Prostate Cancer And Erectile Dysfunction
Erectile dysfunction, also called impotence, is the inability to develop or sustain an erection satisfactory for sexual intercourse.
- Surgery to remove the entire prostate gland
- Radiation therapy, whether by external beam or radioactive seed implants
- Hormone therapy
Different treatments can lead to impotence sooner than others.
When Should You Seek Medical Advice
Ideally, you should seek medical attention as soon as you notice somethings off before the symptoms get worse and start disrupting your peace.
Currently, we have no conclusive studies to show ED drugs are safe and completely effective at treating urinary symptoms of an enlarged prostate. Do not start any prescription medications without the help of a doctor. Your doctor might also be able to help you in making the right lifestyle changes and exercises needed to treat an Enlarged prostate and the resulting symptoms.
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Prostate Cancer And Ed
What is erectile dysfunction?
Erectile dysfunction or ED is the consistent inability to achieve an erection sufficient for satisfactory intercourse. Although not all people with ED identify as men, as many as 30 million Americans have ED. Most men with ED are sexually active, but they are usually having problems with how they may expect their body to respond or function during intercourse.
How does prostate cancer lead to erectile dysfunction?
Prostate cancer does not directly cause ED, but treatments for prostate cancer can cause a patient to experience this condition. In fact, ED is one of the most common side effects after any kind of prostate cancer treatment.
Treatments for prostate cancer can decrease your bodys ability to create testosterone. Low testosterone can impact your libido and ability to achieve and maintain an erection.
Other treatments, such as prostatectomy, can affect the blood vessels and nerves responsible for causing erections. If these structures in your body experience trauma, it can make it more difficult for them to work properly, causing ED.
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What Current Options Exist To Treat Erectile Dysfunction After Radical Prostatectomy
Options include pharmacologic and nonpharmacologic interventions. Pharmacotherapies include the oral PDE-5 inhibitors , intraurethral suppositories , and intracavernous injections . Non-pharmacologic therapies, which do not rely on the biochemical reactivity of the erectile tissue, include vacuum constriction devices and penile implants .
Men who have undergone nerve-sparing technique should be offered therapies that are not expected to interfere with the potential recovery of spontaneous, natural erectile function. In this light, penile prosthesis surgery would not be considered an option in this select group, at least in the initial 2 year post-operative period, until it becomes evident in some individuals that such recovery is unlikely.
Enlarged Prostate And Sex Drive
Although we cant say for certain that an enlarged prostate will cause erectile dysfunction or problems ejaculating, there is plenty of evidence that the condition can and does impact the sex lives of those who experience it. BPH can affect your sex drive , because you might feel generally stressed or anxious about your symptoms.
If you feel that your prostate is impacting your sex life, you should talk to your doctor.
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The Initial Causes Can A Prostate Biopsy Cause Erectile Dysfunction
One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.
Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.
If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.
Can You Take Erectile Dysfunction Medications If You Are Taking Prostate Problems Medications
Actually, yes. Taking medication for erectile dysfunction may also be useful in treating the symptoms of something like benign prostatic hyperplasia .
In fact, there is a medication that’s used to treat both problems with an erection as well as issues that have occurred from an enlarged prostate.
Let’s take tadalafil for example. This medication can treat both issues, and it can also treat pulmonary hypertension. This medication is more well-known as Cialis or at Adcirca.
It might also be beneficial to know that some men who have an enlarged prostate and erectile dysfunction often experience alleviation of their symptoms after erectile dysfunction medications.
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Psychological Effects Of Cancer Treatment On Erections
Many men report disappointment, fear, and distress when they have trouble with erections. They report they feel that something important is missing. Men may report a general unhappiness with life and depression when they have problems with erections. These feelings are a natural part of coping with erection problems. And most men, if they are able find effective treatments to help with their erections, will start to feel better. If these feelings are severe or persist, most men find it very helpful to see a mental health professional who specializes in sexual issues or a psychiatrist who can help address these feelings.
Worries about self-image and performance can sometimes lead to erection problems, too. Instead of letting go and feeling excited, a man may focus on whether he will be able to function, and fear of failure might make it happen. He may blame the resulting problem on his medical condition, even though he might be able to have an erection if he were able to relax.
A therapist or mental health professional who specializes in helping patients with sexual issues can often assist in the treatment of erection problems caused by anxiety and stress. Any treatment for an erection problem should be based on the results of a thorough exam, which should include both medical questions and certain medical tests.
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.
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Does And How Are Erectile Dysfunction And Prostate Problems Connected
There is a clear link between erectile dysfunction and prostate problems. In fact, many experts believe that erectile dysfunction is one of the earliest signs of prostate trouble.
It’s a common complication of various prostate diseases, including prostate cancer, benign prostatic hyperplasia , and prostatitis. Urinary tract issues are also often caused due to an enlarged prostate.
In fact, up to 50% of men that have prostate cancer treatment like brachytherapy experience erectile dysfunction long-term.
The prostate is a small gland located just below the bladder. It’s about the size of a walnut and plays a role in both sexual health and urination. When the prostate becomes enlarged, it can put pressure on the urethra.
It can also interfere with both urinary and sexual function. This pressure can cause problems such as difficulty starting or stopping urination, a weak urine stream, dribbling or leaking after urination, and most commonly, erectile dysfunction.
In fact, at least 50% of men that are 50 or older often show symptoms of BPH. The chances of showing symptoms increases by 10% every ten years as a person ages.
Additionally, urinary tract issues that are often caused by frequent urination and other problems caused by an enlarged prostate show the possibility of association with erectile dysfunction. Stress is also shown to cause an overactive bladder and be a contributor to ED.
Erectile Dysfunction Following Radical Prostatectomy
Assuming the management of erectile dysfunction requires expert diagnosis and treatment.
Diagnosis includes sexual function history, general medical history, psychosocial history, medication history, physical examination, and appropriate laboratory testing.
Psychological treatment is an important adjunct to managing erectile dysfunction. If our diagnosis suggests a psychological association with your erectile dysfunction, we may recommend that you pursue counseling with a qualified psychologist available through the Clinic.For instance, there may be relationship problems that negatively affect sexual functioning with your partner. Referrals can be made to the Johns Hopkins’ noted Sexual Behaviors Consultation Unit.
Erectile dysfunction following radical prostatectomy for clinically localized prostate cancer is a known potential complication of the surgery. With the advent of the nerve-sparing radical prostatectomy technique, many men can expect to recover erectile function in the current era.
However, despite expert application of the nerve-sparing prostatectomy technique, early recovery of natural erectile function is not common. Increasing attention has been given to this problem in recent years with the advancement of possible new therapeutic options to enhance erection function recovery following this surgery. Visit Dr. Burnett’s Neuro-Urology Laboratory
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What Kinds Of Prostate Problems Can Cause Erectile Dysfunction
Erectile dysfunction and prostate enlargement issues are two completely different problems. They usually will come with different symptoms, as well as different causes, and at one point, different treatments. When men reach middle age, the prostate will often start to enlarge.
Any form of enlargement can cause a range of difficulties with urination. The prostate itself causes issues, not for sex, but urination in particular. A few common prostate issues could cause erectile dysfunction.
Treatments that are meant to treat benign prostatic hyperplasia can cause ejaculatory or erectile dysfunction issues. BPH is a non-cancerous enlargement of the prostate
Some of these treatments that could present these causes could be:
- Anti testosterone drugs
- Transurethral resection of the prostate
5 Alpha reductase inhibitors show a potential for risk association that could impact erectile physiology. These inhibitors provide a drop in median serum dihydrotestosterone levels between 60% and 93% within at least two years.
While it’s possible that alpha-blockers could contribute to ED, they often don’t cause issues with erections. Some men often see improvement in their condition after taking the medication. Anti testosterone drugs could cause lower amounts of testosterone.
Are There Any Surgical Techniques That Have Been Developed To Improve Erectile Function Outcomes
At this time, there are several different surgical approaches to carry out the surgery, including retropubic or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation. Much debate but no consensus exists about the advantages and disadvantages of the different approaches. Further study is needed before obtaining meaningful determinations of the success with different new approaches.
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Radiation Given For Prostate Cancer
Some men will have issues with erections within a few years of external beam radiation for prostate cancer. Some of these men may have erections that allow penetration, but only a small portion report their erections are as good as they were before treatment.
Some men with early-stage prostate cancer have a choice between radiation and surgery to treat their cancer. When looking at how mens erections are affected by prostate cancer treatment, there does not seem to be much long-term difference between the two. Men who have had radiation may see a general decrease in the firmness of their erections over time . In contrast, after surgery most men have erection problems right away and then have a chance to recover erections in the first 2 years following the surgery. About 4 years after either treatment, the percentage of men reporting ED is about the same. Treatments can often help these men get their erections back whether theyve had surgery or radiation.
Urinary Symptoms Linked To Sexual Dysfunction
In this study, published in the current issue of Mayo Clinic Proceedings, researchers studied 2,115 men between the ages of 40 and 79. The men completed questionnaires about their sexual function and urinary tract symptoms every two years.
Researchers found that each of the indicators of sexual function was inversely related to the severity of urinary tract symptoms reported by the men. As the mens urinary symptoms increased, their level of sexual function decreased.
After adjusting for age, urinary tract symptoms resulting from an enlarged prostate that were most strongly associated with sexual dysfunction were:
- A feeling of urgency
- Needing to get up multiple times at night to urinate
- A weak urine stream
These symptoms were associated with:
- Difficulty getting or maintaining an erection
- Sexual satisfaction problems
However, the association with mens urinary tract symptoms and sexual dysfunction diminished with advancing age. No association between these symptoms and most sexual problems were found in men over age 70.
Researchers say that because both of these conditions are common in aging man, it may be very difficult to see if a true association exists outside of an age-related one.
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What Causes Prostate Enlargement
Multiple factors cause prostate enlargement. Documented causes include specific medications, some of which are commonly used for prostate problems, as well dietary issues, disease processes, and hormonal imbalances.
Nutritional and dietary issues are known to be common causes of BPH. A diet heavily laden with animal fat is one of the most significant causes. Foods known to have high levels of animal fat include red meat and dairy products.
Aside from BPH, a diet high in animal fats is also known for causing cardiac problems and diabetes. Increasing epidemiological evidence suggests that these foods significantly increase the risk of developing BPH.
How Soon After Prostate Cancer Treatment Can I Be Sexually Active Again
This will depend on what type of treatment you have had and how you feel. It could be several weeks, for others it may be a lot longer for erections to return. Some men will never be able to keep an erection without the help of artificial methods like medicines or medical devices . If you were having problems having erections before treatment, this will not get better after treatment.
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How Can A Swollen Prostate Cause Erectile Dysfunction
If you know anything about prostatic diseases, then you may be aware of how strongly they can affect the quality of life.
A condition like benign prostatic hyperplasia may cause lower urinary tract symptoms .
Urinary tract infections , bladder damage, blood in the urine, as well as urinary retention are often complications that result from BPH.
In understanding how BPH may lead to ED, letâs get familiar with a little something called the alpha 1-adrenergic receptor.
In BPH, there is an imbalance in the autonomic control of smooth muscles, their contraction and relaxation.
This leads to increased smooth muscle tone in the prostate. Increased smooth muscle tone is caused by the a1-adrenergic receptor.
When this receptor is activated by noradrenaline , the penile tissues are contracted.
Erectile dysfunction favors the contraction of smooth muscles which encourages detumescence, and complicates the relaxation of these muscles, which is responsible for erections.
It is believed that 70 percent of men with BPH have an associated erectile dysfunction.
With prostatitis, erectile dysfunction may be induced by the pain caused from the condition.
If you suffer from chronic bacterial prostatitis for example, it isnt uncommon to experience pain in the genital area and groin.
This pain can last for three months and above.
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Enlarged Prostate And Erectile Dysfunction: How Are They Related
An enlarged prostate is common and often happens as men age. While it may cause troublesome symptoms and require treatment, an enlarged prostate is not always harmful. In fact, it often goes unnoticed. However, your physician should always check and manage this condition if you have it.
Erectile dysfunction ¹ is a different condition. Its sex-related and involves difficulty gaining and maintaining an erection. Experts have found that ED may be related to prostate enlargement.²
The relationship between an enlarged prostate and ED is quite complex. The conditions can occur together with some links between them, possibly due to the similar risk factors contributing to each condition. Risk factors include obesity and high blood pressure.Researchers believe prostate enlargement and its treatments contribute to ED.
Medications designed for improving ED³ can improve symptoms of prostate enlargement.
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