Navigating the Sexual Side Effects of an Enlarged Prostate
By Dr. David Samadi
As men age, one of the most common anatomical changes they experience is the growth and enlargement of their prostate gland. This change has a name – benign prostatic hyperplasia (BPH). While noncancerous, BPH can significantly affect quality of life, including a man’s sexual health.
BPH is a prevalent condition, impacting about half of men aged 51–60 and as many as 90% of men over 80. As the prostate grows, (an enlarged prostate can grow to be over three times the normal size, or more than 80 grams, approaching the size of either an orange or a baseball), can cause urinary symptoms including frequent nighttime urination, weak urine flow, difficulty starting urination, and the sensation of an incompletely emptied bladder. But beyond these physical inconveniences, BPH can also result in notable sexual side effects. Here’s how this condition may affect a man’s sex life and what can be done about it.
Retrograde Ejaculation
Men with BPH may require treatment to alleviate bladder issues, such as urinary frequency. A standard surgical procedure, transurethral resection of the prostate (TURP), is often effective but comes with potential side effects. One of these is retrograde ejaculation, also known as a “dry orgasm.”
Retrograde ejaculation means semen flows into the bladder instead of exiting through the penis during climax. While retrograde ejaculation doesn’t typically impact the ability to achieve orgasm, it can cause infertility and affect a man’s overall sexual experience. Men experiencing this should discuss fertility concerns and alternative treatment options with their healthcare provider.
Reduced Libido
Although surgical treatments for BPH rarely diminish sexual desire, certain oral medications, such as 5-alpha-reductase inhibitors, may lower libido in some men. If a man notices a decrease in sexual desire while taking these medications, he should consult his doctor about alternative therapies that might better suit his needs.
Reduced Overall Sexual Satisfaction
Frequent nighttime trips to the bathroom not only disrupt sleep but can also dampen overall sexual satisfaction. Men whose sleep is disrupted nightly, can quickly be feeling fatigued, irritable, and reduced interest in intimacy. By working closely with their physician and communicating openly with their partner, men can explore strategies to manage BPH symptoms, restore restful sleep, and enhance their sexual satisfaction.
Erectile Dysfunction
For some men, TURP may result in erectile dysfunction (ED), though this outcome is relatively rare, affecting about 5–10% of patients. Medications for BPH, such as alpha-blockers and 5-alpha-reductase inhibitors, can also contribute to erectile difficulties or reduced ejaculation.
Addressing these concerns with a healthcare provider promptly is essential. In many cases, adjusting treatment or incorporating ED therapies can help resolve the issue and restore confidence.
Managing BPH and Its Impact on Sexual Health
Living with BPH doesn’t mean resigning yourself to its symptoms indefinitely. Numerous treatment options, from lifestyle adjustments to medications and minimally invasive procedures, can help manage the condition effectively.
Simple changes such as increasing physical activity, improving dietary habits, and reducing caffeine and alcohol intake may alleviate symptoms. Medications or procedures tailored to the severity of the condition can also provide relief while minimizing the impact on sexual health.
The key is open communication, both with healthcare providers and with partners. By addressing these issues early, men can maintain their health and quality of life.
If you’re experiencing symptoms of BPH or its associated sexual side effects, don’t hesitate to seek medical advice. With the right approach, it’s possible to regain control over your symptoms and enjoy a fulfilling life.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of Prostate Cancer, Now What? and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911.