Does an Enlarged Prostate Affect a Man Sexually?

What Is an Enlarged Prostate?

An enlarged prostate, or benign prostatic hyperplasia (BPH), is a non-cancerous growth of the prostate gland. The gland lies below the bladder and surrounds the urethra, the tube that carries urine.

When the prostate becomes larger, it can press on the urethra and make urination harder. These problems are grouped as lower urinary tract symptoms (LUTS). Common LUTS include:

• Frequent need to urinate, especially at night.
• Urgency with fear of leakage.
• Weak or slow urine stream.
• Dribbling at the end of urination.
• Feeling that the bladder does not empty fully.

These urinary changes can also influence a man’s confidence and comfort in daily life, including his sexual health.

How Can an Enlarged Prostate Affect Sexual Function?

Because the prostate is part of both the urinary and reproductive systems, enlargement can influence:

• Erections (difficulty with achieving or keeping them).
• Libido (interest in sex).
• Ejaculation (reduced semen volume, discomfort, or absence).

Erectile Dysfunction and BPH

Men with BPH often face problems with erections. This can happen because the enlarged prostate puts pressure on nearby nerves and blood vessels, which are important for normal erectile function. Stress and anxiety related to constant urinary difficulties can also make erections more difficult.

Changes in Libido

Sexual desire can also decrease in men with BPH. Poor sleep due to frequent night urination and the ongoing discomfort of urinary symptoms may lower energy and mood. Worries about health problems and natural hormonal shifts that come with age can further reduce sexual interest.

Ejaculatory Problems

Because the prostate produces part of the semen, an enlarged prostate can change the way a man experiences ejaculation. Some men notice less semen volume, while others may feel pain during ejaculation. In some cases, semen may flow backward into the bladder instead of exiting through the penis, a condition called retrograde ejaculation.

Does Treatment for Enlarged Prostate Affect Sex?

Treatments for an enlarged prostate are often effective for urinary problems, but they can sometimes affect sexual health.

Medication Side Effects

• 5-alpha reductase inhibitors can shrink the prostate and ease symptoms over time. However, they may reduce semen volume and lower sexual desire in some men.
• Alpha blockers relax the muscle fibers in the prostate and bladder neck, which helps urine flow. They often work quickly to ease symptoms. However, they can cause side effects such as dizziness, low blood pressure, and ejaculatory problems, including retrograde ejaculation.
• Other medicines can also lead to erection problems or decreased ejaculation volume. Not every man experiences these effects, but they are common enough to discuss with a doctor.

Surgery and Sexual Function

• TURP (transurethral resection of the prostate) is a well-known procedure that clears tissue blocking the urethra. It usually relieves urinary symptoms effectively.
  A common side effect is retrograde ejaculation. After TURP, semen often flows backward into the bladder rather than out of the penis. 
• Laser enucleation (HoLEP or similar procedures) removes enlarged prostate tissue using a laser. Sexual side effects are similar to TURP and include retrograde ejaculation. Some men may notice temporary changes in erection strength, but most regain normal function.

This does not cause harm but can affect fertility and sexual satisfaction. Erections usually remain possible after surgery, but some men report temporary changes. These effects improve with time.

When to See a Doctor

You should talk to a healthcare professional if you notice:

• Sudden changes in erection quality or sexual desire.
• Pain during sex or ejaculation.
• Worry about how urinary problems influence intimacy.
• Any new or unusual symptoms.

Doctors can provide options tailored to your needs and check for other possible causes

What Can Doctors Do

Doctors may:

• Adjust or change medications if side effects affect sexual function.
• Switch between different treatment options (for example, from medication to a procedure) if symptoms persist.
• Recommend therapies that reduce prostate size or improve urine flow.
• Suggest surgical options such as TURP or laser enucleation for severe cases.
• Provide guidance on lifestyle changes that support both sexual and urinary health.

How to Maintain Sexual Health with an Enlarged Prostate

Sexual health depends on both body and mind. Here are some helpful steps:

• Stay active: Exercise supports blood flow and reduces stress.
• Sleep enough: Poor sleep from night urination can lower desire and mood.
• Eat wisely: A diet rich in vegetables, fruits, and whole grains benefits general health and may support the prostate.
• Communicate with your partner: Sharing concerns builds trust and reduces anxiety.
• Practice relaxation methods: Breathing exercises or meditation can ease tension and improve performance.