Categories
Enlarged Prostate

BPH Medications and Sexual Dysfunction: Something to Consider

Some treatment methods for an enlarged prostate can increase problems with sexual dysfunction, and in some cases, even cause them.

Though prescription drugs are often very good at improving the symptoms of Benign Prostate Hyperplasia- such as urinary issues, they can come with their own set of problems. Because of this, some men may resort to surgery, however, that too comes with its risks regarding sexual function.

Some surgical procedures for men with an enlarged prostate can increase the risk of inadvertently damaging structures around the penis which can lead to erectile dysfunction and other problems.

But before we get to that, let’s take a look at some of the common BPH medications and the effect they can have on sexual health.

We’ll start with the commonly prescribed 5-Alpha reductase inhibitors and the impact these medications that are used to shrink the prostate and reduce BPH symptoms can have on sexual health.

5-Alpha reductase inhibitors show promising results in their ability to shrink the prostate and reduce benign prostate hyperplasia symptoms.

These medications work by inhibiting the 5-alpha reductase enzyme from converting some of the body’s testosterone into dihydrotestosterone- which can cause further prostate growth. Unfortunately, one of the most common side effects of 5-alpha reductase inhibitors is sexual problems.

Several clinical trials have looked at the problem of side effects caused by the 5-alpha inhibitor finasteride, also known by the brand name Proscar.

These studies found that sexual adverse effects occur at the rates of 2.1% to 3.8%, erectile dysfunction (ED) being the most common, followed by ejaculatory dysfunction and loss of libido.

Another common 5-alpha reductase inhibitor, dutasteride (Avodart), has neem known to cause a multitude of adverse effects concerning sexual function. 3.4 to 15.8% of men treated with dutasteride experience erection problems, loss of libido, and reduced semen volume.

Most of these sexual issues caused by 5-alpha inhibitors are believed to be due to their effect on decreasing levels of dihydrotestosterone which is a natural sex hormone and is essential for normal sexual function.

Another type of medication that is commonly prescribed to treat the symptoms of an enlarged prostate is alpha-blockers.

Alpha-blockers, such as tamsulosin ( Flomax) doxazosin (Cardura), and terazosin (Hytrin) work by relaxing the bladder neck, and prostate muscles. Unfortunately, they can also cause erectile issues such as decreased ejaculation. Men who take these medications may also experience lower sperm count, decreased sperm volume, and lower sperm movement.

According to a 2008, Cochrane systematic review that looked at the sexual side effects of Flomax for BPH, 63% of users reported some form of side effect from the medication. The side effects of tamsulosin that were reported the most included erectile dysfunction, reduced libido, and something called retrograde ejaculation or a dry orgasm- where the semen exits into the bladder rather than out of the penis.

Combination medication therapies, such as dutasteride and tamsulosin ( brand name Jalyn), can also cause sexual problems.

Clinical trials found that the most common adverse reactions reported were impotence, decreased libido, breast disorders (including breast enlargement and tenderness), ejaculation disorders, and dizziness.

In fact, studies have found that ejaculation disorders occurred significantly more in subjects receiving coadministration therapy (11%) compared with those receiving dutasteride (2%) or tamsulosin (4%) as monotherapy.

The Bottom Line:  Issues with sexual dysfunction that are caused by certain BPH treatment medications should be taken into consideration.

These issues can be very upsetting and have a detrimental effect on a man’s private life and relationships. Therefore it’s important to discuss any risk of sexual problems that can come alongside your preferred treatment method for BPH.

There are many options out there for treating an enlarged prostate, so it’s important to be open and honest about your concerns and work with your doctor to find the best treatment option with the lowest risks of sexual side effects, such as Prostate Artery Embolization.

To learn more about this state-of-the-art procedure, please call and set up a consultation today.

Categories
Enlarged Prostate

Phenoxybenzamine: A Permanent Solution?

Other alpha-blockers, cause a return of symptoms once the medication is discontinued, however, the effect of phenoxybenzamine is permanent.

Phenoxybenzamine was one of the first alpha-blockers studied for its ability to reduce some symptoms of an enlarged prostate.

As a non-specific alpha-blocker, early studies reported that phenoxybenzamine successfully relaxes the urethra and reduces the frequency of urination in patients with BPH.

Though lower doses of phenoxybenzamine may be used to relieve bladder obstruction before surgery, it is rarely used in the treatment of BPH due to its adverse effects.

Some of the side effects and risks of using phenoxybenzamine are:

– stuffy nose
– mild dizziness or drowsiness
– blurred vision
– trouble having an orgasm
– upset stomach
– tired feeling.
– impotence
– ejaculatory dysfunction
– fainting
– fast heartbeat
– vomiting

Phenoxybenzamine also carries the potential risk for irregular absorption and mutation, which can cause adverse effects and permanent damage.

Another downside to phenoxybenzamine is that, just like the other alpha-blockers, phenoxybenzamine does not reduce the size of an enlarged prostate, but rather treats some of the urinary symptoms. However, there is a class of medications that can shrink the prostate itself. These medications are known as 5-alpha-reductase inhibitors.

Medication is not for everyone, and many find that a non-invasive procedure such as Prostate Artery Embolization, which we specialize in here at MidAtlantic Vascular and Interventional is a better fit.

However, medication is still worth being knowledgeable about, especially if your provider has suggested it as part of your treatment plan. It’s important to know what these medications do, as well as their benefits and their risks.

In our next article, we will continue our look into medications that are used to treat the symptoms of BPH, by focusing on the use of 5-alpha-reductase inhibitors in the treatment of an enlarged prostate.