By Dr. Rabbiya Khan, MD | Last Review: Dec 2nd, 2018
If you’re experiencing significant bathroom problems, then chances are you are also facing difficulties in your bedroom too.The link between the two is your prostate gland… sitting in your pelvis.
This walnut-sized gland enlarges as you age and inflicts urinary as well as sexual health problems.
As you can see in this illustration, on the left is a healthy prostate and urine pours out of the tube i.e. urethra in a pretty stream.
Whereas on the right, the enlarged prostate impinges on the tube making urine dribble, sputter… even leak.
So What’s The Problem With Prostate?
Prostate enlargement, a.k.a benign prostatic hyperplasia (BPH), is increase in the size of the prostate gland under the influence of male hormone testosterone with increasing age.
The good news is it’s non-cancerous.
But this benign enlargement puts pressure on the Urethra & the Bladder (also shown in the graph above) which then leads to lower urinary tract symptoms (LUTS) like:
- Frequency: Frequent urination
- Urgency: a sudden urge to urinate immediately
- Passing urine frequently at night
- Difficulty in starting urine stream
- Weak urinary stream etc.
To make matters worse, BPH takes away your confidence, social life and sleep… But it doesn’t stop at that… as BPH deals a heavy blow to your erections too.
What Is Erectile Dysfunction?
Erectile dysfunction (ED) or impotence means inability to achieve or maintain an erection long enough to have intercourse.
If these symptoms persist for a long time, then it can be a cause of worry.
However, ED can also be caused by psychological problems, certain medications and surgery.
But How Are Prostate Enlargement and Impotence Linked?
Enlarged prostate and erectile dysfunction are intricately linked by these following 3 factors:
Aging seems to be a common denominator for both BPH and ED. Studies show that as men grow older, their chances of having BPH and ED increases.
According to the researchers, although both sexual dysfunction and BPH have independent factors, the presence and severity of ED is strongly related to both age and presence of BPH which has a significant impact on the quality of life1.
The medications prescribed for the treatment of BPH can lead to or worsen ED.
For example, alpha blockers (like Doxazocin and Terazocin) used for treating BPH can lead to ejaculation problems because of their ability to relax the smooth muscles of bladder and prostate.
Alpha reductase inhibitors which are used to limit the effects of testosterone on prostate can lead to decreased libido.
Other BPH drugs like tamsulosin, dutasteride and finasteride are also reportedly linked with ED. Hence, erectile dysfunction may also result from medical treatment of enlarged prostate2.
Conversely, ED medications, like sildenafil and tadalafil, may help improve BPH symptoms3.
Post-surgical erectile dysfunction:
If you opt to undergo surgery (TURP) to reduce the size of enlarged prostate, you are at a strong risk (50-75%) of developing retrograde ejaculation4.
Retrograde Ejaculation is a condition where semen is discharged backwards into the bladder (dry orgasm), instead of out through the urethra.
Unfortunately, it has been linked with reduced ability to perform in bed and decreased fertility.
Your BPH and ED symptoms are strongly interlinked.
Hence, if you are having trouble in bed and bathroom at the same time, its time you take the matter up with your doctor to figure out a better treatment options so you get your manhood and sleep back.
1. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, O’Leary MP, Puppo P, Robertson C, Giuliano F. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). European urology. 2003 Dec 1;44(6):637-49.
2. Rosen RC, Giuliano F, Carson CC. Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). European urology. 2005 Jun 1;47(6):824-37.
3. Egerdie RB, Auerbach S, Roehrborn CG, Costa P, Garza MS, Esler AL, Wong DG, Secrest RJ. Tadalafil 2.5 or 5 mg administered once daily for 12 weeks in men with both erectile dysfunction and signs and symptoms of benign prostatic hyperplasia: Results of a randomized, placebo‐controlled, double‐blind study. The journal of sexual medicine. 2012 Jan;9(1):271-81.
4. Kassabian VS. Sexual function in patients treated for benign prostatic hyperplasia. The Lancet. 2003 Jan 4;361(9351):60-2.