Prostate Treatments May Have Sexual Side Effects, But Patients Not Always Aware
Some treatments for an enlarged prostate and related urinary symptoms have sexual side effects. However, doctors don’t always let patients know about them, according to a recent survey.
The medical term for an enlarged prostate is benign prostatic hyperplasia (BPH). As men get older, their prostate gland grows inward. For some men, the process causes urinary problems, since the enlarged tissue squeezes the urethra.
Unfortunately, some treatments have sexual side effects. For example, men who take medications called 5α-reductase inhibitors (5-ARIs, such as dutasteride and finasteride) may have trouble with erections or ejaculation. Their sex drive can decrease, too. Men who have surgery for BPH might develop retrograde ejaculation, when semen travels backward into the bladder instead of forward out of the penis.
For the study, researchers surveyed 245 healthcare providers who were attending the 2015 World Congress of Endourology in London. Eighty-one percent of the respondents were urologists, specialists that typically treat an enlarged prostate.
The doctors were asked about the treatments they typically prescribed, how often they discussed ED and ejaculatory disorders as side effects, and the alternative treatments they might suggest if patients were concerned about sexual dysfunction.
The three most commonly-used treatments were alpha-blockers (another type of medication), 5-ARIs, and a surgical procedure called transurethral resection of the prostate (TURP).
The survey revealed that many providers don’t discuss sexual side effects with their patients. For instance, only 70% of the doctors said they explained ejaculatory disorders associated with alpha-blockers. About 60% of doctors prescribing 5-ARI therapy covered possible ejaculatory problems. For doctors recommending TURP, the rate was 80%.
In addition, many doctors didn’t discuss alternative treatments if their patients had sexual concerns.
In an interview with Reuters, lead author Dr. Simone Giona said, “We need to talk to patients about their expectations and offer the treatments that will help them, including new alternatives.”
“Patients should mention all their worries and discuss their sex life concerns. Urologists should get a full picture of what will make their patients happy,” Dr. Giona added.
The study was published online in April in the World Journal of Urology.
Resources
International Society for Sexual Medicine
“Are sexual problems linked to 5ARI use for benign prostatic hyperplasia (BPH)?”
http://www.issm.info/sexual-health-qa/are-sexual-problems-linked-to-5ari-use-for-benign-prostatic-hyperplasia-bph/
“Does surgery for benign prostatic hyperplasia (BPH) affect a man’s sexual function?”
http://www.issm.info/sexual-health-qa/does-surgery-for-benign-prostatic-hyperplasia-bph-lower-urinary-tract-sympt/
What is benign prostatic hyperplasia (BPH)? How is it diagnosed?
http://www.issm.info/sexual-health-qa/what-is-bph/
Reuters
Crist, Carolyn
“Doctors don't always explain sexual side effects of prostate treatments”
(May 11, 2018)
https://www.reuters.com/article/us-health-prostate/doctors-dont-always-explain-sexual-side-effects-of-prostate-treatments-idUSKBN1IC26C
World Journal of Urology
Giona, Simone, et al.
“Urologists’ attitudes to sexual complications of LUTS/BPH treatments”
(Abstract. First online: April 21, 2018)
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