Prostate Issues and ED: Myths & Misconceptions

Many people assume that if a man develops prostate issues, he's likely to face problems with erectile dysfunction (ED). But the truth is there are numerous misunderstandings regarding ED and prostate problems. 

Let's take a look at some of the main contenders and debunk them.

Myth: Prostate cancer treatment always results in ED.

Reality: Some modern treatment options can significantly reduce the chances of long-term ED.

As the second most commonly diagnosed type of cancer in men, prostate cancer has been studied from every angle for decades and treatment methods have evolved as a result of all that research. 

• Radiation: It's true that men who undergo radiation therapy for prostate cancer may suffer damage to delicate blood vessels and nerves that can cause increased erectile dysfunction. However, according to the Prostate Cancer Foundation, radiation therapy has less impact than surgery on erectile function during the first five to 10 years following treatment. What's more, some 70 percent of men who have a baseline level of erectile function prior to radiation treatment will retain that function afterward. 
• Surgery: Since the 1980s, "nerve-sparing" prostatectomy has been the goal. Surgeons take care to avoid severing the delicate nerves associated with erectile response while removing the prostate and the seminal vesicles. A small number of patients retain the same function as before surgery, but that is relatively uncommon. Unfortunately, most men have worsening function, if not complete loss, even with a nerve-sparing procedure, and doctors make every effort to set appropriate expectations. 
• Early treatment: For cancers that are spotted and treated early, it's easier to spare the nerves during surgery, which creates better chances of healthy, ongoing erectile function. Surgeons working on men with advanced, high-risk cancer might have a harder time sparing the nerves because the cancer cells may have spread beyond the nerves or even the prostate itself, resulting in worse outcomes for erectile function after surgery.

In addition, cases of low-grade prostate cancer can be observed rather than treated, which means  less interruption and complication to your sex life. 

Myth: A noncancerous enlarged prostate causes ED.

Reality: Both benign prostatic hyperplasia (BPH) and erectile dysfunction occur in men as they get older, but the two conditions are not related.

BPH is a common condition in men over age 50, causing symptoms including a weak urine stream, difficulty starting the urine stream, a frequent need to urinate, and an inability to empty the bladder.

A few risk factors for BPH do align with those for ED, including aging, diabetes, heart disease, obesity and lack of exercise. The two conditions also have some ties through medications. Silodosin and Tamsulosin (better known by their respective brand names, Rapaflo and Flomax) are common BPH medicines and both can cause retrograde ejaculation, though they do not affect erections. Other products, such as dutasteride and finasteride, shrink the prostate and can decrease the ejaculate volume, but may cause some degree of erectile dysfunction.

Taken all together, these commonalities show that any link between BPH and ED is due to secondary factors, not the conditions themselves.

Conclusions

Prostate problems are common, especially as men age. But there's no reason to assume that BPH, or even prostate cancer, signals the decline of your sex life. 

Talk with your doctor about available options if you've been diagnosed with either condition and get tested as is appropriate for your age and other factors.