Sexual side effects in men with BPH

It’s not unusual for a man with benign prostatic hyperplasia to have it impact his sex life.  Benign prostatic hyperplasia or BPH is when a man has an enlarged prostate. Having BPH is common and more so in men who are older.  It is a noncancerous condition affecting about half of all men between the ages of 51 and 60 have BPH and up to 90% of men over the age of 80 have it. 

When the prostate enlarges this can irritate or block the bladder.  This can result in one of the most common symptoms of BPH which is the need to urinate more frequently, especially during the night.  BPH can also cause a weak urine flow, dribbling of urine, trouble starting urination, or a feeling that the bladder is full, even right after urinating.

Besides causing several problems for men with urination, BPH can also lead to sexual side effects.  Once a man is diagnosed with BPH, he may discover his sex life has or may change due to four potential side effects:

1.     Retrograde ejaculation

Men with BPH who do have bladder issues of urinary frequency will sometimes undergo a surgery called transurethral resection of the prostate or TURP.  TURP is generally a safe procedure which can help relieve these symptoms but like any medical procedure there is the potential for men to experience a side effect affecting his sex life. 

A side effect of TURP can be a condition called retrograde ejaculation.  Also called dry orgasm, retrograde ejaculation occurs when semen enters the bladder instead of the entering and exiting out of the penis.  A man will still be able to reach climax but he will ejaculate very little to no semen.  The main issue with this is sterility as without the semen being able to exit through the penis it would be very difficult to conceive a baby.

2.     Reduced libido

Usually surgical procedures for BPH do not have an effect on libido.  If there is a reduction in libido it is more likely to be caused by an oral medication for treating the symptoms of BPH such as 5-alpha-reductase inhibitors.  If that is the cause, a man should discuss with his physician about an alternative treatment method.

3.     Reduced overall sexual satisfaction

When a man has to wake up several times during the night to urinate, this can lead to sleep issues and anxiety that may result in an overall reduced satisfaction with his sex life.  Working with his physician and an understanding partner, a man can work on ways to help reduce his symptoms of BPH in order to restore better sleep and better sex.

4.     Erectile dysfunction

Another side effect of the procedure TURP some men will experience is erectile dysfunction.  This inability to achieve or maintain an erection will affect only about 5 to 10 percent of men who have TURP but it can put a halt to their sex life. 

Two common type of medication used to treat BPH, alpha-blockers and alpha-reductase inhibitors, can also lead to difficulty in maintain an erection and reduced ejaculation. 

Again, bringing this side effect up to his physician can help a man resolve it quicker than ignoring the problem. 

Treating BPH

It is important for all men over the age of 50 to have their prostate checked annually even if there are no symptoms.  A yearly physical exam along with a PSA test and a digital rectal exam can help determine if a man’s prostate is enlarging. 

There several treatment methods that can be used to reduce the symptoms a man may be having. If a man has no symptoms or if they are very mild, treatment may not be required. Treatment for BPH will depend if the prostate is continuing to enlarge and what symptoms are present. Options for treating BPH include: 

·       Active surveillance or watchful waiting. This is done if a man has few if any symptoms and the prostate enlargement is stable.

·       Medications used for controlling symptoms such as Avodart, Cardura, Uroxatral, Proscar, Cialis, and Flomax

·       Transurethral resection of the prostate (TURP). This surgery is considered to be the optimum treatment for BPH. It reduces symptoms in 80-90% of patients.

·       Transurethral needle ablation (TUNA). This procedure involves passing a scope into the urethra placing needles into the prostate gland. Radio waves pass through the needles heating and destroying excess prostate tissue blocking urine flow. 

Men with BPH who have symptoms need to work with their doctor determining which treatment option is right for them. Every man should be treated uniquely as an individual who has their own specific needs. This is not about a one-size-fits-all approach. Men deserve the very best in dealing with BPH so they can get their sex life back and live their life to the fullest.