How Does Prostatitis Affect a Man’s Sexual Function?
Men who have prostatitis (inflammation of the prostate) who are also experiencing erectile dysfunction or other sexual difficulties are not imagining things; the two are related. Although there is not a lot of research on the topic, a few previous studies have examined the relationship between prostatitis and sexual function. Now, a new analysis has taken it a step further.
What do we know about prostatitis and sexual function?
In prior research on the subject, such as that from investigators at Memorial Sloan Kettering Cancer Center, it’s been noted that “most of the data linking the two [prostatitis and sexual function] suggest that CP/CPPS [chronic pain/chronic pelvic pain syndrome] impairs the overall quality of life and it is this that contributes to or causes erectile dysfunction.” While this may be true, the authors of a recent study published in International Brazilian Journal of Urology evaluated the effect of histological prostatitis (prostatitis based on prostate biopsy findings) on lower urinary tract symptoms (LUTS) and sexual function.
More specifically, the investigators compared the effect of histological prostatitis on LUTS and sexual function in men with the prostate condition as well as those with symptoms but without histological prostatitis. Here’s what they discovered:
- Mean international prostate symptom scores (IPSS) in men with prostatitis were similar to those in men without prostatitis. This means that LUTS associated with prostatitis were similar among men with and without the disease.
- Mean international index of erectile function-5 (IIEF5) scores among men with prostatitis were significantly lower than those in men without prostatitis.
From these findings, the authors concluded that the presence of histological prostatitis “notably affected sexual function of patients and may serve as a major risk factor for sexual dysfunction while having little effect on lower urinary tract symptoms.” Men who had been diagnosed with histological prostatitis experienced more serious erectile dysfunction than their peers without prostatitis.
Sexual function can be impacted by prostatitis even in men who are not experiencing significant lower urinary tract symptoms. Men and their healthcare providers should be aware of this possibility and make treatment plans based on this knowledge.
What men with prostatitis can do for better sexual health
Men have a variety of treatment options for dealing with inflammation of the prostate gland. Certainly a number of pharmaceuticals are available, including nonsteroidal anti-inflammatories, antimicrobial therapy, 5a-reductase inhibitors, and alpha-blockers, but their use can be associated with some significant side effects. Natural lifestyle and alternative methods are suggested as the first line of defense to manage prostatitis and thus help with sexual function issues. Men are encouraged to consider one or more of these methods and to discuss them with a knowledgeable health professional to ensure they choose the ones that fit their lifestyle and needs.
- Acupuncture. Several studies have shown that acupuncture can be effective for symptom relief in men with CP/CPPS. Full body, ear, and electroacupuncture all have shown some success.
- Biofeedback. Use of biofeedback for CP/CPPS is based on the idea that men with this most common form of prostatitis have pain associated with pelvic floor muscle tension. Biofeedback can be used to manage this pain.
- Diet. A new study published in Prostate Cancer and Prostatic Diseases noted that an imbalanced diet, insufficient water intake, and consumption of caffeinated beverages are risk factors for or are associated with more severe pain in CP/CPPS. Men are encouraged to try a wheat-free diet (which has been shown anecdotally to help with symptoms), focus on fresh fruits and vegetables, include healthy fats in their diet, choose plant protein over animal protein, and drink green tea to promote a healthy prostate and help ward off prostatitis.
- Prostatic massage. This is a therapeutic method men can learn to do themselves or have a partner or medical professional do for them. Use of prostatic massage can help release accumulated fluids (and thus relieve pressure on the urethra), improve blood flow, and help the prostate return to normal size.
- Reflexology. This hands-on therapy is one men can easily learn to do on their own or have a partner do it for them. Reflexology for prostatitis is best for helping with pain relief.
- Stress management. Stress is both a risk factor and a factor that exacerbates prostatitis symptoms. Men are encouraged to make stress management techniques a part of their daily routine, whether it be deep breathing, tai chi, yoga, progressive relaxation, guided visualization, meditation, aerobic exercise, or other ways of relaxing.
- Supplements: Among the natural supplements scientifically shown to be beneficial for better prostate health are beta-sitosterol, cranberry, curcumin, green tea extract, indole3-carbinol (DIM), Pygeum africanum, quercetin, rye grass pollen, saw palmetto, stinging nettle root, vitamin D, and zinc. Rather than take these remedies individually, they are available in one high-quality supplement for prostate health.
- Trigger point release therapy. This is a hands-on therapy that involves applying pressure to specific points in the pelvic floor and related muscles. The trigger points are accessed both internally and externally, usually by a trained therapist.
What’s the Risk of Prostatic Abscess in Prostatitis
Men who have been experiencing symptoms of prostatitis for an extended period of time are at increased risk of having a prostatic abscess and should undergo imaging to make that determination, according to new research published in BMC Urology. It’s important to identify a prostatic abscess early because it can be treated effectively more easily.
What is a prostatic abscess?
Prostatic abscesses smaller than 20 millimeters are usually easy to treat while larger ones may require surgical intervention. Before treatment can be initiated, physicians usually take a fluid sample from the abscess utilizing ultrasound to help them locate the formation. Once the type of bacteria is identified, the appropriate antibiotics can be prescribed.
In some men, the abscess needs to be drained, in which case an instrument is passed through the penis to the abscess. A minute cut is made, the abscess is allowed to drain, and antibiotics are then usually prescribed. Catheterization also may be required because of swelling associated with the procedure.
What did the new study reveal about prostatic abscess and prostatitis?
An expert team from The Catholic University of Korea retrospectively reviewed 31 prostatic abscesses that were identified in 142 men who had acute prostatitis. Overall, the investigators found that having urinary voiding problems and symptoms of prostatitis for an extended period of time were associated with a significantly greater risk of developing a prostatic abscess. In addition:
- Men with diabetes had an increased risk of prostatic abscess
- The length of antibiotic treatment was generally longer among men with an abscess than those without one
- Men who had an abscess smaller than 20 mm did not need to undergo surgery and were cured without complications
- Men with an abscess larger than 20 mm who underwent transurethral resection required antibiotics for a shorter time than did men who did not have surgery
- Prostatic abscesses were often discovered in men who did not improve after undergoing initial treatment
Overall, the authors concluded that “Routine imaging studies such as CT [computed tomography] or TRUS [transrectal ultrasonography] should be considered in cases of acute prostatitis…especially in patients with long-term symptom duration and voiding disturbances.” Imaging will allow doctors to be prepared for the presence of an abscess, which should be treated immediately and may need to be drained.