Hyperplasia
Well get to that, but first lets explore the prostate to understand how this condition may affect its effectiveness.
Your prostate is a part of your reproductive system responsible for producing the fluid that goes into your semen.
For a walnut-shaped gland, it’s a big part of your fertility and does impact your chances of having children.
The prostate surrounds the urethra at the neck of the bladder.
In cases of benign prostatic hyperplasia, the prostate becomes enlarged without being cancerous.
Because of the increase in size, the gland presses against and pinches the urethra, making it harder for urine to flow out.
In response, the bladder walls become thicker, eventually weakening the bladder and making it unable to empty the urine in it completely.
This may lead to complications like urinary tract infections, bladder damage and blood in the urine.
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How Are Enlarged Prostate And Erectile Dysfunction Related
Many men wonder if BPH can cause erectile dysfunction. The short answer? Not really. While the prostate is an important organ for male sexual function, BPH is more of a urination issue than a sexual one. The prostate goes through two major growth spurts during a mans lifetime: one during puberty and another around 50 or 60 years of age. It is estimated that more than half of men will have some form of BPH in their 50s , which is why we see so many older men complaining of LUTS.
Usually, an enlarged prostate isnt a problem unless symptoms become burdensome and treatment is needed. Thats where concerns about erectile dysfunction come in. To treat BPH, your options are medications to relax the prostate or stop it from getting bigger, and surgery. and similar medications are part of a class of drugs called alpha-blockers, which cause the blood vessels of the prostate to constrict, relaxing muscles in the prostate so urination can occur more easily. One side effect of these drugs is less blood to flow into the penis during an erection though, and that could be a problem. Another drug, , is an anti-testosterone drug that stops the prostate from growing. However, lower testosterone levels in the body may cause ED as well. Lastly, surgical procedures can also cause ED due to damage to structures around the penis, which I will go into detail below.
Does Having An Enlarged Prostate Affect Sexual Performance
It might. Some men with an enlarged prostate develop erectile dysfunction or problems with ejaculation.
The technical term for an enlarged prostate is benign prostatic hyperplasia . BPH occurs when prostate tissue increases in size. This growth moves inward, pressing on the urethra . As a result, some men with BPH have trouble urinating and need treatment.
Unfortunately, some treatments might have sexual side effects:
Medications. 5-alpha reducatase inhibitors and alpha-blockers are two types of drugs commonly prescribed for BPH. However, 5-alpha reducatase inhibitors might lower a mans sex drive or interfere with erections. Alpha blockers could lead to difficulty ejaculating.
Finasteride in particular has been associated with a greater risk for ED. In a 2015 study of 700 men with BPH, men who took finasteride gradually developed ED while a comparison group of men who took tamsulosin did not.
Minimally-invasive procedures. These approaches, which could include stents, heat treatments, or laser treatments, can sometimes lead to ED or retrograde ejaculation .
Surgery. Transurethral incision of the prostate , which involves widening the urethra, sometimes results in ED. Transurethral resection of the prostate , in which the inner portion of the prostate is removed, can lead to retrograde ejaculation.
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What Is Prostate Enlargement
Enlargement of the prostate occurs when the prostate gland cells begin to multiply and cause the prostate gland to swell. This swelling tends to compress the urethra, limiting urine flow and causing symptoms known as lower urinary tract symptoms . BPH is a condition that many men encounter with aging.
Most of the symptoms of BPH are associated with urinary function. They are:
- Frequent need to urinate
- Urinary retention inability to empty the bladder
- An intense urge to urinate, even shortly after urinating
- A weak urine stream or an interrupted urine stream
- Difficulty starting or stopping urination
While BPH itself is not a directly linked cause of sexual problems, most men that suffer from it do indeed find it affects sexual performance. Some common sexual side effects of BPH are:
- Inability to maintain an erection
Are There New Strategies In The Near Future That May Be Helpful In Improving Erection Recovery After Surgery
Recent strategies have included cavernous nerve interposition grafting and neuromodulatory therapy. The former, as a surgical innovation meant to reestablish continuity of the nerve tissue to the penis may be particularly applicable when nerve tissue has been excised during prostate removal. In the modern era of commonly early diagnosed prostate cancer, nerve-sparing technique remains indicated for the majority of surgically treated patients.
Neuromodulatory therapy, represents an exciting, rapidly developing approach to revitalize intact nerves and promote nerve growth. Therapeutic prospects include neurotrophins, neuroimmunophilin ligands, neuronal cell death inhibitors, nerve guides, tissue engineering/stem cell therapy, electrical stimulation, and even gene therapy.
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Treatment Of Erection Problems In Men With Enlarged Prostate
Effective treatment options are available for the treatment of erectile dysfunction include medications such as Viagra, Cialis, Stendra, and Levitra. Other effective treatment options include penile injections with medications such as Trimix and Caverject. A penile implant is also an effective treatment option for erectile dysfunction, in particular for men for whom oral medications, penile injections, and other treatment options do not work well.
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Enlarged Prostate Tied To Sexual Dysfunction
Urinary Tract Symptoms May Be Associated With Erectile Dysfunction
The study shows that urinary tract problems caused by an enlarged prostate, such as getting up many times during the night to urinate, may be associated with erectile dysfunction and other problems relating to sex in older men. They say these two extremely frequent conditions may share a common cause.
Researchers say lower urinary tract symptoms become more common as men age and their prostates enlarge . Meanwhile, problems with erectile dysfunction also become more prevalent in older men, affecting more than 100 million men worldwide over age 65.
But researchers say few studies have looked at whether the two issues are related or simply a by-product of age.
Correlation Between Erectile Dysfunction And Symptomatic Benign Prostatic Enlargement
The severity of ED was directly related to prostate size and men with larger prostate had ED compared to those with smaller prostate. Braun et al. noted that the prevalence of ED in men with BPE was 72% in their Cologne Male Survey involving approximately 5000 German men and this was similar to the high prevalence of 76.9% in men with BPE observed in this study. This shows that ED is common in men with BPE and further supports the need to consider ED in managing patients with symptomatic BPE. Raymond et al. in another clinic-based population study in Western countries observed that the prevalence of ED in patients with LUTS ranged from 41 to 71% with statistical significance . This finding was similar to that noted in this study with a P value of 0.001 which was statistically significant.
Ngai et al. noted a statistically significant correlation between ED and symptomatic BPE. This was similar to the observation made in this study which shows positive correlation between ED and symptomatic BPE with statistical significance . BPE may be an indicator of ED, and patients should be evaluated holistically due to the high prevalence of ED in men with symptomatic BPE and positive correlation between both pathologies .
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Enlarged Prostate Treatment And Your Sex Life
Getting older? If youre a man, the size of your prostate might become a concern.
Prostate growth is a natural part of aging. For most men, this typically walnut-sized gland starts getting bigger around age 40. About 90% of men over age 80 have an enlarged prostate.
The medical term is benign prostatic hyperplasia , and scientists arent exactly sure why it happens. The most important word is benign. The growth isnt a sign of anything wrong. Its not a tumor and its not related to prostate cancer, although it is possible to have both conditions at the same time.
Still, an enlarged prostate can create some problems due to anatomy. The urethra, which carries urine and semen out of the body, goes right through the prostate gland. And with BPH, tissue grows inward, putting pressure on the urethra, making urination difficult.
Lower urinary tract symptoms include problems with weak urine flow, an urgent need to urinate, and nocturia .
Its usually the urinary bother that makes men seek treatment. Unfortunately, treatments can have sexual side effects, like erectile dysfunction and trouble with ejaculation.
Not all men have these complications, but you should know the possibilities before you move forward. Your urologist can tell you more about your personal situation.
Lets look at the sexual side effects of BPH treatment in more detail.
How might enlarged prostate treatments affect my sex life?
Can the sexual side effects of BPH treatment be managed?
Prostate Cancer And Erectile Dysfunction
Prostate cancer may lead to erectile dysfunction in two ways, the tumor itself may invade and damage the surrounding tissues leading to erectile dysfunction, or the treatments to remove, treat, or shrink the tumor may lead to temporary or lasting erectile dysfunction.
A quickly developing case of ED may even be a sign of a developing prostate cancer, so abrupt changes in erectile function should always be brought to the attention of your doctor.
If required, surgical removal of the prostate gland due to prostate cancer may lead to the severing of arteries and nerves needed to develop an erection and may lead to ED in some patients. It is estimated that between 25% and 80% of men will regain their sexual function after a radical prostatectomy, but this will depend on the tumor location, nerve-sparing techniques used, the skill of the surgeon, and the patientâs age. It is important to note, that during the period of time that the vessels, nerves, and tissues are healing from surgery you may experience ED, but once everything has had time to recover, erectile function may improve.
Radiation therapy for prostate cancer may also lead to damage of the surrounding tissues and cause erectile dysfunction. Certain hormonal medications are sometimes utilized for the treatment of prostate cancer, such as Leuprolide, Goserelin, Flutamide, or Bicalutamide can also lead to hormonal effects that cause ED in some users.
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Treatment Of Bph Can Improve Sexual Health
Treatment for ED and BPH
Fortunately, effective treatment for enlarged prostate can help with some sexual symptoms such as problems with ejaculation, tiredness and energy levels.
Urolift, an innovative procedure for BPH and an enlarged prostate, has been shown to improve sexual symptoms and ejaculation problems in men.
For some men with mild symptoms of BPH who also have erectile dysfunction, medications such as Cialis may help with symptoms of BPH and ED.
For most men with an enlarged prostate who have difficulty obtaining and maintaining erections, erectile dysfunction needs to be treated separately from urinary symptoms caused by an enlarged prostate.
What Drugs Interact With Cialis
Do not take Cialis if you:
- take any medicines called “nitrates”.
- use recreational drugs called “poppers” like amyl nitrite and butyl nitrite.
- take any medicines called guanylate cyclase stimulators, such as riociguat.
- are allergic to Cialis or Adcirca, or any of its ingredients.
Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.
Enlarged Prostate And Erectile Dysfunction
Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate gland. The prostate gland continues to grow throughout a manâs life, so, commonly when men get into older age, they may start experiencing urinary issues due to this enlargement. The enlargement of the prostate itself is unlikely to cause ED problems, but some of the medications or therapies used to treat it may lead to erectile disruptions.
âCertain medications like alpha-blockers or 5-alpha reductase inhibitors are commonly used to treat BPH, and they may have the side effect of erectile dysfunction in users.
If you are using these medications for your BPH and developed ED after starting your treatment, you may be able to speak with your doctor about other treatment options that have less risk of ED.
If oral medications fail to help with your BPH symptoms, a doctor may perform a surgical resection of the prostate to help with your BPH. Sometimes this procedure can lead to ED in a small percentage of men.
Is Another Treatment Option Better For Preservation Of Erectile Function
The growing interest in pelvic radiation, including brachytherapy, as an alternative to surgery can be attributed in part to the supposition that surgery carries a higher risk of erectile dysfunction. Clearly, surgery is associated with an immediate, precipitous loss of erectile function that does not occur when radiation therapy is performed, although with surgery recovery is possible in many with appropriately extended follow-up. Radiation therapy, by contrast, often results in a steady decline in erectile function to a hardly trivial degree over time.
Address Your Whole Health At Low T Center
Getting quality health care is easy with our team at Low T Center. Were dedicated to making mens health care convenient, accessible, and affordable. Our providers take a holistic approach to mens health. We are here to help you identify potential causes of your symptoms. We also help find treatment solutions to help you feel your best. Make an appointment today to take the first step toward better health and get a comprehensive health assessment!