Is prostate enlargement associated with weak libido?

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Last week I discussed “Sex, age and decline in libido”. I have about 15 people with Benign Prostatic Hypertrophy (BPH), who regularly consult me, for guidance and prescriptions. One of them pointedly asked “if prostate enlargement is associated with weak erection “

A recent research in New England Journal of Medicine, stated inter-alia that if you are above 50, all erectile dysfunction has a contributory factor from prostate enlargement, but that not all prostate enlargements lead to erectile dysfunction. Confusing isn’t it? I was confused myself until I read the body of the research. So let me paraphrase it for non medical readers. In clear terms, men with BPH, a non cancerous enlargement of the prostate may also experience erectile dysfunction and ejaculatory problems. Although BPH does not itself cause these problems on its own, but most of the people who have erectile dysfunction also have BPH.

My last week article on sex, age and decline in libido has been published for two weeks due to people’s request, majority of them above 50 wanted to know whether their weak erections were due to their enlarged prostates. One perticular man, wanted clarification from me, he said in my earlier write ups, I had stated that decrease in libido was 90% psychological. Correct, I told him, that prostate enlargement fits into the remaining 10% with associated other causes. Most of them wanted me to revisit prostate enlargement, sexual dysfunction and possibly remedial measures, since they do not want surgery.

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I know, I have discussed BPH an sexual dysfunction ad nauseam. I have also discovered over the years, that most of my patients who take alpha adrenergic blockers experience some relief both in their enlarged prostate and weak libido. Let me explain. Alpha adrenergic blockers were drugs originally used to treat high blood pressure, reduce tension of smooth muscles in blood vessel walls and relax smooth muscle tissue in prostate.

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As a result daily use of an alpha adrenergic blocker drug, may increase urinary frequency and nocturia, and improve erectile dysfunction, by increasing libido. Example of alpha adrenergic blocker is terazosin (hytrin). Most of my patients who have been on terazosin for more than 6 weeks have reported remarkable improvement, in both their prostate symptoms and sexual function. A few said they are yet to experience total relief, I told them to continue for at least, since it took years for the fibroblastic tissues of the prostate to enlarge, it will take months if not years for any drug to drastically reduce the enlargement.

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You could Google my earlier write ups on signs and symptoms of BPH, and other firms of treatment, and fill in the remaining blanks. Always be medically guided.

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