Can an Enlarged Prostate Cause ED?

Kristin Hall, FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 3/7/2023

Can an enlarged prostate cause ED (erectile dysfunction)? Here’s everything you need to know.

Erectile dysfunction is a common condition affecting around 30 million men each year. ED can impact your ability to get and maintain an erection, which can affect not only your sex life but also your overall quality of life.

Erectile dysfunction can have psychological causes, such as depression, performance anxiety or stress. The use of antidepressants and certain medications for managing high blood pressure may also cause sexual dysfunction as a side effect.

However, medical conditions account for many ED cases. Could a health condition like an enlarged prostate cause ED? Can a swollen prostate cause erectile dysfunction? Is there any connection between an enlarged prostate (also known as benign prostatic hyperplasia or BPH) and ED?

We’ll explore the connection between an enlarged prostate and ED while answering the question: Does an enlarged prostate cause ED?

What Is Benign Prostatic Hyperplasia?

If you’re concerned about your prostate and erectile dysfunction, it’s important to understand what an enlarged prostate is so you don’t have to Google “does enlarged prostate cause ED” anymore.

The prostate is a walnut-shaped gland. Part of the male reproductive system, it’s responsible for creating the fluid that goes into your semen.

Benign prostatic hyperplasia is when the prostate is enlarged but not cancerous. The prostate grows throughout a man’s life during two periods, first during puberty and again around the age of 25 when it continuously grows.

Due to this growth, the prostate presses against and pinches the urethra, which causes the bladder wall to thicken and makes it more difficult for urine to come out. The bladder can eventually weaken and lose its ability to completely empty urine. This can lead to complications like urinary tract infections and bladder damage.

One possible cause for an enlarged prostate is dihydrotestosterone (DHT), a male hormone useful for the development and maintenance of the prostate. Unfortunately, DHT can cause excessive prostate growth in adults.

Another condition that can affect the prostate (as well as sexual health) is prostatitis, an inflammation of the prostate.

There are four types of prostatitis:

  • Acute bacterial prostatitis. This is a short-term type of prostatitis resulting in a bacterial infection of the prostate.

  • Chronic bacterial prostatitis. This condition is a recurrent infection of the prostate that goes on for a long time.

  • Chronic pelvic pain syndrome/chronic prostatitis. This type of prostatitis involves pain in the lower back and pelvic area that may be caused by an infection, though not from bacteria. It may also be due to inflammation from other causes.

  • Asymptomatic inflammatory prostatitis. This is an inflamed prostate with no symptoms.

Chronic pelvic pain syndrome can be caused by many infective and non-infective factors. Acute bacterial prostatitis and chronic bacterial prostatitis are caused by a bacterial infection of the prostate that leads to pelvic pain and urinary tract issues, like frequent urination and urinary retention.

But can an enlarged prostate cause ED? Or can a swollen prostate cause erectile dysfunction?

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Does an Enlarged Prostate Cause ED?

Now that you know a bit more about enlarged prostates, you can imagine how they would affect not only someone’s quality of life but potentially their sex life as well.

Benign prostate conditions can lead to lower urinary tract symptoms, such as urinary tract infections (UTIs), bladder damage, blood in the urine and urinary retention.

Benign prostatic hyperplasia is also linked to pain during or after ejaculation, kidney damage and bladder stones. BPH can also affect sexual function, such as:

  • Erectile dysfunction

  • Reduced sexual satisfaction

  • Trouble maintaining an erection

  • Low sex drive

Like BPH, erectile dysfunction is affected by age — a common link both conditions share. Seventy percent of men with BPH are thought to have associated erectile dysfunction.

To better understand how benign prostatic hyperplasia may lead to ED, it helps to know more about the alpha 1-adrenergic (a1-adrenergic) receptor.

These receptors mediate the tone of smooth muscle cells in tissue. Erections are dependent on the contraction and relaxation of the corpus cavernosum smooth muscles, meaning a1-adrenergic receptors are important for erectile function. 

In BPH, an imbalance in the autonomic control of smooth muscles leads to increased smooth muscle tone in the prostate caused by the a1-adrenergic receptor. This then results in contracted penile tissues, which aren’t conducive to erections.

So, does enlarged prostate cause ED? Possibly.

But erectile dysfunction and other sexual issues may be caused more often by treatment options for an enlarged prostate rather than BPH itself.

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Treatment for an Enlarged Prostate

If you have benign prostatic hyperplasia, proper treatment options typically include medication or surgery.

While these treatments can help reduce the size of the prostate, they can also cause side effects and impact sexual function.

Medications to manage BPH, like alpha-blockers and 5-alpha-reductase inhibitors such as finasteride and dutasteride, often have side effects that include erectile dysfunction.

If ED occurs after treatment for an enlarged prostate, the use of PDE5 inhibitors or intracavernosal injections may be able to treat sexual dysfunction.

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Enlarged Prostate and ED: A Recap

An enlarged prostate and ED are separate issues. Both increase with age, but one causes problems in the bathroom and the other in the bedroom. That said, your prostate and erectile dysfunction are somewhat linked.

An enlarged prostate might cause sexual dysfunction, such as low libido or erectile dysfunction, due to a1-adrenergic receptors that affect smooth muscle control in the penis. However, enlarged prostate treatments could be the culprit of erectile dysfunction.

As always, you should talk to your healthcare provider to find the right treatment for your condition. They can work with you to determine what might be causing an enlarged prostate or the best erectile dysfunction medications for you.

Explore the options at Hims today.

13 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.