Erectile Dysfunction (ED) is not a disease but a multidimensional symptom resulting from alterations in organic, endocrine, relational, or psychological components of ED. Swollen prostate, like in Benign Prostatic Hyperplasia (BPH) and prostatic cancer, can also cause ED.
What Is ED?
ED is a condition in which a man is unable to attain or sustain an erection sufficient to perform satisfactory sexual intercourse (1). ED is commonly reported among older men, affecting approximately 1.2 million men in the United States alone (1). It can present acutely, occasionally, or even as a chronic condition, which can be extremely stressful.
ED can be due to a disturbance in any of the components involved in the sexual response pathway; organic, psychological, and relational (2). To produce a sufficiently firm erection, all the bodily systems act together harmoniously.
What Causes ED?
The causes of ED in an individual can be broadly classified into vascular, endocrine, psychogenic, neurogenic, or metabolic.
Several common conditions leading to ED are as follows:
- Neurogenic causes
- Vascular Causes
- Metabolic Syndrome
- Psychogenic Causes
- Endocrine Causes
- Others- Drugs, tobacco, dehydration
The prostate is a gland located below the urinary bladder and is a part of the male reproductive system. It produces fluid that, together with sperms, makes semen (3). Multiple conditions can alter the prostatic function and cause it to swell.
Common causes of swollen prostate include (4):
- Prostate Cancer
- Benign Prostatic Hyperplasia
- Hormonal disorders
Swollen and enlarged prostates produce many urinary and sexual symptoms.
Following urinary symptoms occur from the compression of bladder and urethra by enlarged prostate (5):
- Urgency in micturition
- Increased urinary frequency
- Weak urinary stream
- Difficulty and straining in starting urinary flow
Sexual symptoms usually result from abnormal prostatic function and indicate advanced disease. Symptoms include (6):
- Reduced libido
- Poor Erection and Ejaculation
- Lack of sexual satisfaction
Swollen Prostate and ED
Although enlarged Prostate and ED are two separate entities, both are somewhat linked to each other.
ED is a severe side effect of hormonal medications prescribed in prostatic cancer. Even advanced prostate cancer can cause ED due to compression of nerves and arteries.
Benign Prostatic Hyperplasia
Although BPH itself does not cause ED, anti-testosterone drugs used to treat BPH can cause ED in about 3.7% men.
10-20% of men with ED have Hormonal disorders like a testosterone deficiency. Since testosterone controls sex drive and performance, its low levels can contribute to the development of ED.
Severe prostatic inflammation can cause ED due to pain that is localized to the perineum, suprapubic area, and penis (7).
The connection between prostate swelling and ED is complex. However, both conditions are associated with other comorbidities like diabetes, obesity, hypertension, and other cardiovascular diseases (8).
How to Treat ED Due to Swollen Prostate?
Successful treatment of ED due to BPH starts with lifestyle modifications because both ED and BPH have the same risk factors as Diabetes Mellitus and Cardiovascular Diseases. Therefore, the following changes can help relieve symptoms of ED and improve sexual performance:
- Eat a healthy diet
- Eat fresh fruits and Vegetables
- Avoid processed food
- Eat foods rich in Omega-3 fats like Salmon, trout, and mackerel for their anti-inflammatory properties
- Regular exercise
The most common and effective drugs used to treat ED are Phosphodiesterase-5 (PDE-5) inhibitors. Sildenafil, sold under the brand name Viagra, is a short-acting PDE-5 inhibitor with a half-life of 4-6 hours. Tadalafil, sold under the brand name Cialis, is a long-acting PDE-5 inhibitor producing effects for up to 36 hours.
NOTE: If you’re taking alpha-blockers to treat your swollen prostate, you cannot take PDE-5 inhibitors due to possible drug interactions. Therefore, always talk to your doctor first.
Surgery can reduce the symptoms of ED resulting from compression due to a swollen prostate. However, it may cause long-term sexual complications. Following surgical options are available for BPH:
- TURP (transurethral resection of the prostate)
- TUIP (transurethral incision of the prostate)
- TUMT (transurethral microwave thermotherapy)
Radiotherapy and Chemotherapy can be used to treat swollen prostate due to cancer.
ED is a debilitating and stressful sexual dysfunction that has numerous etiologies. Answer to the question “Can a swollen prostate cause erectile dysfunction?” is “Maybe” because swollen prostate can “indirectly” cause ED due to factors discussed above.