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.
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:
Prostate Cancer And Occurrence Of Sexual Dysfunction
Although the prostate is close to the penis, there has been no report of sexual dysfunction caused directly by prostate cancer. However, if a growing prostate tumor causes lower urinary tract symptoms, such as prostate hypertrophy, it could decrease sexual function. That would be a secondary reduction in sexual function caused by severe lower urinary tract symptoms, rather than a direct effect of the prostate cancer. That is, prostate cancer does not directly cause abnormalities of the corpus cavernosum.
A sudden reduction in sexual function in patients with prostate cancer frequently occurs because of psychological instability caused by the occurrence of the cancer, and, in particular, depression., The occurrence of prostate cancer also often has a negative effect on the mental status of the female partner, causing a decrease in sexual function in the female partner. Because a diagnosis of prostate cancer simultaneously causes fear and anxiety in married couples regarding the effects of prostate cancer on their lives, it also creates an unstable mental status in their sex life, resulting in reduced sexual activity.
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 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 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.
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
- Decreased libido
What Can I As A Partner Expect
One of the effects of prostate cancer treatment is erectile dysfunction or impotence. This means that your partner may not be able to have erections that are hard enough for him to have sex with you or that he may not be interested in sex because of the medicine he is taking to treat his prostate cancer. This affects not only the man, but you, too, as his intimate partner. If you are the partner of a man with erectile dysfunction, it can be difficult to cope with changes in your sexual relationship. Sometimes men struggle to come to terms with changes in their body image or their ability to perform sexually. This can sometimes result in him staying away from intimate situations where he may feel under pressure to make love. As a partner you may feel rejected by what seems like a lack of sexual interest or intimacy. This may not have anything to do with his feelings for you, but is a result of his cancer treatment. Erectile dysfunction can be difficult for both of you. You may want to reassure your partner that:
- Sex is not as important as long as he is healthy and that he is no less of a man to you
- You will work through it with him
- You understand his feelings
- He is important to you
It may help if you explain to your partner how important nonsexual touching and intimacy such as kissing and cuddling is to you.
Pelvic Radiation Therapy Effect On Erections
Prostate, bladder, colon, and rectal cancer are sometimes treated with radiation to the pelvis. This can cause problems with erections. The higher the total dose of radiation and the wider the section of the pelvis treated, the greater the chance of erection problems later. If radiation therapy is part of your treatment plan, talk to your doctor before it starts. Ask how your arteries and nerves might be affected by radiation therapy so you know what to expect.
Will Treatment Cause Erectile Dysfunction
When youre sexually excited, nerves cause tissues in your penis to relax, allowing blood to flow into the organ. The nerves that control erection are very delicate. Surgery or radiation for prostate cancer may damage them enough to cause ED. When you have ED, you cant get or keep an erection.
Radical prostatectomy is a surgery to remove the prostate gland. When your surgeon removes the gland, they may damage the nerves and blood vessels that run along it. If theyre damaged enough, you wont be able to get an erection following the procedure.
Today, doctors can do nerve-sparing surgery, which helps prevent permanent ED. Your surgeon can still touch those nerves and blood vessels, causing ED as a temporary side effect. Many men have trouble getting an erection for a few weeks, months, or even years after their procedure.
Radiation therapy also damages blood vessels and the nerves that control erection. Up to half of men who have radiation for prostate cancer experience ED afterward. In some men, this symptom will improve with time. Sometimes radiation side effects dont appear until a few months after the treatment. If ED starts late, it may not be as likely to go away.
A few treatments can help with ED until youre able to have erections on your own again.
Additional treatments include the following:
Brachytherapy And Sexual Function
Unlike conventional radiotherapy, which may cause radiation-induced side effects, like inflammation in the tissues near the cancer tissue due to radiation, brachytherapy only irradiates the cancer tissue, reducing this complication. Brachytherapy has been widely used in the USA and Europe for the past 10 years. Now, it accounts for approximately 30% of the early treatment of prostate cancer. After prostate cancer surgery, incontinence, a common postoperative complication, occurs in 50~90% of patients who undergo the operation, and above all, erectile dysfunction may occur in 10~90% of patients who undergo such surgery. Thus, many patients who undergo such surgery suffer from inconvenience in their daily living after the surgery. In the case of brachytherapy, urinary incontinence and erectile dysfunction occur in 0.6% and 14~35% of patients, respectively, who undergo it. Thus, the frequency of erectile dysfunction is significantly lower in the brachytherapy group than in the conventional surgery group.
How May Erectile Dysfunction Affect My Sexual Relationships
Prostate cancer and its treatment can affect your desire for sex. Every man is different but the feelings caused by having cancer and the physical stress of treatment can affect the way you feel about your body and your relationships. Some men talk about feelings of a loss of their role within the partnership or family. This can sometimes affect a mans self esteem and confidence. For others, the physical effects of treatment may lead to tiredness and a lack of energy. Physical changes after some treatments can also affect the way you feel about your body and appearance . All of these things may result in a lack of interest in sex.
If you are feeling tired or under stress, tell your partner how your feel. Loss of interest in sex does not mean you lose interest in a loving and supportive relationship. There are ways to remain physically intimate without having sex. If you are used to a close physical relationship, it is important to remember that hugs, cuddles and kisses maintain intimacy, provide support, and do not have to lead to sex.
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Questions To Ask Your Doctor Or Nurse
- How could my prostate cancer treatment affect my sex life?
- How soon after treatment can I masturbate or have sex?
- Which treatments for erection problems would be best for me? Can I get them on the NHS?
- Is there anything I can do to prepare myself before I start my prostate cancer treatment?
- What happens if the treatment doesn’t work? Are there others I could try?
- What other support is available to me?
- Can my partner also get support?
Available Treatments For Ed
ED is a common concern after cancer treatment. You should not hesitate to discuss these concerns with your provider. There are treatments to help patients restore and maintain erections. Your healthcare provider can determine if the treatment is right for you, and the likelihood you will benefit from a specific treatment. These treatments may include the following:
If you are having erectile dysfunction, you should discuss the benefits and risks of each treatment option with your healthcare provider. You may want to see a urologist , who can offer treatments for erectile dysfunction and other sexual concerns.
Why Is There Increasing Concern At This Time Regarding Erectile Dysfunction Issues Following Radical Prostatectomy
The reality of the recovery process after radical prostatectomy today is that erectile function recovery lags behind functional recovery in other areas. Patients are understandably concerned about this issue and, following months of erectile dysfunction, become skeptical of reassurances that their potency will return.
Does Enlarged Prostate Cause Ed
Of the many symptoms caused by BPH, one of the most common complaints men have when visiting a urologist is Erectile Dysfunction or ED. This is defined as the inability of a man to attain or maintain an erection sufficient for vaginal penetration and satisfactory sexual performance.
BPH does not directly cause ED, but many men with BPH seek medical attention to relieve ED.
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.
How Erectile Dysfunction Affects Patients With Prostate Cancer
Regardless of whether the nerves were spared during surgery or whether the most precise dose planning was used during radiation therapy, nearly all men will experience some erectile dysfunction for the first few months after treatment. The reason for this is simple: the nerves and blood vessels that control the physical aspect of an erection are incredibly delicate, and any trauma to the area will result in changes to the natural order, explain the Prostate Cancer Foundation regarding the causes for erectile dysfunction in prostate cancer patients.
Erectile dysfunction can, however, vary and about 40 to 50% of patients with intact nerves start to see improvements a year after the treatment. After two years, about 30 to 60% of the patients are expected to return to their normal function before the treatment. However, not all treatments can spare the patients nerves. In the case of radiation therapy, erectile dysfunction is not a such common side effect, affecting only about 50% of the patients, while in the case of brachytherapy, between 25 and 50% of the patients are affected. Erectile dysfunction not only affects patients sexual life, but can also cause emotional problems.
Treatment Of Prostate Cancer And Sexual Function
Prostate cancer treatments include surgery, hormone therapy, radiotherapy, and chemotherapy. Each treatment method is selected primarily according to the disease stage of the patient. In prostate cancer treatment, as testosterone is involved in the prostate and its mechanism of action, erectile dysfunction often occurs as a critical complication regardless of the selection of a surgical treatment or hormonal therapy.
Can Erectile Dysfunction Be Treated
There are several treatment and management options for erectile dysfunction. However, your ability to have an erection after prostate cancer treatment can be affected by several things:
- How good your erections were before treatment
- Other medical conditions like high blood pressure and diabetes
- Other medicines you may take
- Your lifestyle, drinking, or smoking
- The type of treatment you had
Treating Erectile Dysfunction With Shockwave Therapy
For over four decades, shockwave therapy has been used to treat patients with heart problems, kidney stones, fractures, and joint inflammation. Recently, researchers found that it could help men improve their sex life. Since this discovery, it has become one of the most preferred treatments for ED.
Shockwave therapy uses low-energy frequencies from acoustic waves to trigger a process known as neovascularization in the targeted parts of the body. This will help improve blood flow to the area, which is a critical factor in erectile function. Most of the physical conditions that cause ED typically form plaques that block blood flow to the penile arteries. The therapy combines its repairing and regenerative effects first to remove the plaque and then stimulate a re-growth process of new and healthy blood vessels.
How To Return To An Active Sex Life After Prostate Cancer Treatment
No matter the cancer, treatments often cause side effects that affect patients quality of life. But with prostate cancer, the potential side effects can be particularly concerning to men who are trying to decide which approach is right for them. Surgery, radiation therapy and other treatments may impact a patients sex life, causing challenges like low sex drive, loss of penis length, dry orgasm or low sperm counts. Despite the angst these issues may cause, experts say most of these side effects can be managed and many men have a good chance of returning to a full sex life after prostate cancer treatment.
Unfortunately, sexual dysfunction is a possibility for nearly all treatment options for prostate cancer, including surgery, says Scott Shelfo, MD, FACS, Medical Director of Urology at our hospital near Atlanta. The degree of dysfunction depends on many factors, including the patients overall health, co-existing medical problems, as well as the patients level of sexual function and ability before treatment.
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How Are Prostate Cancer And Erectile Dysfunction Related
If you have issues with your prostate, a general workup can include urine tests, bloodwork, and a physical exam. This exam usually consists of a digital rectal exam , where a doctor will feel your prostate from inside your anal cavity. If the prostate feels smooth and round, thats generally a sign that you probably only have BPH. Otherwise, you may need to undergo further testing, and cancer may be a concern. Men who are diagnosed with prostate cancer worry about many areas of their health. I have heard many of these questions over the years: How bad is it?, What options do I have?, and What are possible complications of treatment?
Currently, the mainstays of treatment for prostate cancer are anti-testosterone therapy, surgery, and radiation therapy. Each of these has pros and cons related to treatment success and long-term effects on the body. However, one of the most common complications for all three of these options is erectile dysfunction. We talked about how anti-testosterone therapy can affect erections when we discussed BPH treatments above. Lets now look at prostate surgery and radiation therapy.
Sex And The Prostate: Overcoming Erectile Dysfunction When You Have Prostate Disease
If you are concerned about erectile function, its important to understand what erectile dysfunction really is. Failing to have an erection one night after youve had several drinks or even for a week or more during a time of intense emotional stress is not erectile dysfunction. Nor is the inability to have another erection soon after an orgasm. Nearly every man occasionally has trouble getting an erection, and most partners understand that.
Erectile dysfunction is the inability to attain and maintain an erection sufficient for sexual intercourse at least 25% of the time. The penis doesnt get hard enough, or it gets hard but softens too soon. The problem often develops gradually. One night it may take longer or require more stimulation to get an erection. On another occasion, the erection may not be as firm as usual, or it may end before orgasm. When such difficulties occur regularly, its time to talk to your doctor.
Erectile dysfunction can have many causes, including some forms of prostate disease and medications and surgery for prostate cancer. Fortunately, in many cases, this problem can often be effectively addressed. Some men find relief by taking medications to treat erectile dysfunction. If these arent effective for you, a number of other options, including injections and vacuum devices, are available. The possibility of finding the right solution is now greater than ever.
Chemotherapy Targeted Therapy And Immunotherapy Effects On Erections
Other types of treatment for other types of cancer sometimes affect sexual desire and erections because certain drugs slow down testosterone output. Whether chemotherapy, targeted therapy, or immunotherapy drugs cause problems with erections depends on the type of cancer being treated and the type of drug or drugs being given. Some of the medicines used to prevent nausea during chemo can also upset a mans hormone balance. But hormone levels should return to normal after treatment ends.
Why Does Erectile Dysfunction Happen With Prostate Cancer Treatment
To help you understand why prostate cancer treatment may cause you to have erectile dysfunction, it is good for you to learn how your body may be changed by your treatment. Usually when a man is sexually aroused :
Radical Prostatectomy
The prostate is a gland that is about the size of a walnut. It sits around the urethra like a donut. The urethra is the tube that carries urine and semen to the outside of your body. Located near the prostate gland are the nerves, blood vessels and muscles needed to have an erection and to control your bladder. When you have a radical prostatectomy, you have surgery to remove your prostate gland. These nerves, blood vessels, and muscles may be weakened when you have surgery for your prostate cancer.
Radiation Therapy
Radiation therapy may damage the nerves near your prostate gland that help you have erections. Over time, you may notice that you are not having as many erections as you used to. Some men start having erectile dysfunction six months or more after their radiation therapy. If this happens, the erectile dysfunction usually does not improve.
Hormone Therapy