Enlarged prostate worsens sex life

Findings from the largest survey ever conducted to evaluate sexual and prostate health in older men were presented this year at the 17th Congress of the European Association of Urology.  The 14,000 men questioned were drawn from 50 to 80 year olds in the US, France, Germany, Italy, the Netherlands, Spain and the UK.

This survey, carried out by Dr Rosen of the University of Medicine, New Jersey, clearly shows that sexual activity is an important quality of life component.  83% of men in this age group had experienced sexual activity in the previous four weeks and 65% of the over 70s said they were still sexually active.

90% of those surveyed said they were affected by the symptoms of an enlarged prostate, the most common being the need to get up during the night.  More than 30% said they experienced moderate to severe urinary tract disorders.  Sexual activity in this group was reduced by about 45% compared to the men with no symptoms.

A high proportion of men see their sexual behaviour as a major contributor to their quality of life.  This aspect needs to be considered when prescribing treatment for men with benign enlargement of the prostate (BPH).  The different treatments available vary considerably in their impact on sexual function.  Surgery has the worst record in this respect although much depends on the skill and experience of the particular surgeon.  The drug finasteride can result in a significantly higher incidence of impotence, decreased libido and abnormal ejaculation.  Abnormal ejaculation is a recognised side effect of tamsulosin.  The alpha blockers terazosin and alfuzosin, on the other hand are associated with a much lower rate of sexual dysfunction.

An alarming finding of the survey was that only 24% of Europeans with symptoms and 15% of US men sought care to correct the problem.  The study was funded by the French based pharmaceutical company Sanofi- Synthelabo.