The impact and management of sexual dysfunction secondary to pharmacological therapy of benign prostatic hyperplasia

Abstract

Benign prostatic hyperplasia (BPH) is one of the most common genitourinary complications in men over 50 years of age and typically presents with lower urinary tract symptoms (LUTS). Classes of medications include α1-adrenoceptor blockers, 5α-reductase inhibitors, and phosphodiesterase 5 inhibitors. Today, α1-adrenoceptor blockers and 5α-reductase inhibitors are often combined to give a synergistic effect. A review of the current literature identified several adverse sexual side effects, including erectile dysfunction (ED), decreased libido, orgasmic disorders, and ejaculatory disorders. We believe it is important to know the extent of these side effects, as the clinician and patient will need to decide the cost of improved voiding symptoms. The chief adverse effect is ejaculatory disorders, including the absence of ejaculation. Clinical consideration for BPH should include the elements of male sexual function, patients’ age, and the characteristics and comprehensive effects of each group of drugs. Methodological bias in clinical studies, such as the subjective evaluation of the sexual side effect, makes it difficult to determine the ideal drug for treatment.

Phytotherapy Adds to the Therapeutic Armamentarium for the Treatment of Mild-To-Moderate Lower Urinary Tract Symptoms in Men

“…Studies with finasteride and dutasteride showed increased risks of sexual dysfunction, erectile dysfunction, ejaculation disorders, and decreased libido [21]. Also, the occurrence of erectile dysfunction is a known class effect of selective α 1 -blockers [22,23]. 0 31 69 18 Denmark 0 28 72 22 Ireland 0 45 55 22 Sweden 0 22 78 23 Belgium 41 9 50 24 UK 0 33 67 28 Hungary 43 7 50 29 The Netherlands 0 24 76 29 Austria 3 21 76 30 Switzerland 23 17 60 35 Germany 20 11 69 47 France 25 17 58 43 Greece 2 19 79 44 Czechia 14 16 70 44 Finland 0 39 61 52 Italy 4 27 69 53 Spain 15 19 65 56 Poland 9 18 73 57 Portugal 9 35 56 5-ARIs, 5α-receptor inhibitors; PI, prescription index.…”

Drugs used in prostatic enlargement and lower urinary tract symptoms: unseen and overlooked effects on sexual health

“…However, clinical studies in the 1990s reported that despite the amelioration of LUTS, adverse effects of BPH drug therapy began to surface. 1 These effects were noted as sexual dysfunction, which can be divided into erectile dysfunction (ED), ejaculatory dysfunction (EjD), orgasmic disorders as well as sexual desire disorders.…”

“…Adverse sexual side effects can occur as a result of the drug group itself or specific drugs within the group. 1 Watchful waiting is usually utilized in patients with an American Urological Association (AUA) symptom score <10. ABs bind to á 1 -adrenoceptors and act by relaxing the smooth muscles of the prostate and bladder neck to improve urine flow and facilitate urination.…”

High glucose induces the proliferation of prostatic cells via downregulating MRE11

“…Benign prostatic hypertrophy (BPH) is the most common benign tumor in males, characterized by an increased number of glandular and connective cells in the prostate and ( 1 ). BPH typically causes prostate enlargement and the secondary condition of chronic bladder outlet obstruction ( 2 ).…”

“…Type 2 diabetes mellitus (T2D), characterized by persistent hyperglycemia, affects >370 million people worldwide and is a major cause of morbidity and mortality ( 8 ). T2D is a disease in which tissues are resistant to the effects of insulin and/or insulin production is insufficient to meet requirements ( 1 ). The consequence of this is an inability to regulate blood sugar, resulting in chronic hyperglycemia.…”