Can the prostate play a part in ED?

The prostate is part of the male reproductive system. It is a small, golf-ball-sized gland that sits behind the base of the penis and in front of the rectum.

The most important job of the prostate is to make seminal fluid. This fluid mixes with sperm from the testes to make semen.

This seminal fluid has to be an optimal environment for the sperm to travel in, so as to achieve successful fertilisation during intercourse.

The prostate also plays a role in hormone production and works to regulate urine flow as it sits right below the bladder.

Does the prostate affect your ability to have an erection?

Whilst the prostate is a necessary part of reproduction, it doesn’t normally play a role in achieving or maintaining erections.

An erection occurs when the blood vessels in the penis relax and open up, allowing blood to rush in. A series of valves then increases the pressure, which keeps the blood there.

The prostate only affects ejaculation. However, a bundle of nerves and blood vessels (called the neurovascular bundle) on each side of the prostate serve a role in erectile function.

If these nerves become damaged, erectile function may be impacted.

The prostate itself doesn’t directly affect your ability to get an erection. However, some prostate conditions (and medications used to treat them) have been linked with causing sex problems and impotence.

BPH

BPH (benign prostatic hyperplasia) is a term used to refer to an enlarged prostate. As it is not cancerous, it is generally not considered dangerous.

When the prostate gland increases in size it begins to press against the urethra. Due to this, the main symptoms include trouble with urination.

An enlarged prostate does not affect your ability to get an erection. However, treatments used for BPH have been linked with causing impotence.

According to one study:

A common treatment for BPH (called Finasteride) was linked to erectile dysfunction in 3.7% of male patients.

The same drug was also reported to affect libido - diminishing it in 3.3% of men.

Prostatitis

Prostatitis refers to inflammation of the prostate gland, or when it becomes swollen.

This is different from an enlarged prostate and is differentiated from BPH primarily by the level of pain felt by the patient.

Prostatitis is an infection caused by bacteria. It usually requires a course of antibiotics in order to be treated.

When prostatitis becomes chronic (symptoms last for more than 3 months) it can start causing sexual problems, including erectile dysfunction.

Prostate cancer

Prostate cancer is the second most common cancer in men worldwide, contributing to 12.2% of all diagnosed cancers.

Unfortunately, many of the available treatments for prostate cancer can affect your sex life and erectile function.

Hormone therapy and radiotherapy lower your testosterone levels, which can make it more difficult to get an erection. It can also damage some of the nerves involved with erectile function.

Prostate surgery involves the removal of the prostate (prostatectomy). Without a prostate, you will no longer ejaculate semen (however, you can still achieve orgasm).

In most cases, a prostatectomy will cause erectile dysfunction. Some men will regain the ability to achieve erections after a few months or years - but some will have to rely on ED treatment indefinitely.

Treatment for BPH and prostatitis

Fortunately, you can treat BPH with an ED medication called Tadalafil. By taking 5mg daily you can ease your symptoms and improve erectile function.

For ED caused by prostatitis, it is best to treat the infection first with antibiotics. Your erectile function should return to normal once you are completely cured of your infection.

Treatment following a prostatectomy

After prostate cancer treatment, there are many options available to help you feel more in control of your erectile function.

These include:

• tablets for ED (such as Viagra, Levitra, Cialis, and Spedra)
• counselling or sex therapy (which can also help if your ED is affecting your mental health)
• pelvic floor exercises

• vacuum pumps
• penile implants (which require a short operation)
• topical creams

Changing your exercise routine and diet is another way of beating erectile dysfunction.

The prostate is essential for reproduction, but doesn’t affect your ability to get an erection.

However, prostate conditions like prostatitis and BPH can cause erectile dysfunction in severe cases. Some treatment for benign prostatic hyperplasia, or an enlarged prostate, could also contribute to ED but can be treated with other ED medication.

Treatment for prostate cancer including radiotherapy and removal of the prostate result in more permanent erectile dysfunction. Nonetheless, there are a variety of treatment options available to provide you with more sexual freedom.