Can Testosterone Replacement Therapy Cause Enlarged Prostate
Testosterone replacement therapy is a common treatment for men with low T. Many people wonder if theres a connection between testosterone and an enlarged prostate. This is a common misconception. However, many researchers have concluded theres little to no evidence that men using testosterone have higher risks for an enlarged prostate. If you think you have a testosterone deficiency, its important to discuss the particulars of your case with one of our treatment providers, including any potential risks. However, research suggests an enlarged prostate isnt a major concern for those who start a testosterone therapy regimen.
Testosterone replacement therapy can help improve symptoms of low T. Research suggests it doesnt increase the risk for enlarged prostate.
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.
Diagnosis Of Enlarged Prostate Gland And Urinary Problems
If you are troubled by urination problems, see a doctor no matter what your age. If your doctor agrees that your symptoms need further evaluation and treatment, you may need to undergo a few tests.These may include:
- general examination medical history and review of any health conditions including obesity, diabetes, obstructive sleep apnoea, depression and erectile dysfunction. A rectal examination may be done to check the size and shape of your prostate gland
- a urine check to ensure the prostate is not infected
- a flow-rate check to estimate the speed with which you pass urine
- an ultrasound examination to assess if the bladder is emptying completely and to examine your kidneys
- urodynamics a series of tests on the bladder to see how your urinary system is functioning may be recommended in some circumstances.
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Can Anything Be Done For Erectile Dysfunction Caused By Prostate Cancer Treatment
Yes, there are things you can try if you have erectile dysfunction after your prostate cancer treatment. You should keep in mind that the following things will affect your ability to have an erection after your prostate cancer treatment:
- How good your erections were before your treatment
- Other medical conditions you have like high blood pressure or diabetes
- Some types of medicines you may take such as medicines for high blood pressure or antidepressants
- Things you do in your life such as drinking or smoking
- Your age
- The type of prostate cancer treatment you had
It is important that you and your partner speak with your doctor or healthcare team about what you can do. Your doctor or healthcare team will speak with you about what might work best for you if you have erectile dysfunction. It is important that you speak with them since some treatments for erectile dysfunction can affect other medical problems you may have.
Types of treatment for erectile dysfunction include:
What Have I Learned By Reading This
You learned about:
- Why prostate cancer treatment can cause erectile dysfunction
- What can be done about erectile dysfunction
- How erectile dysfunction may affect your sex life
- What your partner can expect
If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control. It will also help you manage any side effects you may have from your treatment.
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Are There Things I Can Do To Help Myself If I Have Erectile Dysfunction
Yes, there are changes you can make in your life that may help with your erectile dysfunction. Remember to speak with your doctor or healthcare team before making any of these changes.
Some changes you may want to consider are:
- Try to exercise on a regular basis.
- Try to eat a healthy diet.
- Drink responsibly. Long-term, heavy drinking lowers your ability to have an erection.
- Try to lower your stress and fatigue . Being diagnosed with prostate cancer and working in all the changes it brings to your life can be stressful. Stress and the tiredness caused by your prostate cancer treatment, can make it difficult for you to get in the mood. Many men going through prostate cancer treatment feel this way. Talking with your partner might help lower your stress. You may also speak to your doctor or healthcare team about how you are feeling. They are there to help you through this time.
- Stop smoking. Research studies show that smoking can harm your ability to have sex. If you need help to stop smoking, speak with your doctor or healthcare team.
- Practice your Kegel exercises. Kegel exercises help strengthen your pelvic floor muscles, which support your bladder and bowel. These muscles also help with erections. For more information, please see the IMPACT booklet, Kegel Exercises for Men.
Why Erectile Dysfunction May Result From Prostate Disease
In the past, it was thought that most cases of erectile dysfunction were psychological in origin, the result of such demons as performance anxiety or more generalized stress. While these factors can cause erectile dysfunction, doctors now think that 70% of the time the problem can be traced to a physical condition that restricts blood flow, hampers nerve functioning, or both. Such conditions include diabetes, kidney disease, multiple sclerosis, atherosclerosis, vascular disease, and alcoholism.
However, some types of prostate disease and treatments may also be responsible.
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What Foods Can Cause Interstitial Cystitis
No research consistently links certain foods or drinks to interstitial cystitis , although many people find that certain foods and drinks can make their IC symptoms worse, such as alcohol, caffeine, and high-acid foods.
Interstitial cystitis is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain.
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.
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Presence Of Nitrergic Innervation In The Prostate And Cavernous Bodies
Some authors demonstrated there is intense nitrergic innervation in the prostate glandular epithelium, fibromuscular stroma and blood vessels of normal gland this innervation is diminished in BPH. On the other hand, the importance of nitric oxide in maintaining erectile function is well known .
Lee and colleagues studied a population of 372 men from Taiwan and found that polymorphism of eNOS gene G894T is more frequent in males presenting ED and LUTS/BPH . Such polymorphism was described in exon 7 of the eNOS gene, which encodes the enzymes that produces endothelial nitric oxide. This polymorphism causes a change in the amino acid sequence, resulting in altered activity of the enzyme and reduced production of nitric oxide . This finding shows that there may even be a genetic origin for the association between ED and BPH/LUTS.
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Providing Your Medical History
At first, the doctor will probably ask you about your medical history. Do you have any chronic illnesses? What illnesses and operations have you had in the past? What medications are you taking, if any? Your doctor is also likely to ask about your psychological well-being and lifestyle: Do you suffer from depression? Are you under a lot of stress? Do you drink alcohol? Smoke? Use illegal drugs? Have you felt a loss of affection for your partner? Have you recently grown interested in a new partner?
As part of this health history, be prepared to tell your doctor specific details about the symptoms that brought you to the office and when they began. Your doctor might want to know how often you had sex before the problem started and if there have been weeks or months in the past when youve had erectile dysfunction. Your doctor may conduct a written or verbal screening test.
If the cause is clear a recent operation for prostate cancer, for example the conversation may move directly to your treatment options. Otherwise, you may need to answer more questions to help the doctor narrow down the possible causes and avoid unnecessary testing.
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Can A Reversal Of The Vasectomy Be Performed
Although a vasectomy should be considered a permanent surgical procedure, there is a surgical procedure that can reverse a vasectomy. It is called a “Vasovasostomy.” A vasovasostomy involves surgical reconnection of the vas deferens to re-establish the flow of sperm. Patients are cautioned that fertility is not guaranteed.
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!
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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.
What Causes Benign Prostatic Hyperplasia
Its a little hard to say for sure what causes BPH.
What we do know for a fact is that men go through two main stages of prostate growth in their lives first at puberty, where the prostate doubles in size, and then growth begins around the age of 25 and continues during most of a mans life.
BPH is known to surface in this second stage, and mostly affects men above the age of forty. Autopsy data has found evidence of the condition in about 90 percent of men above the age of eighty.
The growth of the prostate in this second stage may be linked to androgens in the body. Men produce testosterone throughout their lives. They also produce estrogen the female hormone but only in small amounts.
When testosterone levels drop as they inevitably do with age a higher proportion of estrogen may remain.
This increase in the ratio of Estrogen or its receptors to testosterone may directly and indirectly affect the growth of prostate cells.
Another possible cause is DHT or dihydrotestosterone. This male hormone is a bit of a villain. It is a major cause of alopecia in men, but is however useful for the development and maintenance of the prostate.
Unfortunately, this role can be dangerous for the adult prostate, as DHT can cause excessive growth.
BPH may also result when there is an imbalance between the production and death of prostate cells. When the imbalance is in favor of cell proliferation, it can lead to BPH.
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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 urologist’s office to confirm that the specimens are free from sperm.
Treatment Options For Symptomatic Bph
Symptoms related to BPH, particularly LUTS, can be managed by waiting for spontaneous improvement of symptoms, by medical therapies, or by various surgical procedures. The choice of treatment depends on the severity and annoyance of the patients symptoms, his expectations of treatment, and his acceptance of the risks of treatment.
One of the factors most frequently considered by patients contemplating a particular therapy for BPH is the effect of that therapy on sexuality. An inability to ejaculate or a significant decrease in ejaculate volume is significantly associated with deterioration in QOL. The selective 1-blockers cause few sexual side effects as a result, they are associated with a higher QOL. Physicians should inquire about sexual function as part of each patients pretreatment evaluation and, where appropriate, manage BPH and ED simultaneously.
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Do Ed Medications Work For Bph
Some research has shownthough not definitivelythat ED meds may also help BPH. It seems against logic, since ED meds tend to affect the vascular system and BPH is not a vascular problem. Despite logic, ED meds might work for BPH.
For example, tadalfil , when taken daily,has been shown to improve erectile function, ejaculatory function, and sexual satisfaction in men showing both BPH and ED.Another study found that ED and BPH symptoms share common pathophysiological pathways that can be treated by tadalafil. This is likely because tadalfil increases cGMP, which is the chemical that both enhances blood flow to the penis and relaxes the muscles in the prostate and bladder. Nevertheless, tadalfil is not an approved treatment for BPH.
However, despite the research, there is still hesitancy to start prescribing tadalfil for all men with ED and BPH. ED pills dont get to the root of the problem, instead just masking the symptoms indefinitely. This means you will be on pills the rest of your life in order to stay healthy. Moreover, medications often host a number of mild and serious side effects that arent worth the trouble, including blood pressure and heart concerns.
You want to get to the root of the problem of your BPH and erectile dysfunction. As we know, the causes of erectile dysfunction are also the shared causes of BPH. In this way, fixing the root cause can solve both problems in the long-term.
Why Can Prostate Issues Cause Erectile Dysfunction
Prostate concerns commonly occur in men as they age, and the first symptoms may be difficulty urinating, or more frequent trips to the bathroom in the middle of the night.
But, is there a correlation between prostate problems and developing erectile dysfunction?
Both of these conditions increase in frequency as men get older, so it is difficult to know if one is definitely correlated with the other, but there may be a few things going on when you have prostate problems that can lead to issues in the bedroom as well.
Below, we will cover just how issues with the prostate gland including benign prostatic hyperplasia , and prostate cancer may have impacts on erectile function.
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