It is difficult to say if an enlarged prostate would cause erectile dysfunction (ED) or not. It will undoubtedly have some effect, so the critical question is to what extent.
The prostate is a wall nut sized gland that plays a vital role in male fertility. It produces a fluid in which male sperms can swim.
Why Could Prostate Swell?
Swelling of the prostate is a common problem, and in the medical language, it is called benign prostatic hypertrophy (BPH). It is a condition in which the prostate increases in size, but an increase is benign or noncancerous. Although, it might increase the risk of developing cancer at later stages.
The risk of swollen prostate increase with age. Men older than 50 years of age are more likely to be living with the condition. Those with a family history of prostate diseases or living with obesity and diabetes are also at higher risk.
Interestingly enough, there seems to be some connection between erectile dysfunction and swollen prostate, as the condition is more common among men complaining about ED.
Primary complains of swollen prostate are related to difficulties in urination like higher frequency, trouble starting urinating, nocturia (1).
Swollen prostate may cause pain while ejaculating. Thus, it will have an impact on sex life in multiple ways (2).
Swollen Prostate and ED
Although swollen prostate and ED may seem two unrelated and different conditions, they may frequently occur with each other. Any condition that influences the health of the lower urinary tract also increases the risk of ED. Studies show that men with lower urinary tract symptoms and swollen prostate are more likely to have ED (3).
Recent studies now show there these two conditions have more links than thought earlier. Both are more common among middle-aged men or older males. They also share many common risk factors apart form lower urinary tract symptoms like sedentary lifestyle, diabetes, metabolic disorders, vascular diseases (4).
Studies also show that surgical removal of the prostate, which is one of the treatments of swollen prostate reserved for severe cases, increases the risk of ED (5).
Medications for Swollen Prostate May Worsen Erectile Function
One of the issues faced by men treated for swollen prostate is the unexpected side effects of medications on sexual wellbeing. Few medicines used to treat swollen prostate may reduce the quality of ejaculation. It happens as they relax the bladder and surrounding muscles a bit. Thus, alpha-blockers like Cardura (doxazosin) may worsen the sexual experience.
Some of the drugs may even lower sex drive. Thus, alpha-reductase inhibitors like dutasteride or finasteride may reduce libido (6).
Some of the medications for swollen prostate may even have a negative influence on male fertility, as they might reduce sperm count.
ED Treatment and BPH
There is some good news for those diagnosed with ED and swollen prostate. Some of the commonly used medications to treat ED seems to be beneficial for prostate health too. They might not only help get a hard erection but may assist in reducing the size of the prostate, also. Drugs used to treat ED may help reduce lower urinary tract symptoms.
At present, three commonly used drugs for treating ED are Viagra (sildenafil), Cialis (tadalafil), and vardenafil (Levitra). However, not all are equally good for a swollen prostate.
Among all these medications, tadalafil (Cialis) requires a special mention, as it is now the first drug used to treat ED that is also approved for daily use and for treating swollen prostate. Tadalafil may even help when taken at a lower dosage of 5 mg daily. It might be used alone or in combination with more potent medications (7).
Some studies suggest that in many cases, tadalafil may be as good as medications specifically recommended for BPH. Thus, in one of the clinical trials in men older than 45 years of age, 172 men received a placebo, 171 got 5 mg tadalafil daily, and the third group of 168 men received tamsulosin. After 12 weeks of therapy, those on tamsulosin or tadalafil benefited greatly, and only the tadalafil group reported improved erectile function (8).
Physiotherapy May Help With Swollen Prostate and Is Suitable for ED Too
One of the right ways to get rid of swollen prostate and irritating lower urinary tract symptoms is to consider physiotherapy. Since it does not involve the use of any medications, it is safe and can help improve erection quality too.
One of the most commonly used Kegel exercises for the pelvic floor may be suitable for both prostate health and improving the quality of erection. It is also a good idea to do Kegel exercises with a female partner as they are ideal for both the genders.
To conclude, swollen prostate can influence the quality of sex life certainly, though it may not impact the quality of erectile function in all the cases. Both conditions share many common underlying causes.
It is worrisome that some of the medications used to treat swollen prostate are bad for male fertility and erectile function. Thus, anyone living with erectile dysfunction must share this information with the treating doctor so that the specialist may choose the right drug therapy.
The good news is that some of the medications used to treat erectile dysfunction are also quite good for a swollen prostate. Thus, medicines like tadalafil/Cialis may not only help get a hard erection but may also improve lower urinary tract symptoms related to an enlarged prostate.