What Causes Benign Prostatic Hyperplasia
Its a little hard to say for sure what causes BPH.
What we do know for a fact is that men go through two main stages of prostate growth in their lives first at puberty, where the prostate doubles in size, and then growth begins around the age of 25 and continues during most of a mans life.
BPH is known to surface in this second stage, and mostly affects men above the age of forty. Autopsy data has found evidence of the condition in about 90 percent of men above the age of eighty.
The growth of the prostate in this second stage may be linked to androgens in the body. Men produce testosterone throughout their lives. They also produce estrogen the female hormone but only in small amounts.
When testosterone levels drop as they inevitably do with age a higher proportion of estrogen may remain.
This increase in the ratio of Estrogen or its receptors to testosterone may directly and indirectly affect the growth of prostate cells.
Another possible cause is DHT or dihydrotestosterone. This male hormone is a bit of a villain. It is a major cause of alopecia in men, but is however useful for the development and maintenance of the prostate.
Unfortunately, this role can be dangerous for the adult prostate, as DHT can cause excessive growth.
BPH may also result when there is an imbalance between the production and death of prostate cells. When the imbalance is in favor of cell proliferation, it can lead to BPH.
Medications For Prostate Enlargement
Typical medications used to treat prostate issues are Finasteride , dutasteride , and tamsulosin . Finasteride and dutasteride are 5-alpha reductase inhibitors that reduce the amount of the 5-alpha reductase enzyme in the blood. This enzyme converts testosterone in the blood into estrogen. High levels of estrogen exacerbate prostate growth and can result in BPH.
Men with high estrogen levels also tend to develop breast enlargement . Any man who spends a lot of time at the gym has probably noticed older men with enlarged breasts due to a high estrogen level. Enlarged male breasts are an outward indicator, but BPH is most likely also present inwardly.
Tamsulosin is an alpha-blocker that works by relaxing the prostate and bladder muscles so that urine flows easier.
Each of these drugs has a profile of severe sexual side effects. Alpha-blockers can lead to difficulty ejaculating, and 5-alpha reductase inhibitors can destroy libido as well as alter the sensation of orgasm or interfere with erections. For example, in several studies, Finasteride has been shown to increase the risk for men with BPH to develop erectile dysfunction.
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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.
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How Are Prostate Cancer Stages Determined
Once all testing has been completed, your doctor will tell you the stage of your cancer, or how much it has progressed and whether it has spread beyond your prostate. The stage will help your medical team decide which treatment is best for you. The higher the stage, the more advanced your cancer. The most common way to stage prostate cancer is the TNM system, developed by the American Joint Committee on Cancer, which hinges on three important factors:
T : How much of your prostate the tumor affects
N : Whether the cancer has spread beyond your prostate to nearby lymph nodes
M : Whether your cancer has metastasized, or spread far beyond your prostate to your bones, to nearby organs such as your bladder or rectum, or to more distant organs like your lungs, liver, or brain.
The TNM system also includes your PSA level and your Grade Group, based on your Gleason score. With your stage designated, which is labeled in a range of T1 to T4 , a treatment plan can be developed.
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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?
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The 4 Causes Of An Enlarged Prostate
It is normal for a prostate to become enlarged as a man ages. The prostate is approximately the size of a walnut in younger men but can grow to be much larger as they get older. An enlarged prostate can cause no visible symptoms but will eventually impact urinary and erectile functions if not properly treated.
There are many reasons a prostate gets enlarged, and most of them arent cancerous. Here are the most common:
Enlarged Prostate Doesnt Just Affect Your Bladder
According to research, as many as half of the men aged 51 to 60 will develop BPH or benign prostatic hyperplasia. An enlarged prostate. The good news about BPH lies in that one little, yet the uber-important word benign. To have an enlarged prostate doesnt indicate that you have prostate cancer, or that your risk for cancer is substantially higher. It can mean that you have to face a few unpleasant symptoms, though.
The most common symptoms of benign prostatic hyperplasia revolve around urination. Because your prostate gland is adjacent to the bladder, its enlargement can cause the blockage. This may result in frequent urination, difficulty starting urination, a sensation of fullness after urination, dribbling, and weak urine flow. These are the symptoms that most men have been told or experienced for themselves. But theres more. BPH can also affect your sex life. Heres how:
- Reduced sex drive and sexual satisfaction. This is related to the loss of sleep that stems from having to urinate frequently through the night more than it does any other aspect of BPH. Additionally, when the bladder feels uncomfortably full due to pressure from the blockage, anxiety may coincide with sex, diminishing the overall experience.
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Why Can Prostate Issues Cause Erectile Dysfunction
Prostate concerns commonly occur in men as they age, and the first symptoms may be difficulty urinating, or more frequent trips to the bathroom in the middle of the night.
But, is there a correlation between prostate problems and developing erectile dysfunction?
Both of these conditions increase in frequency as men get older, so it is difficult to know if one is definitely correlated with the other, but there may be a few things going on when you have prostate problems that can lead to issues in the bedroom as well.
Below, we will cover just how issues with the prostate gland including benign prostatic hyperplasia , and prostate cancer may have impacts on erectile function.
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.
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 UroliftÂ® 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 prostatectomy , 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 Elephant In The Room
Lets get to the point. Yes, BPH can affect your sex life.
It can cause a reduced sexual drive, there can be a reduction in sexual satisfaction, and thirdly, it can cause ED or erectile dysfunction. Erectile dysfunction is defined as the inability to attain and maintain an erection for intercourse at least 25% of the time.
Some drugs used to treat BPH can lead to ED. They can also reduce sperm count, lower sperm movement and sperm volume.
At the same time, certain ED treatments like Viagra, Cialis, and Levitra can improve BPH and reduce those urinary symptoms.
Yes, its complicated.
To continue, specifically, Proscar, an anti-testosterone drug prescribed for BPH has been linked to ED in 3.7% of men using it, with 3.3% having diminished libido, whereas alpha-blockers like Flomax can improve the symptoms of BPH with a lower risk of sexual side effects.
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Does An Enlarged Prostate Affect A Man Sexually
An enlarged prostate can cause sexual problems in men, such as:
- Erectile dysfunction
- Reduced sex drive
Sudden onset of erectile dysfunction may be a sign of prostate cancer and needs medical evaluation. Erectile dysfunctions may also occur after the therapy for prostate cancer including surgery, radiotherapy, and hormonal therapy.
Sexual problems, such as erectile dysfunction or ejaculation problems, may occur in men with noncancerous enlargement of the prostate . Sexual dysfunction in BPH usually results from the treatment rather than the disease. Medications for BPH, such as the antitestosterone drug and finasteride , have been associated with erectile dysfunction in 3.7% of men who use it. Finasteride is also linked with diminished libido in 3.3% men. Other medications for BPH, such as terazosin , tamsulosin , and doxazosin , can improve BPH symptoms with a lower risk of sexual side effects.
Surgical procedures for BPH, such as the transurethral resection of the prostate , are often used when medications fail. Erectile dysfunction can occur because of TURP in a small percentage of men.
Can Bph Affect Sexual Function
There has been an ongoing medical debate on whether or not BPH does actually affect sexual function. Scientists cannot explain why a large number of men who suffer from BPH eventually also develop some form of sexual problems.
Some argue that, since the majority of patients who suffer from either condition are over 50, sexual dysfunction is not actually a result of BPH, but rather just another age related condition and the two are not linked. On the other hand, some studies suggest that patients with severe benign prostatic hyperplasia are more at risk of developing problems with their sexual function.
Although science cannot prove if in fact there is an actual medical correlation between benign prostatic hyperplasia and sexual dysfunction, all will agree that the stress caused by urinary symptoms as well as some treatments used to relieve BPH symptoms can cause erectile dysfunction and other sexual side effects.
The Effects of Stress Caused by Urinary Symptoms on Sexual Function
The Effects of BPH Medications on Sexual Function
Some medications used to reduce BPH symptoms can cause difficulty in maintaining an erection. Patients have also reported experiencing a decreased libido from BPH drug treatments. Not all drug therapies will cause these symptoms and patients should speak with their doctor before making any decisions regarding medical treatment. However, BPH medication is a reported cause of impaired sexual function in men suffering from BPH.
Treatment For Erectile Dysfunction When You Have Prostate Issues
If you have prostate conditions such as BPH or prostate cancer and erectile dysfunction, there may be treatments that you can use to help regain some or all of your erectile function.â
Oral medications like Sildenafil or Tadalafil are often used as first-line treatment for erectile dysfunction. These medications work by helping to improve and enhance blood flow to the penile tissues when you are aroused. However, these medications may not be appropriate for you if you have cardiovascular problems or take certain medications like nitrates.
If oral medications do not work for you or you are not a good candidate for them, injection medications to bring blood flow to the penile area like Alprostadil or compounded âTrimixâ or âBimixâ injections may be able to help you. These medications are injected into the side of the penis before sexual activity. Injection medications are the most effective treatment for men who have ED due to prostate surgery.
An insertable urethral suppository containing Alprostadil called Muse may also help with ED in some men. If oral or injectable medications are not a good fit for you, vacuum or surgical options including a penile pump, a penile band, surgical implants, or vascular surgery may be able to help you maintain or achieve an erection. If you have a prostate condition along with erectile dysfunction, there are many potential treatment options, and your doctor can help you find the best ones for you.
Bph And Sexual Dysfunction Explained
Benign prostatic hyperplasia is a condition in which the prostate becomes so enlarged that it begins to put pressure on the urethra. When this happens, the patient begins to experience lower urinary tract symptoms , including frequent urination, urgency, incontinence, nocturia and weak urine flow. For some men, the condition worsens, causing more severe symptoms that include kidney or bladder problems and urinary retention .
Sexual dysfunction refers to persistent and recurring problems with experiencing satisfaction from sexual activity. Problems can include a decrease in sexual pleasure, a reduced sex drive and difficulty in getting or maintaining an erection .
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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 .