The prostate gland, a small organ located beneath the bladder in men, plays a role in both urinary and reproductive functions. As men age, it is common for the prostate to enlarge, a condition known as benign prostatic hyperplasia (BPH). BPH is not cancerous, but its growth can lead to various urinary and sexual symptoms, including concerns about ejaculation.
What is an Enlarged Prostate?
The prostate gland’s main function involves producing seminal fluid, which nourishes and transports sperm. This walnut-sized gland sits directly below the bladder and encircles the urethra, the tube responsible for carrying both urine and semen out of the body. As men age, typically starting around age 25, the prostate undergoes a second growth phase that continues throughout life, often leading to BPH. Benign prostatic hyperplasia signifies a non-cancerous increase in the size of the prostate gland. This enlargement can compress the urethra, potentially obstructing the flow of urine and affecting other functions, including ejaculation.
How an Enlarged Prostate Changes Ejaculation
An enlarged prostate can significantly alter the ejaculatory process through several mechanisms. The most common change is retrograde ejaculation, where semen is forced backward into the bladder instead of exiting the penis during orgasm. This occurs because the enlarged prostate, or sometimes its treatments, can interfere with the proper closing of the bladder neck muscles during ejaculation, allowing semen to flow into the bladder.
The mechanical obstruction caused by the enlarged prostate compressing the urethra can also lead to a noticeable reduction in ejaculatory force or volume. When the prostate grows, it can squeeze the urethra, making it more difficult for semen to pass forward efficiently during ejaculation.
While less common, some men with an enlarged prostate may experience pain or discomfort during or immediately after ejaculation. This pain can manifest as a burning sensation in the penis or surrounding areas, or discomfort in the bladder or rectum. This symptom can sometimes be associated with inflammation of the prostate, known as prostatitis, which can coexist with BPH.
Addressing Ejaculatory Concerns
Treating the underlying benign prostatic hyperplasia (BPH) can often help alleviate associated ejaculatory symptoms. Medical interventions for BPH include alpha-blockers, which relax the smooth muscles in the prostate and bladder neck, making urination easier. However, alpha-blockers, particularly tamsulosin, are known to cause ejaculatory dysfunction, including retrograde ejaculation or a complete absence of ejaculate, as a side effect in some men.
Another class of medications, 5-alpha reductase inhibitors like finasteride and dutasteride, work by shrinking the prostate gland over several months. These medications can also lead to decreased ejaculate volume, reduced sexual desire, or ejaculatory dysfunction by affecting hormone levels.
Surgical procedures for BPH, such as Transurethral Resection of the Prostate (TURP), are highly effective at relieving urinary symptoms but commonly result in retrograde ejaculation, affecting a significant majority of patients. While some newer minimally invasive procedures like UroLift and Rezum may preserve ejaculatory function more effectively, it is important to discuss potential sexual side effects with a healthcare provider.
Lifestyle adjustments can also indirectly support prostate health and potentially improve sexual function. Maintaining a healthy diet rich in fruits, vegetables, and omega-3 fatty acids, along with regular exercise and a healthy weight, can contribute to overall well-being.
When to Consult a Doctor
It is advisable to seek medical attention for any new or worsening urinary or ejaculatory symptoms. Changes such as significant alterations in ejaculation, including a lack of ejaculate or new pain during or after ejaculation, warrant a professional evaluation. Urinary difficulties like frequent urination, a weak stream, or the sensation of incomplete bladder emptying are also important indicators.
A doctor can accurately diagnose the cause of these symptoms, differentiating between BPH, prostate cancer, or other conditions that might present similarly. Early diagnosis and appropriate treatment are important for managing symptoms effectively and preventing potential complications. Open communication with a healthcare provider about all symptoms, including sexual concerns, is crucial for developing a personalized treatment plan.