Prostate enlargement, also known as benign prostatic hyperplasia (BPH), is a common condition among older men that can cause urinary symptoms such as difficulty starting and stopping urination, weak urine flow, and frequent urination. While BPH is not directly linked to erectile dysfunction (ED), there are several ways in which the two conditions can be related.

Medications for BPH:

Medications commonly used to treat BPH, such as alpha-blockers and 5-alpha reductase inhibitors, can cause erectile dysfunction as a side effect. Alphablockers relax the muscles in the prostate and bladder neck, which can make it easier to urinate, but they can also cause a drop in blood pressure and result in ED. 5-alpha reductase inhibitors reduce the size of the prostate by blocking the production of a hormone called dihydrotestosterone (DHT), but they can also cause sexual side effects such as ED and decreased libido.

Prostate Surgery:

Surgery to remove part or all of the prostate gland, such as transurethral resection of the prostate (TURP) or a prostatectomy, can damage the nerves and blood vessels involved in achieving and maintaining an erection, leading to ED.

Psychological Factors:

Men with BPH may experience anxiety and stress related to their urinary symptoms, which can contribute to ED. Additionally, the use of medications and surgery for BPH can also cause psychological stress and anxiety, which can worsen ED.


Both BPH and ED are more common among older men, and age-related changes in the body can contribute to both conditions. As men age, testosterone levels decline, which can contribute to both BPH and ED.

In summary, while BPH and ED are not directly linked, there are several ways in which the two conditions can be related. Medications and surgery used to treat BPH can cause ED as a side effect, psychological factors related to BPH can contribute to ED, and both conditions are more common among older men. If you are experiencing symptoms of either condition, it's important to speak with your healthcare provider to determine the best course of treatment for your individual needs.

Dr Shyam Varma is a Consultant Laparoscopic/ Robotic Urologist & Renal Transplant Surgeon. He has over 15 years of experience in successfully treating complex urological diseases. His expertise includes diagnosing & treating Kidney stones, prostate enlargement, prostate cancer, kidney cancer, bladder cancer & incontinence, male infertility & erectile dysfunction.