How Does Benign Prostatic Hyperplasia Affect Sexual Function
Benign prostatic hyperplasia increases by 7 times the risk of erectile dysfunction and severe urinary disorders. When BPH is treated successfully, erection is also improved. It is mainly Phosphodiesterase type 5 inhibitors that contribute significantly to the treatment of both ED and urinary problems. There is one PDE-5 inhibitor, tadalafil, that has been officially approved in the 5mg dose for the treatment of both ED and BPH.
Cause And Risk Factors
The prostate gland can enlarge as men grow older. The exact reasons for continued growth are unclear but may be related to changes in sex hormones as men age. While the exact cause of BPH or an enlarged prostate remain unclear, there are risk factors that are important to keep in mind, including aging, family history, obesity and underlying conditions that may increase the risk of BPH like diabetes and heart disease.
Symptoms Of Prostate Cancer
In its early stages, prostate cancer doesnt necessarily cause symptoms. Men with prostate cancer might experience some of the following symptoms:
- needing to pee frequently or suddenly
- finding it difficult to pee, including trouble getting started or maintaining a strong or steady flow
- feeling like you havent completely emptied your bladder after going to the toilet
- pain, burning or discomfort when peeing
- blood in pee or semen
- or pain in the lower back, upper thighs, hips or chest
- feelings of weakness or numbness in the legs or feet
- unexplained weightloss
- feeling tired, short of breath or dizzy
- a rapid heart beat
- pale skin.
Youll notice a lot of these symptoms are similar to symptoms of other conditions, including an enlarged prostate or prostatitis, which is why its important to always see your doctor if you notice any of these symptoms or changes.
Treatment For Benign Prostate Hyperplasia
Treatment for benign prostate hyperplasia can involve:
- Lifestyle changes, such as limiting a night-time consumption of liquids, avoiding caffeine and alcohol, avoiding medication such as diuretics, decongestants and antihistamines and getting more exercise, as well as dietary improvements, such as eating more fibre, avoiding artificial sweeteners and sweetened beverages.
- Medication, such as alpha-blockers or 5-alpha-reductase inhibitors.
- Interventions, such as the ® system, a non-surgical proprietary device that uses tiny implants to lift the prostate away from the urethra and thereby relieve BPH symptoms that result from pressure on the urethra.
- Surgical procedures, such as a , transurethral microwave thermotherapy , prostate laser, and Transurethral Resection of the Prostate .
- Herbal prostate treatments, such as saw palmetto extract. Saw palmetto extract is made from the fruit of the saw palmetto, which is native to the southeast and Gulf coasts of North America and may potentially assist in reducing urinary frequency and increasing urinary flow.
Treatment of prostate cancer can involve:
The Problem With Traditional Bph Treatment
The initial treatment of BPH is generally with a medication called an alpha blocker like Flomax, alfuzosin and Rapaflo. These medications help to relax smooth muscles in the prostate to take some of the pressure off the urethra. Unfortunately, these medications often have side effects including dizziness, decreased energy, and/or retrograde ejaculation. Retrograde ejaculation occurs when semen enters the bladder instead of emerging through the penis during orgasm. Although you still reach sexual climax, you might ejaculate very little or no semen. This is sometimes called a dry orgasm. Retrograde ejaculation isn’t harmful, but it can cause male infertility.1
Another class of medications is 5-reductase inhibitor, like finasteride or dutasteride. Unfortunately, these medications have a high rate of causing decreased erectile function, decreased energy, and decreased libido.
When a patient cannot or chooses not to tolerate the side effects of BPH medications, or if they are not effective, the next step is to look into a BPH treatment procedure.
Because of the large amount of blood loss associated with TURP, GreenLight laser was developed. It is very similar to a TURP, except that instead of using a cutting device, a very high-powered laser is used to literally vaporize the prostatic urethra and tissue beyond.
Does Chronic Prostatitis Affect Sexual Function
Symptoms of prostatitis include difficulty to urinate, pain in the genital area and pelvic floor, painful ejaculation, premature ejaculation, erectile dysfunction and low sexual desire. Once the inflammation is treated, sexual problems are resolved. However, in the meantime until remission of inflammation, there are erectile drugs called Phosphodiesterase type 5 inhibitors that can be used to restore quality of erection and increase perfusion of the prostate gland which is essential to treat the inflammation. In very rare cases only, erectile dysfunction may remain even though symptoms have subsided. If so,, the problem is purely psychogenic and it is highly recommended to visit a Sexologist.
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?
Yes.
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Eating Diet And Nutrition
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing prostatitis. During treatment of bacterial prostatitis, urologists may recommend increasing intake of liquids and avoiding or reducing intake of substances that irritate the bladder. Men should talk with a health care provider or dietitian about what diet is right for them.
Coping With Retrograde Ejaculation
It is important that men realize retrograde ejaculation is not a dangerous condition. The major concern lies with fertility. With this in mind, men should understand how they can cope with this condition.
Drugs used to treat retrograde ejaculation may be helpful, but men should understand the risks of these medications. The drugs should not be used if the man is taking medicine to treat high blood pressure. Some drugs used to treat retrograde ejaculation can cause blood pressure to drop suddenly. Combined with drugs that treat hypertension, the drop in blood pressure may cause dangerously low readings.
If a man wants to implement a method to fix retrograde ejaculation, they should ensure they understand all of the options that are available. The man should talk to their doctor. The doctor will be able to provide support to the patient. When the patient understands all of the options, he will be able to make a more informed choice.
Since retrograde ejaculation does not cause harm when there are no associated diseases, some men may prefer to leave it for the time being. This can be the case when fertility is not something that the man worries about. The man can still experience a climax during sexual activity he will just need to get used to dry orgasm. The term dry orgasm refers to the moment he reaches a climax, but no semen comes out of the penis.
Diagnosis Of An Enlarged Prostate
In order to establish the possible underlying causes for an enlarged prostate, doctors will perform a variety of tests.
Tests which are commonly used to find the cause of an enlarged prostate include:
- A digital rectal exam. A physician or nurse will insert a gloved finger into the patientâs rectum to digitally examine the prostate for swelling and/or enlargement.
- Swab tests for urethral discharge or urine. To determine underlying conditions such as STIs/STDs and urinary tract infections. A swab of discharge or urine is taken and sent to a medical laboratory for culturing, so that any microorganisms are identified.
- Urinalysis. A urine sample is sent to a medical laboratory for analysis and may be tested for urea nitrogen or creatinine, among other things.
- Blood tests. A sample of blood is sent to a medical laboratory for analysis, which may include tests for creatinine or blood urea nitrogen, as well as antibodies and infectious agents.
- Prostate-specific antigen test. A blood sample is sent to a medical laboratory to be tested for prostate-specific antigen , an enzyme produced by cells in the prostate. A change in PSA levels can indicate that there is a problem with the prostate.
If patients are referred to a urologist, they may have further tests, including:
Before referring the patient for tests, the physician may also ask questions in order to determine the possible causes of the discomfort, their severity, and their duration. Such questions may cover:
Connection Between Ejaculation And Prostate Cancer
The amount of ejaculations included those from sexual intercourse, masturbation and nocturnal emissions . The one study found that men who ejaculated 21 or more time a month had a 33% decreased chance of developing prostate cancer compared to those who ejaculated 4-7 times a month. The second study showed that men who averaged 4-7 ejaculations a week showed a 36% decreased chance of developing prostate cancer, before the age of 70, as compared to men who ejaculated less than 2-3 times a week.
It’s not known how this increased rate of ejaculation leads to a decreased risk of prostate cancer. The theory behind it is that ejaculation expels potentially harmful or irritating substances from the prostate, thereby decreasing the chances of the occurrence of a malignancy.
Doctor Does Too Much Sex Enlarge The Prostate
Prostate cancer is the commonest cancer in men. There are concerns on whether frequent sex contributes to the development of prostate enlargement in general and especially in the evolvement of prostate cancer.
The prostate gland is an important part of the male reproductive system. It is a major contributor to the formation of the seminal fluid that comes with ejaculation at the peak of sexual intercourse in males.
It produces nourishing materials, especially the sugary fructose, for the wellbeing of sperm cells. It is located just below the bladder where urine is stored, and in front of the rectum the last portion of the large intestine where the feces is stored.
Prostate enlargement: 100 for 100
In anatomical relationship, the prostate surrounds the tube that drains the urine from the urinary bladder, just as the tube is leaving the bladder.
A point of fact is that the prostate gland is destined to enlarge in all men as they get older, albeit at different rates in men of different extractions. Anyhow it goes, it is estimated with corroborative findings on autopsy that all men who lived up to 100 years had enlarged prostate a case of 100 for 100!
The good thing however is that most prostate enlargements are usually of no clinical consequence and are not problematic or symptomatic to the affected men since the prostate growth are mostly non-cancerous and non-strangulating.
Pde5 Inhibitors: Viagra Levitra And Cialis
Approved by the FDA in 1998, sildenafil revolutionized the way we think about and treat erectile dysfunction, largely because it is so easy to use and effective. Since then the FDA has approved three closely related drugs, vardenafil , avanafil and tadalafil .
All four drugs work in a similar fashion, by affecting the normal physiology of the penis. In particular, they block PDE5, an enzyme that breaks down the erection-producing chemical cyclic guanosine monophosphate. This enables the penis to fill with blood and to stay erect long enough for intercourse. Of course, its important to realize that none of these drugs is an aphrodisiac. Youve got to feel sexually stimulated in order for them to work.
The main differences between the drugs have to do with timing: how quickly they begin to work, and how long their effects last . Levitra may start working slightly faster than Viagra although the FDA says that like Viagra, it should be taken about an hour before sexual activity. Some studies suggest that Levitra may help some men who dont respond to Viagra. And while some doctors are skeptical about this claim, theres no harm in trying Levitra or Cialis if Viagra doesnt work for you.
Cialis has also been approved to treat men with both erectile dysfunction and BPH. The dose is lower, usually 5 milligrams per day.
Treatment Of Enlarged Prostate And Ed
While an enlarged prostate can cause ED, there are treatment options available to you to facilitate normal sexual function. Luckily many forms of enlarged prostate-associated erectile dysfunction are treatable, and by tackling the underlying problem of an enlarged prostate, many men can restore or greatly improve their sexual performance.
Can Flomax Cause Ejaculatory Dysfunction
Flomax is a prescription drug that men may use when they have a benign prostatic hyperplasia condition. The drug focuses on the urinary symptoms that men experience when they have an enlarged prostate. The drug is also known as . It is classified as an alpha-blocker. A doctor will provide a specific dosage for the patient based on the severity of the condition.
Flomax is helpful when a man has problems like urinary incontinence. The drug can, however, cause side-effects. Among side-effects associated with Flomax, some men report problems with their ejaculation such as ejaculatory dysfunction. A lot of men who use Flomax find that it becomes harder to ejaculate.
The delayed ejaculation could interfere with a mans ability to reproduce. When the man has difficulty ejaculating, he may start to develop other complications too. In addition to delayed ejaculation, some men have reported retrograde ejaculation.
Thus, patients should be aware that Flomax can be a reason for their ejaculation dysfunction. If the patient experiences this condition and takes Flomax, they should report it to the doctor. The doctor may remove the patient from . A different prescription may help to reduce urinary symptoms of an enlarged prostate without causing problems with ejaculation.
Bph Medications And Sexual Side Effects
Some drugs used to treat BPH can cause difficulty in maintaining an erection. Men who take such as and may experience decreased ejaculation. This is because alpha-blockers relax the bladder and prostate muscle cells.
Alpha reductase inhibitors can also cause ED. Additionally, reduced sex drive is a possible side effect of the alpha reductase inhibitors dutasteride and finasteride.
Approximately 3 percent of men taking dutasteride reported experiencing a decreased libido in the first six months. About 6.4 percent of those taking finasteride experienced this within the first year. Roughly 4.5 percent of men taking dutasteride-tamsulosin reported decreased libido in the first six months.
Men who take these medications may also experience lower sperm count, decreased sperm volume, and lower sperm movement. Adverse events typically decrease with continued use.
Medications that treat erectile dysfunction may help improve BPH. The ED drugs below have all been shown to reduce BPH symptoms:
- sildenafil
- tadalafil
However, they arent currently approved to treat BPH.
These medications inhibit a protein that breaks down a chemical called cyclic guanosine monophosphate , which increases blood flow to the penis. By inhibiting the protein that breaks down cGMP, blood flow to the penis can be increased.
One comparing tadalafil and a placebo showed that men who took 5 milligrams of tadalafil daily had significant improvement in both BPH and ED symptoms.
Types Of Ejaculatory Dysfunctions
Ejaculatory dysfunction is a term that can refer to different conditions affecting the male reproductive system. Studies show that ejaculatory dysfunctions are relatively common among men. These conditions can affect young and older men.
One study found that premature ejaculation is the most common type of ejaculatory dysfunction. This condition causes a man to ejaculate quickly after initiating sexual activity. Premature ejaculation means both the man and his sexual partner will not feel satisfied at the time of orgasm. There is no specific time to ejaculation used to diagnose this condition, although most men report ejaculation within one minute. Studies show that up to 40% of men may experience premature ejaculation.
Apart from premature ejaculation, there are two other common types of ejaculatory dysfunctions. This includes delayed and retrograde ejaculation.
Delayed ejaculation means it takes longer than usual for a man to ejaculate.
Drugs That May Help Men With Retrograde Ejaculation
- Midodrine
- Phenylephrine
- Ephedrine
The use of these drugs may improve the function of the muscle that controls the bladder neck. When a man ejaculates, this muscle should contract. This causes the bladder neck to close, ensuring semen cannot push back into the bladder.
It is important to note that there are some drugs that may cause side-effects. Blood pressure may increase when the patient uses some of these medications. There is also a risk of a fast heart rate. Thus, men with existing heart diseases may not be able to take these drugs.
There are cases where medication does not help. This is often the case when a surgical procedure causes retrograde ejaculation. If this is the case, the options available may be limited or ineffective.
If the man wants to reproduce, assistive procedures might be needed. Intrauterine insemination is a possibility when is a problem due to retrograde ejaculation. In this case, a doctor may attempt to recover semen from a mans bladder. The semen is then sent to a laboratory for processing. The processed semen is then used as a means of inseminating the mans partner.
Enlarged Prostate This Treatment Can Help You Avoid Sexual Side Effects
December 06, 2018
Benign prostatic hyperplasia , or enlarged prostate, is a common condition in men older than age 50. BPH occurs when the prostate gland becomes enlarged and begins to press on the urethra the tube that carries urine out of the body.
When the prostate continues to grow, it can lead to urinary symptoms that include:
- Leaking or dribbling of urine
- Frequent nighttime awakenings to urinate
- Urinary retention or urgency
- A weak urine stream
BPH is not prostate cancer and it doesnt lead to cancer. However, the two conditions may have similar symptoms in the early stages
So its important that men who experience these symptoms be evaluated by a mens health specialist to rule out cancer and determine the best treatment options to relieve their symptoms.
Without treatment, BPH can lead to serious complications in some men, including , kidney or bladder damage, urinary tract infections and bladder stones. In some extreme cases, BPH can cause a total inability to urinate and require emergency catheterization.
The Link Between An Enlarged Prostate And Erectile Dysfunction
In the past, the relationship between BPH and erectile dysfunction was believed to be based solely on age. The risk of having enlarged prostate increases with age; so, does the risk of erectile dysfunction.
The link between BPH and erectile dysfunction was assessed in several clinical trials. One of the most important clinical trials was the Male Cologne Survey, including 4,489 men aged between 30 and 80. The study participants were questioned about their sexual activities and related factors. The results have shown that a high percentage of men who had lower urinary tract symptoms due to BPH also had erectile dysfunction.
Another study was the Multinational Survey of the Aging Male . More than 14,000 men aged between 50 and 80 years were enrolled. The study confirmed that high prevalence of BPH associated with lower urinary tract symptoms is linked with to an increased risk of erectile dysfunction.
The relationship between BPH and erectile dysfunction was not clearly understood by the researchers. One idea concerns the sympathetic nervous system, which studies show is hyperactive in animals and men with BPH-associated urinary tract symptoms. Nerve fibres in the sympathetic nervous system transmit signals that have an impact on stress and stress-related symptoms. An increase in these signals may lead to overactivity in the sympathetic nervous system, which is associated with erectile problems.
Symptoms Of Prostatitis Can Include:
- needing to pee urgently, often in the middle of the night
- pain when peeing or after you ejaculate
- blood in your urine
- a feeling of heaviness behind your scrotum
- a urinary blockage, which means you cant pee when you need to.
There are different types of prostatitis. Bacterial prostatitis is caused by a bacterial infection, and can be treated with antibiotics. Then theres chronic prostatitis, or chronic pelvic pain syndrome. Doctors dont know yet what causes this condition, but it can be trigged by things like an injury, nerve damage or stress.
Prostate Specific Antigen Testing
Prostate Specific Antigen is a protein made by the cells in your prostate. Your PSA levels can be measured using a blood test and give an indication of your prostate health.
A PSA test isnt a test for cancer. Higher levels of PSA might indicate prostate cancer, but a high reading could also be caused by other conditions. It is also possible to have low level readings and have prostate cancer. This means that a PSA test isnt enough to definitively diagnose or rule out prostate cancer. Your PSA levels can vary, so your doctor might run this test a few times to compare your results and help determine your risk of prostate cancer.
Treatment Options For Retrograde Ejaculation
Before beginning treatment for retrograde ejaculation, the patient needs a thorough inspection. A doctor needs to determine why the man is experiencing retrograde ejaculation. The treatment provided will usually focus on addressing the underlying cause.
If the doctor finds that the patient is using medication that contributes to the condition, then there may be a change in the patients prescription. By removing drugs such as Flomax that cause retrograde ejaculation, the ejaculatory dysfunction may decrease and return to normal. The doctor may ask the patient to use the new drugs for some time and monitor for changes in ejaculation.
There are a few drugs that doctors prescribe that may possibly help with retrograde ejaculation. These drugs are not specifically for this condition but rather as a treatment for other illnesses.
Its Complicated: Enlarged Prostate And Sex
BPH and sexual function
Prostate enlargement, also known as benign prostatic hyperplasia , and erectile dysfunction are separate problems. Both increase with age, but one causes problems in the bathroom and the other in the bedroom. However, the two are somewhat linked.
BPH happens when your prostate becomes enlarged, but cancer isnt the cause. A mans prostate continues growing throughout most of his adult life. This is why many older men are affected by the condition.
ED is the inability to get or maintain an erection. It can be caused by physical conditions such as:
It can also be caused by psychological issues.
These two conditions dont necessarily seem linked, but certain treatments that relieve BPH can cause ED and other sexual side effects. On the other hand, treating ED can improve enlarged prostate symptoms.
- inability to empty the bladder
- a weak urine stream
A surgery called transurethral resection of the prostate can help relieve these symptoms. Men who have this procedure often experience sexual side effects after surgery.
Between 50 and 75 percent of men experience retrograde ejaculation after TURP, according to Harvard Medical School. This means that semen released during orgasm enters the bladder rather than exiting the penis. Retrograde ejaculation is sometimes called dry orgasm. Its not harmful but can affect male fertility.