Roger-Luc Chayer (Image: AI / Gay Globe)
Benign prostatic hyperplasia (BPH) is a condition that affects many men over the age of 50 in the general population. In gay men, if left untreated, this condition can have repercussions not only on physical health but also on mental health. Indeed, this segment of the male population often remains sexually active longer than heterosexual men.
What is Benign Prostatic Hyperplasia (BPH)?
Benign prostatic hyperplasia, often referred to as BPH, is the enlargement of the prostate that commonly occurs as men age. The prostate, a gland located beneath the bladder and surrounding the urethra, can become enlarged and exert pressure on the urethra. This can lead to urinary issues such as weak urine flow, frequent urges, especially at night, or the feeling of not completely emptying the bladder. While not dangerous or linked to cancer, it can disrupt daily life.
What are the Symptoms?
Symptoms of benign prostatic hyperplasia typically involve difficulty urinating. These may include frequent trips to the bathroom, the feeling of not completely emptying the bladder, or interruptions in urinary flow. There may also be strong urges to urinate, occasional leaks, and difficulty starting urination. These issues are often more pronounced at night, affecting sleep.
What are the Effects on Sexuality and Mental Health?
BPH can impact sexuality by causing reduced libido, erectile dysfunction, or discomfort during intercourse. These difficulties, combined with bothersome urinary symptoms, can lead to frustration, dissatisfaction, or loss of self-confidence. The mental health impact may manifest as anxiety, low mood, or even social isolation, particularly for individuals for whom sexual activity plays a central role in emotional well-being.
How is BPH Treated?
Treatment varies based on the severity of symptoms and individual needs. In milder cases, lifestyle changes such as improved hydration and specific exercises may be sufficient to relieve symptoms. For more bothersome or persistent symptoms, medications may be prescribed to address urinary obstruction problems. In more severe cases, surgical intervention may be considered to remove part of the prostate and reduce symptoms.
The medications used primarily aim to alleviate urinary obstruction symptoms and improve the patient’s quality of life. Here are the main classes of medications:
- Alpha-1 blockers: These relax the muscles of the prostate and bladder, making it easier to pass urine. Common examples include:
- Tamsulosin
- Alfuzosin
- Doxazosin
- 5-alpha-reductase inhibitors: These reduce prostate size by blocking the hormone responsible for growth. These are typically suited for men with larger prostates. Examples include:
- Finasteride
- Dutasteride
- Herbal supplements: Though not conventional medications, some herbal treatments like saw palmetto or rye pollen extracts may be used to relieve symptoms.
Does Surgery Pose the Same Risks as Prostate Cancer Surgery?
No, surgery for benign prostatic hyperplasia does not necessarily mean the end of sexual function. In fact, it can significantly improve this aspect of life for those affected.
Modern surgical interventions aim to treat urinary symptoms while minimizing impacts on sexual function. In many cases, patients experience improvements in urinary symptoms without significant loss of sexual function. However, there may still be potential risks and side effects, such as erectile dysfunction or decreased libido. These complications are often temporary and vary from person to person. Recent surgical advancements and less invasive techniques have contributed to reducing these risks.
It is important to note that BPH (benign prostatic hyperplasia) is not cancer. The prostate’s growth is not due to abnormal cell multiplication, as seen in cancer, but rather due to glandular swelling. Unlike cancer, the reduction in prostate size due to BPH is limited to the space occupied by the gland, rather than linked to abnormal cell presence. Blood tests (PSA – Prostate-Specific Antigen) remain normal in the case of BPH.
A family doctor is qualified to diagnose BPH.