Many men notice changes in both urinary habits and sexual performance as they age. This can lead to questions about how these issues may be connected. One common concern is: Can BPH cause impotence?
Benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) are distinct conditions. However, they often appear together. They may share symptoms and treatments for one can influence the other.
Here's what you need to know about BPH and ED.
What is BPH?
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. The prostate sits just below the bladder and surrounds the urethra, the tube that carries urine out of your body. As the prostate grows, as it often does with age, it can press against the urethra and interfere with urine flow.
Common symptoms of BPH include:
- A weak or slow urine stream
- Difficulty starting urination
- Frequent urination, especially at night (nocturia)
- A feeling that the bladder doesn't empty completely
- Sudden urges to urinate
- Dribbling at the end of urination
While these symptoms can become disruptive, BPH is not cancer. It requires treatment only when symptoms become bothersome.
What is Impotence?
Impotence is an older term for erectile dysfunction (ED). ED refers to difficulty achieving or maintaining an erection firm enough for sexual activity. Occasional trouble with erections is common and not a cause for concern. However, persistent ED can be frustrating and unsettling. Men with ED may experience:
- Trouble getting or keeping an erection
- Reduced interest in sex
- Anxiety around sexual performance
ED can result from many causes, including:
- Poor blood flow
- Nerve damage
- Hormonal imbalances
- Certain medications
- Mental health concerns
Chronic and underlying medical conditions like diabetes, high blood pressure, and heart disease are also closely linked.
Does BPH Cause Impotence?
BPH and ED often occur together in older men. This overlap may be due to shared risk factors such as:
- Age
- Having a higher body weight
- Vascular disease
- Chronic urinary symptoms
In addition, the treatments for BPH, particularly medications and procedures, can play a role in sexual function.
Some common BPH medications, like finasteride or dutasteride, may reduce libido. They can also cause difficulty with erections or ejaculation.
Most BPH treatments aim to minimize sexual side effects. But some procedures, especially those that involve heat or cutting tissue near the prostate, can affect nearby nerves. These nerves are often involved in achieving an erection. If they are damaged, it can lead to ED.
Procedures like TURP or laser therapies can sometimes lead to temporary or, rarely, long-term ED. Other approaches, like UroLift or Rezūm, are designed to preserve sexual function and may be better suited for men concerned about ED.
Treating BPH and ED Together
When both conditions occur together, your urologist can help build a treatment plan that addresses both urinary and sexual symptoms without making one worse. This might mean carefully choosing medications or selecting procedures that reduce the risk of ED.
BPH treatment options may include:
- Lifestyle changes like cutting back on evening fluids, limiting caffeine and alcohol
- Prescription medications
- Minimally invasive therapies such as Rezūm water vapor therapy or UroLift, which relieve obstruction with minimal downtime
ED treatment options may include:
- Oral medications like sildenafil or tadalafil, which improve blood flow to the penis
- Vacuum erection devices that use suction to help achieve an erection
- Penile injections or urethral suppositories when pills aren't effective
- Penile implants, which are a surgical option for men with severe or treatment-resistant ED
If you have both BPH and ED, some treatments can address both. For instance, tadalafil is approved to treat both BPH and ED in one medication.
When to Talk to a Urologist
Many men are hesitant to talk about urinary or sexual symptoms, but both are common and treatable. Seeing a urologist can help you sort out the root cause of your symptoms. They can also help you choose a treatment that aligns with your lifestyle and goals.
BPH and ED are not the same condition, but they frequently appear in the same phase of life. Treatments for one may impact the other, so personalized care is essential. A urologist can provide this balance as they have extensive training in both areas.
Don't continue to wonder, "Can BPH cause impotence?" - schedule an appointment today!