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Mani Arumugam

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“I had never had so many troubles in my marriage before. Yes, we used to fight even before I got BPH, but sex was our way to make peace and let the other person know how important they were to us. That was suddenly taken away from me, from the both of us. Sex wasn’t pleasurable, because I never was in the mood. And that left us with only downs to the marriage.” – Anonymous

Let's start off by directly addressing the elephant in the room: Is benign prostatic hyperplasia (BPH) the same as an erectile dysfunction (ED)? No, they are two completely different conditions.

Can an enlarged prostate cause erectile dysfunction? Yes, it can. 

And for those of you who are clueless about what's up, let's take a walk...

What is the Prostate Gland?

The prostate gland is found in men. It looks like a walnut and is located just below the urinary bladder. The prostate surrounds the top part of the urethra, a tube that drains urine from the bladder. It has the job of making the liquid in your seminal fluid.

What causes prostate enlargement?

The reasons for the enlargement of the prostate are not known. But the prostate increases in size first when a teenage boy reaches puberty. Then around 25 years of age, the prostate starts growing again and keeps growing till a man dies. 

Growth of the prostate is nothing out of the ordinary. Problems occur when it starts growing too much, too fast. Unnaturally fast growth of the prostate gland is called benign prostatic hyperplasia or BPH. 

Since, the prostate sits right on top of the urinary bladder, the symptoms of an enlarged prostate can include: 

  • Feeling a urgent and frequent desire to pee

  • Waking up multiple times in the night

  • Difficulty in starting urination

  • Weak urine stream or a stream that stops and starts

  • Dribbling at the end of urination

  • Not being able to fully empty the bladder

  • Urinary incontinence or leaking urine

BPH and Sexual Function

Experts aren't sure why but an enlarged prostate and sexual dysfunction are closely linked together. The worse your symptoms of BPH are, the less you are likely to enjoy your sexual life.

Sexual problems of men with BPH

It is speculated that your genes or age have something to do with the sexual side effects of an enlarged prostate. It is also possible that the mental anguish and anxiety has something to do with sexual performance and satisfaction. Nonetheless, men with an enlarged prostate go through a lot of sexual problems including:

  • Erectile Dysfunction - Erectile dysfunction is a condition wherein a man is unable to get or keep an erection firm for long enough to reach sexual satisfaction. An enlarged prostate and erectile dysfunction were found to be closely linked together in several studies. But why does an enlarged prostate cause erectile dysfunction is not clear yet. 

  • Decreased drive - Men who suffer from an enlarged prostate also suffer from a decreased sexual drive. The libido goes down significantly. 

  • Reduced sexual satisfaction - BPH can lead to ejaculation issues such as reduced semen release. This leads to a dissatisfaction in sexual activities.

ED treatments and BPH

Treatment for BPH and ED are not connected, but seem to affect one another. Certain treatments of BPH can make ED worse. On the other hand, treating ED can help with an enlarged prostate. 

Drugs that help in ED and relieve symptoms of BPH also are:

  • sildenafil 

  • vardenafil 

  • tadalafil

BPH medications and sexual side effects

TURP or Transurethral Resection of the Prostate is a surgery that helps relieve the symptoms of an enlarged prostate. But this surgery often results in a lot of sexual issues later. 

More than 50% of men who undergo TURP start experiencing retrograde ejaculation. A condition in which the seminal fluid after release enters the bladder instead of exiting out of the penis. 

In less common cases, men who undergo TURP experience erectile dysfunction. 

Some drugs such as alpha blockers, used to treat BPH can actually cause you trouble in keeping an erection. 

Alpha reductase inhibitors can also cause ED and also result in lower sexual drive. 

Men who take BPH medications might also experience an overall decline in sperm health including low sperm count, decrease in sperm volume, and lower sperm movement.

When Should You Seek Medical Advice?

Ideally, you should seek medical attention as soon as you notice something's 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. 

If you have anymore concerns related to men's health, comment with them below and we'll be sure to take it up soon. For more such blogs, keep checking this space!

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