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.
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Bph Medications And Sexual Side Effects
Some drugs used to treat BPH can cause difficulty in maintaining an erection. Men who take alpha-blockers such as doxazosin and terazosin 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:
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.
What Are The Symptoms Of An Enlarged Prostate
The severity of symptoms in people with BPH varies, but tends to worsen over time. Common symptoms include:
- urgent or frequent need to urinate
- dribbling at the end of urination
The less common symptoms of BPH are:
- inability to urinate
- urinary tract infection
- blood in the urine
You may never get all of these symptoms. In fact, some men with an enlarged prostate do not get any symptoms at all. In some men, the symptoms eventually stabilize and may even improve over time, while in others they may get worse. Some of these symptoms may be caused by other conditions, like anxiety, cold weather, lifestyle factors, certain medicines and other health problems. Therefore, if you have any of the above symptoms, visit your physician to find out what could be causing them.
If the condition cant be controlled with medication, such as in severe BPH or when you have complications like bladder stones, urinary tract blockages or kidney problems, your doctor may suggest surgery. Various forms of surgery include laser therapy, transurethral prostatic incision, needle ablation or microwave therapy. It is important to speak with your urologist about the different surgical options before you are treated. For more information on diagnosis and treatment of BPH, visit the Advanced-Urology-Institute site.
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Analysis Of Authors And Co
The author collaboration network of prostate diseases and ED was observed. According to Figure 6, in terms of frequencies, Mulhall John P , Montorsi Francesco , Mcvary Kebin T , Maggi Mario , and Nelson Christian J were the top five most productive authors during the past decade. The information of author citation was also analyzed. In terms of co-cited author, the top five authors with the largest numbers of citations, which reflected their strongest academic authority, were Mcvary Kebin T , Roehrborn Claus G , Mulhall John P , Emberton Mark , and Maggi Mario .
Figure 6 The font size of each authors name represents the number of articles. The thickness of the curved connecting line represents the collaborative intensity between authors the authors collaboration network of research on prostate diseases and ED different colors inside the circle represent different time intervals.
Table 3 The most productive authors on the research of prostate diseases and ED .
Effects Of Bph On Sexual Function
Lower urinary tract symptoms are common in aging individuals with BPH, the primary cause of LUTS in men over 50. The presence of histological BPH at autopsy is approximately 8% in men ranging in age from 31 to 40 years, 50% in those ranging in age from 51 to 60 years, 70% in those ranging in age from 61 to 70 years, and 90% in those ranging in age from 81 to 90 years . LUTS range from nocturia, urinary frequency, and urgency to a decreased and intermittent stream with incomplete bladder emptying and commonly result in a decreased quality of life.
Findings from epidemiological, pathophysiological, and clinical studies indicate that many of these men also suffer from declining sexual function, especially those undergoing treatment for their BPH-related urinary symptoms. Although urinary symptoms and quality of life may improve with BPH therapy, the resulting effects on sexual function vary according to medical, surgical, and minimally invasive approaches and have not been consistently reported.
The incidence of both BPH and sexual dysfunction increases with aging, which suggests the possibility of an association of the two diseases. Similarly, in a study of 1216 patients in Korea, Yong et al reported that the score for sexual function decreased with severity of LUTS and aging of patients .
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Prostate Cancer And Erectile Dysfunction
And speaking of a swollen prostate causing ED while prostate cancer may not always be a direct cause of sexual dysfunction, a growing prostate tumor could decrease sexual function by causing lower urinary tract symptoms.
Additionally the psychological effects of the diagnosis itself and the treatments for the cancer can also cause erectile problems.
While these conditions are direct causes of erectile function, treatments to manage their effects may also lead to erectile dysfunction.
Loss Of Libido Also Impacts Sex Life
Its not just ED that men can experience in tandem with BPH, says Hemendra Shah, M.D., a urologist at University of Miami Health System. He says that men complain of ejaculation problems and a drop in their sex drive. BPH and sexual dysfunction often go hand in hand, he explains. Loss of libido, he points out, also can be part of aging. Some men resign themselves to such setbacks, while others, he says, very much want to remain sexually active. Unfortunately, some of the medications that treat BPH may make it difficult to maintain the sex life that some men have long known.
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Do Current Recommendations For Treatment Of Bph Make Sense
This brings into question the current management recommendations for BPH. Many men adapt to their urinary symptoms and are not bothered by them even when their AUA symptom score index is pretty significant. There is a significant reticence among men about taking medications. Many would rather wake up 2-3 times per night than being treated with medications.
The question becomes whether we should proactively recommend treatment to prevent secondary health effects of BPH. The current treatment recommendation for BPH based on the presumption that BPH is mostly a quality of life issue is probably outdated. There is accumulating evidence that BPH has a significant health effect on men that extends beyond urinary function.
Sexual Side Effects From Other Meds Common Too
Another class of drugs commonly used to treat BPH may also cause sex problems. Five-alpha reductase inhibitors, which include Proscar and Avodart , shrink the prostate so its easier to pee. Both drugs labels warn of possible ED, reduced libido, and ejaculation problems. But its complicated, says Dr. Hedges. He explains that few men reported sexual side effects during clinical trials of these drugs, and many men with BPH already have sexual issues such as ED before starting these treatments. Still, if you experience sexual side effects from these meds, you do have options.
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Can An Enlarged Prostate Cause Ed
While an enlarged prostate does not cause ED, some BPH treatments may affect the ability to keep an erection, so its important to talk to your doctor to understand possible BPH treatment side effects.
Certain BPH medications may cause decreased sex drive and ED as a side effect.4 For instance, studies have shown a connection between certain anti-testosterone drugs and ED.5 If BPH symptoms continue even after medication therapy, your doctor may suggest a surgical treatment to remove the extra prostate tissue causing your BPH. However, surgical treatment also comes with side effects. A common surgical treatment, transurethral resection of the prostate , has also been shown to cause ED in a small percentage of men.5
You and your doctor may discuss a minimally invasive BPH treatment option, Rezm Water Vapor Therapy. Rezm Therapy treats the cause of BPH by using the natural energy stored in water vapor to remove the extra prostate tissue that is causing urinary issues while preserving sexual function. A five-year clinical study showed that men who had treatment with Rezm Therapy for their BPH did not suffer any procedure-related ED.6 It also showed that the quality of life improved for those men who had Rezm Therapy.6 Learn more about how Rezm Therapy works.
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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.
An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.
A bacterial infection can also lead to prostate issues. Acute bacterial infections can be hard to treat. Some men with a bacterial infection may need to take antibiotics to prevent or treat symptoms. Symptoms of the disease include fever and chills, pain in the lower back and the tip of the penis. Some men may have blood in the urine, frequent urination, and blood in the urine. If you suffer from acute bacterial prostatitis, a medical professional should be able to prescribe you the appropriate treatments to prevent the disease.
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Assessing Your Cardiovascular Health
Your GP may assess your cardiovascular health. Narrowed blood vessels are a common cause of erectile dysfunction and linked with cardiovascular disease .
Your GP may:
- reducing stress
As well as helping to improve your erectile dysfunction, these changes can also improve your general health and may help to reduce your risk of cardiovascular disease .
Read more about preventing cardiovascular disease
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.
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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.
Impact Of Erectile Dysfunction On Qol
Preservation of sexual function should be considered in the management of patients with symptomatic BPE. With increase in elderly population, it is expected that more men will experience ED and symptomatic BPE. There was positive correlation between the severity of ED and prostate size in this study, and patients with severe ED had higher mean prostate size of 122.94 g. This further supports the need to screen patients with symptomatic BPE for ED. Sexual and urinary functions have a direct impact on QoL. This present study shows that QoL has a weak negative correlation with ED and a weak positive correlation with prostate size . This is because patients impression on quality of life varies. While a patient with a huge prostate and severe ED may be satisfied with the symptoms, another patient with milder form may feel terrible with his symptoms .
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Read Real Stories Of Men Who Underwent Treatment Of Enlarged Prostate At New York Urology Specialists
We offer treatment for prostate problems, including slow urine stream, frequent urination at night, difficulty emptying the bladder, and other problems to patients within driving distance to our offices as well as from other states and countries. Our patients come from New York, New Jersey, Pennsylvania, Connecticut, and over 70 countries worldwide.
Side Effects Of Medications For Ed
Medications used for the treatment of BPH infrequently cause ED, but they do affect ejaculation. The risk of ED from taking medications such as Proscar and Avodart is less than 10%, but they can cause decreased production of semen, dry up. Alpha-blockers such as Flomax and Uroxatral can cause retrograde ejaculation, but curiously, on rare occasions, can cause priapism as a side effect.
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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.
An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.
Enlarged Prostate And Ed
Living with an enlarged prostate can be even more difficult if you experience erectile dysfunction, or ED. ED happens when the penis cant get hard enough to maintain an erection to allow sexual intercourse.2 More than 50% of men over 40 suffer from some degree of ED.3 Like BPH, ED can lower quality of life for both you and your partner. Learn more by visiting EDcure.org.
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The Initial Causes Does Prostate Massage Help 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.