Prostate enlargement and erectile dysfunction ED are separate problems. Both increase with age, but one causes problems in the bathroom and the other in the bedroom. However, the two are somewhat linked. Certain treatments that relieve enlarged prostate can cause ED and other sexual side effects. On the other hand, treating ED can improve enlarged prostate symptoms.
Moms and daughters sucking cock. Effects of an enlarged prostate
Several treatment options may help reduce the severity of enlarged prostate symptoms. 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. Read labels. Xxxbetty Veronica. Here are five yoga poses to help you relieve symptoms of prostate enlargement BPH. Enlarged sex what the research says. It can cause Enlarged sex urges to urinate, urinary frequency, inability to empty the bladder, or a weak urine stream. Treatment involves identifying and controlling the cause Voldemort doujinshis the condition. Week of Delight A week's fun with two older ladies at the cottage. Learn more about this procedure.
It's not unusual for a man with benign prostatic hyperplasia to have issues of it impacting his sex life.
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- Prostate enlargement, also known as benign prostatic hyperplasia BPH , and erectile dysfunction ED are separate problems.
- An enlarged liver is one that's bigger than normal.
Nor is the inability to have another erection soon after an orgasm. Nearly every man occasionally has trouble getting an erection, and most partners understand that. The problem often develops gradually. One night it may take longer or require more stimulation to get an erection. On another occasion, the erection may not be as firm as usual, or it may end before orgasm.
Erectile dysfunction can have many causes, including some forms of prostate disease and medications and surgery for prostate cancer. Fortunately, in many cases, this problem can often be effectively addressed. Some men find relief by taking medications to treat erectile dysfunction. The possibility of finding the right solution is now greater than ever. This article explores why men may develop erectile dysfunction as a consequence of some prostate diseases, and details the current treatment options to restore sexual functioning.
At its most basic level, an erection is a matter of hydraulics. Blood fills the penis, causing it to swell and become firm. But getting to that stage requires extraordinary orchestration of body mechanisms. Blood vessels, nerves, hormones, and, of course, the psyche must work together. Problems with any one of these elements can diminish the quality of an erection or prevent it from happening altogether.
Nerves talk to each other by releasing nitric oxide and other chemical messengers. These messengers boost the production of other important chemicals, including cyclic guanosine monophosphate, prostaglandins, and vasoactive intestinal polypeptide.
These chemicals initiate the erection by relaxing the smooth muscle cells lining the tiny arteries that lead to the corpora cavernosa, a pair of flexible cylinders that run the length of the penis see Figure 1. The penis is made up of three cylindrical bodies, the corpus spongiosum spongy body —which contains the urethra and includes the glans head of the penis—and two corpora cavernosa erectile bodies , that extend from within the body out to the end of the penis to support erection.
Blood enters the corpora cavernosa through the central arteries. As the arteries relax, the thousands of tiny caverns, or spaces, inside these cylinders fill with blood.
Blood floods the penis through two central arteries, which run through the corpora cavernosa and branch off into smaller arteries. The amount of blood in the penis increases sixfold during an erection. The blood filling the corpora cavernosa compresses and then closes off the openings to the veins that normally drain blood away from the penis. In essence, the blood becomes trapped, maintaining the erection. As most people know, testosterone is important to the erection process.
Certainly, a man needs a normal level of this hormone to start and maintain an erection. Some signal — usually an orgasm, but possibly a distraction, interruption, or even cold temperature — brings an erection to an end.
This process, called detumescence, or deflation, occurs when the chemical messengers that started and maintained the erection stop being produced, and other chemicals, such as the enzyme phosphodiesterase 5 PDE5 , destroy the remaining messengers. Blood seeps out of the passages in the corpora cavernosa. Once this happens, the veins in the penis begin to open up again and the blood drains out.
The trickle becomes a gush, and the penis returns to its limp, or flaccid, state. A young, sexually active man in good health may be able to get an erection after just a few minutes, whereas a man in his 50s or older may have to wait 24 hours. One reason may be that nerve function slows with age. Indeed, erections may work on a use-it-or-lose-it principle. Some research suggests that when the penis is flaccid for long periods of time — and therefore deprived of a lot of oxygen-rich blood — the low oxygen level causes some muscle cells to lose their flexibility and gradually change into something akin to scar tissue.
In the past, it was thought that most cases of erectile dysfunction were psychological in origin, the result of such demons as performance anxiety or more generalized stress. Such conditions include diabetes, kidney disease, multiple sclerosis, atherosclerosis, vascular disease, and alcoholism.
However, some types of prostate disease and treatments particularly for prostate cancer may also be responsible. A sudden onset of erectile dysfunction may be a sign that a man has prostate cancer, so your doctor will likely order a prostate-specific antigen PSA test and do a digital rectal exam during the diagnostic workup to assess this possibility. Surgery for prostate cancer can sever some of the nerves or arteries that are needed for an erection.
Even so-called nerve-sparing surgical techniques lead to erectile dysfunction in up to half or more of all cases. Even when the nerves are not permanently impaired, it can still take six to 18 months for the tiny nerve fibers to recover from the trauma of surgery and restore sexual function. Radiation treatment for prostate cancer can also harm erectile tissues.
Both external beam radiation and radiation-emitting seeds implanted in the prostate brachytherapy lead to erectile dysfunction in about half of men who receive these therapies. However, these changes may not occur for up to two years after treatment. Erectile dysfunction is sometimes a side effect of some hormone therapy medications prescribed for men with prostate cancer that has spread beyond the prostate. Among such hormone-based medications are leuprolide Lupron , and goserelin Zoladex.
Others, such as flutamide Eulexin and bicalutamide Casodex may cause erectile dysfunction to a lesser degree. Even prostate cancer itself, in its advanced stages, can spread to the nerves and arteries that are necessary for an erection. Many men who have benign prostatic hyperplasia BPH , a noncancerous enlargement of the prostate, also experience erectile dysfunction and ejaculatory problems. For example, finasteride Proscar , an antitestosterone drug prescribed for BPH, has been linked to erectile dysfunction in 3.
But alpha blockers such as terazosin Hytrin , tamsulosin Flomax , and doxazosin Cardura can improve the symptoms of BPH with a lower risk of sexual side effects. Transurethral resection of the prostate, a surgical technique often used when medication fails, also causes erectile dysfunction in a small percentage of men.
Because testosterone helps spark sexual interest, one might assume that low levels of the hormone are to blame for erectile dysfunction. This inflammation of the prostate gland can be either acute usually caused by a bacterial infection or chronic usually not caused by an infectious agent. Symptoms include pain during urination, more frequent urination, and — possibly — a discharge from the penis or fever.
Severe prostatitis can cause erectile dysfunction directly. In milder forms, the condition can produce painful ejaculation, which can certainly interfere with sexual pleasure and may lead to erectile dysfunction. Your doctor may prescribe antibiotics to treat the problem, but it can take several weeks for the infection to clear and for normal erections to return.
Such a conversation is never easy, but thanks in part to greater publicity about this problem and its treatment, many obstacles have been toppled. In reality, your doctor must diagnose the cause of your erectile dysfunction in order to recommend an effective treatment. While therapy usually does involve medication, erectile dysfunction is sometimes a symptom of an underlying condition that requires its own treatment.
Also, medication is more effective for some causes of erectile dysfunction than for others. And if a psychological condition is significantly involved, you may benefit from counseling with a mental health professional trained in sex therapy. At first, the doctor will probably ask you about your medical history.
Do you have any chronic illnesses? What illnesses and operations have you had in the past? What medications are you taking, if any? Your doctor is also likely to ask about your psychological well-being and lifestyle: Do you suffer or have you ever suffered from depression? Are you under a lot of stress? Do you drink alcohol? Use illegal drugs? Have you felt a loss of affection for your partner?
Have you recently grown interested in a new partner? As part of this health history, be prepared to tell your doctor specific details about the symptoms that brought you to the office and when they began. Your doctor may conduct a written or verbal screening test. If the cause is clear — a recent operation for prostate cancer, for example — the conversation may move directly to your treatment options.
Otherwise, you may need to answer more questions to help the doctor narrow down the possible causes and avoid unnecessary testing. A key issue is whether the symptoms came on gradually or suddenly. Erectile dysfunction that comes on gradually often points to causes that involve blood flow or nerves. On the other hand, a sudden loss of sexual desire or the ability to have erections usually suggests that a medication or psychological difficulty, such as depression or stress, may be to blame.
The ability to do so is an important clue in determining whether the problem is psychologically or physically based see Table 1.
The physical exam for diagnosing the cause of erectile dysfunction usually takes about 10—15 minutes. The doctor will listen to your heart for signs of a murmur and other abnormalities that can affect blood flow. He or she will also take your blood pressure; both high and low blood pressure can impair blood flow. The doctor will check your pulse in several places — at the wrist, ankle, and groin.
Slow or low pulse in any of these areas can mean that not enough blood is reaching tissues in the extremities, including the penis. In addition, the doctor will examine your testicles, penis, and chest.
Abnormally small testicles and enlarged breasts are sometimes signs of inadequate testosterone. Your doctor may check the prostate gland for signs of infection or cancer, by doing a digital rectal exam. Your doctor may also test for neurological problems by checking the reflexes in your legs, groin, and anus.
Your checkup will probably include tests for cholesterol to assess your risk of cardiovascular disease and triglyceride and blood sugar levels to check for diabetes. The doctor might also ask for a urine specimen because the presence of blood could be a sign of a urologic disease, such as bladder cancer. Now that medication can successfully treat most men with erectile dysfunction, many once routine diagnostic tests are used only when the doctor suspects the patient has an underlying problem requiring additional treatment.
Hormone tests. Checking testosterone levels used to be one of the first tests ordered for men with erectile difficulty, but that was before doctors realized that testosterone deficiency was rarely the source of the problem. Now, hormone testing is done for men whose medical exams suggest an endocrine problem and for those who have experienced a loss of sexual desire. Your doctor also may want to check your blood levels of prolactin a pituitary hormone that can block the action of testosterone or thyroid—stimulating hormone a good indicator of an under-active or overactive thyroid gland.
Femdom Fetish. In an eight-week trial, men who took 10 mg of vardenafil twice daily showed significant improvement in prostate symptoms compared with men who took a placebo. This helps to increase blood flow to the penis. Both increase with age, but one causes problems in the bathroom and the other in the bedroom. Story Tags Portal swollen pussy.
Enlarged sex. Effects of an enlarged prostate
It’s Complicated: Enlarged Prostate and Sex
Whether you're single or in a relationship, and whatever your sexuality, we hope you will find this helpful. If you're a partner of a man with prostate cancer you may also find it useful. There's also more information in our How to manage sex and relationships guide. Prostate cancer can affect your sex life in three overlapping ways - your mind, body and relationships. Treatment can damage the nerves and blood supply needed for erections. Hormone therapy can affect your desire for sex.
When you're sexually aroused turned on your brain sends signals to the nerves in your penis. The nerves then cause blood flow in to your penis, making it hard.
Anything that interferes with your nerves, blood supply or desire for sex libido can make it difficult to get or keep an erection. You may hear this called erectile dysfunction or impotence. Hormone therapy can also lower your desire for sex and the lack of activity means your penis will stop working so well. Certain medicines, feeling low or anxious and lifestyle factors such as smoking, drinking too much alcohol or being overweight can also cause erection problems.
A group of drugs called PDE5 inhibitors phosphodiesterase type 5 inhibitors could help you get an erection. These include:. You need to be sexually aroused for the tablets to work. The tablets normally start to work about 30 minutes to an hour after taking them. You can take sildenafil, avanafil and vardenafil when you need to.
They will keep working for four to six hours or up to eight hours for vardenafil. So if they work you should be able to get an erection if you're sexually aroused during that time. You can take tadalafil when you need to. It can work for up to 36 hours so it lets you be more spontaneous.
Or your doctor may suggest you take a low-dose 5mg tadalafil tablet every day. If you have a heart problem or take nitrates ask your doctor or specialist about other ways to treat erection problems. Erection problems can also be treated with drugs using an injection that you give yourself. Your nurse or doctor will show you how to inject the side of your penis with a very thin needle. The erection will last for up to an hour. With the pellet, it helps if your urethra, which is the tube you urinate through, is already moist, so urinate first.
With the cream, you or your partner can rub in any cream that's left on the tip and massage your penis to help it absorb the drug. If the pellet works you should get an erection within minutes which lasts for up to an hour.
The cream may take a little longer to work. You use a pump and a plastic cylinder to create a vacuum which makes the blood flow into your penis.
This can give you an erection. After using the pump to get an erection, you slip a constriction ring from the end of the cylinder around the base of your penis. This stops most of the blood escaping when you remove the pump. You shouldn't wear the ring for longer than 30 minutes at a time.
The vacuum pump can be an effective way to get an erection hard enough for penetration. It may also help maintain the length and thickness of the penis if used regularly and soon after surgery. This involves having an operation to put an implant inside your penis.
Although it sounds quite off putting, it can be a good option if other treatments haven't worked. There are two main types:. Because getting an erection also relies on your thoughts and feelings, tackling any worries or relationship issues as well as having medical treatment for erection problems, often works well. Keeping a healthy weight , stopping smoking and doing pelvic floor exercises may help improve your erections.
Your GP, hospital doctor or nurse can prescribe treatment for erection problems for free on the NHS, whether it's for sex or masturbation. There may be a limit on how much treatment they can prescribe, but there is no age limit. It can be difficult talking about sex, but talking to your doctor, nurse or other health professional will mean you can get treatment and support.
You can ask about sexual problems at any stage - before, during or after your prostate cancer treatment. Talking about it before your treatment will mean you know what to expect and can help you to prepare to start treatments for sexual problems soon afterwards. Your team should ask you about your erections and sex life during your treatment for prostate cancer. But if they don't then you may need to bring it up yourself. Not everyone is used to talking about sex.
You might need to bring it up more than once, or with a different person in your team. You can also ask to be referred to an expert in sexual problems or an ED clinic - they will be used to talking about sexual problems.
This is because some types of hormone therapy lower your testosterone levels, which is what gives you your sex drive. Read more about how hormone therapy affects you. If you're on long-term hormone therapy, ask your doctor or nurse about intermittent hormone therapy. This is where you stop hormone therapy when your PSA level is low and steady, and start it again if it starts to rise.
Your desire for sex may improve after hormone therapy is stopped, but this can take several months. You might want to try treatments for erection problems, even if your sex drive is low. Some of the treatments for erection problems may still work for you. Your thoughts and feelings If you are feeling stressed or down then you may have less interest in sex. Tiredness All treatments for prostate cancer can cause tiredness fatigue. This can be during and after treatment.
If you're feeling very tired - you may lose interest in sex or not have enough energy for it. Other side effects Other side effects of prostate cancer treatments such as urinary and bowel problems can affect your sex life. Physical changes caused by hormone therapy, such as weight gain or breast swelling, may make you feel embarrassed and less interested in sex.
Some men notice that their penis is shorter after surgery radical prostatectomy. Some men notice other changes such as a curve in their penis or a narrower area. We don't know for certain why these changes happen, but it could be because of low oxygen levels in the penis, caused by not having erections.
Other treatments such as hormone therapy with radiotherapy may also cause changes to the size of your penis. Encouraging blood flow to the penis after surgery may help prevent this.
In particular, using a vacuum pump, either on its own or with PDE5 inhibitor tablets could help maintain your penis size and improve erections. Although you may not be ready or recovered enough for sex, you can still start treatment for erection problems in the weeks immediately after surgery. It could be taking a low-dose PDE5 tablet once a day or using a vacuum pump, or sometimes both together.
The treatment along with masturbation encourages blood flow to the penis. This can help keep your penis healthy. You may hear this called penile rehabilitation. Think of it in the same way as having physiotherapy if you had injured your arm or leg.
Starting treatment soon after surgery may help improve your chance of getting and keeping an erection.
But it may not work for every man. After prostate cancer treatment you will still have feeling in your penis and you should still be able to have an orgasm, but this may feel different from before. Some men lose the ability to orgasm, especially if they're on hormone therapy. If you've had radical prostatectomy , you will no longer ejaculate when you orgasm.
This is because the prostate and seminal vesicles, which make some of the fluid in semen, are both removed during the operation. Instead you may have a dry orgasm - where you feel the sensation of orgasm but don't ejaculate. Occasionally, you might release a small amount of liquid from the tip of your penis during orgasm, which may be fluid from glands lining the urethra.
With radiotherapy, brachytherapy and HIFU you may also notice a small amount of blood in the semen. This usually isn't a problem but tell your doctor or nurse if this happens. Some men on hormone therapy say their orgasms feel less intense. This is where the semen travels backwards into the bladder when you orgasm, rather than out through your penis. The semen is then passed out of the body when you next urinate.
It isn't harmful and shouldn't affect your enjoyment of sex but it may feel quite different to the orgasms you're used to. Some men leak urine when they orgasm, or feel pain.
Others find they don't last as long during sex and reach orgasm quite quickly. After prostate cancer treatment you might not be able to have children naturally.
With radiotherapy or brachytherapy you may produce less fluid when you ejaculate but you may still be fertile.