Intimacy shouldn’t have an age limit. But the realities of how the prostate changes as men age can pose some barriers to relationships and to the overall quality of life.

It’s important to understand how that can happen, how you can find out if it’s happening, and how you can prevent it from happening in the first place.

Prostate Problems

Prostate problems can impact a man’s sexual function either directly through the physical effects of a disease or disorder or indirectly through the side effects of treatments for prostate diseases and disorders. Conditions such as enlarged prostate (benign prostatic hyperplasia), prostatitis (inflammation of the prostate) and prostate cancer can affect sexual function in various ways.

An enlarged prostate is the most common prostate problem among aging men, affecting half of all men between the ages of 51 and 60,[1] and up to 90% of men over the age of 80.[2]

As men age, the prostate gland can continue to grow. A regular rate of prostate growth does not tend to cause problems. But some men experience a greater rate of prostate growth, and this can lead to the non-cancerous condition known as benign prostatic hyperplasia (BPH). While having an enlarged prostate doesn’t directly cause issues with erection, ejaculation or libido, some common drugs used to treat the condition can impact sexual performance.

[Caption: The prostate gland is located below the bladder and in front of the rectum, and it surrounds the urethra, which is the tube that carries urine from the bladder out of the body.]

Symptoms

The most common symptom of BPH is trouble with urination – trouble starting to urinate, having a weak stream, and never feeling like you’ve fully emptied your bladder. While these symptoms are more bothersome than they are hazardous, they can seriously affect your quality of life through persistent interruptions in your sleep and daily routines. It’s difficult to go about your day or to sleep through the night when you always feel the urge to urinate.

If you are having problems urinating, seeing blood in your urine or semen, or feeling any pain or discomfort in your pelvic area, you should speak to a urologist. I recommend that men have a routine annual prostate exam beginning at age 50, or earlier if they have a family history of prostate issues. In this way, any problems can be caught and treated as early as possible, which is your best chance of improving outcomes for many prostate conditions.

Treatment

There have been many advances in treatment options for enlarged prostate, some of which can help you avoid any impact on your sex life. For an enlarged prostate, there are treatment options that simply open a channel in the urethra so that urine can flow. These options preserve your prostate tissue and avoid any tissue removal. Men tend to prefer these minimally invasive treatment options to drugs or more invasive procedures because they won’t impact their sex life, but not all men are candidates for these procedures.

The best treatment option for prostate problems is one that weighs the risks and benefits for you. Speak to your urologist about any potential side effects of treatment options before starting down any one path. There are strategies for managing the impact on your sex life, and these should also be discussed with your doctor.

Prostate Health

Not all prostate problems can be entirely prevented, but you can reduce your risk of developing prostate issues that might impact your sex life by promoting good prostate health.

• Maintain a healthy diet
• Stay active
• Keep hydrated, especially during hot weather
• Don't smoke
• Manage stress
• Get regular check-ups

By adopting these lifestyle habits and proactive measures, you can help reduce your risk of developing prostate problems and promote overall prostate health.

[1] What is Benign Prostatic Hyperplasia (BPH)? UrologyHealth.org. https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph). Updated September 2021. Accessed August 28, 2023.

[2] Benign prostatic hyperplasia (BPH). Urology Care Foundation. Accessed November 12, 2021. https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph)

Naveen Kella, MD is a paid consultant to Olympus Corporation, its subsidiaries and/or its affiliates.