Important for the Bedroom & the Bathroom

Prostate enlargement and erectile dysfunction (ED) are separate issues that men can suffer from. One causes problems in the bathroom and the other in the bedroom. However, the two are somewhat linked.

Certain treatments that relieve an enlarged prostate can cause ED and other sexual side effects. On the other hand, treating ED can often improve enlarged prostate symptoms.

Prostate enlargement can interfere with urination. It can cause sudden urges to urinate, urinary frequency, inability to empty the bladder, or a weak urine stream. A surgery called transurethral resection of the prostate (TURP) can help relieve these symptoms. Unfortunately, men who have this procedure often experience sexual side effects after surgery.

Disturbingly, between 50% and 75% of men who have this surgery experience retrograde ejaculation. This means that semen released during orgasm enters the bladder rather than exiting the penis. Retrograde ejaculation, sometimes called dry orgasm, is not harmful but can impair male fertility. Some men who have the TURP procedure also experience erectile dysfunction.

Many drugs used to treat BPH can cause difficulty in maintaining an erection. Men who take alpha blockers, which relax bladder and prostate muscle cells, may experience decreased ejaculation. 5-alpha reductase inhibitors can also cause erectile dysfunction.

Diminished sex drive is a potential side effect of the BPH medications dutasteride (Avodart) and finasteride (Propecia), which are both alpha reductase inhibitors. About 3% of men who took dutasteride experienced a drop in libido. With finasteride, the incidence of low libido was a little higher.

Men who take these medications may also experience lower sperm count, decreased sperm volume, and lower sperm movement. The drug combination of dutasteride and tamsulosin is associated with low libido in 4.5 percent of men who take it.

Medications that treat erectile dysfunction may help alleviate BPH. The ED drugs sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) have all been shown to reduce BPH symptoms. However, they aren't currently approved to treat BPH.

Men with BPH should avoid, when they can, the many medications for colds and allergies that contain decongestants, like pseudoephedrine, sold as Sudafed. These drugs, known as adrenergics, can worsen urinary symptoms by preventing muscles in the prostate and bladder neck from relaxing, preventing urine an easy release. Antihistamines, such as diphenhydramine (Benadryl), can also slow urine flow in some men with BPH.

Men who are taking diuretics, which increase urination, may want to talk to their doctor about reducing the dosage or switching to another drug. These are important drugs for many people with high blood pressure, with a proven track record of saving lives. No one should go off these medications without medical supervision.

Erectile dysfunction medications lower your blood pressure. If you also take doxazosin or terazosin to manage symptoms of enlarged prostate, talk with your doctor about timing the dosages of your medications.

Doxazosin and terazosin are alpha-1 blockers, which also lower blood pressure. Your doctor may recommend taking the ED and BPH medications at different times of day to avoid dizziness or a steep drop in blood pressure.

Although modern medicine has many solutions for men with BPH, most are full of potential side effects. Prescriptions drugs for prostate issues can also lead to loss of sex drive, erectile dysfunction and a decrease in semen volume. In rare instances, it can even cause a man's breasts to enlarge.

Early symptoms of prostate problems may take many years to become bigger problems. In most cases, these symptoms may point to an enlarged prostate, but they may also be a sign that other, more serious conditions that require prompt attention. If you are experiencing these early symptoms, it is a good time to see your doctor.

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