Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life

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Abstract
Therapies for benign prostatic hyperplasia (BPH) may either improve or exacerbate sexual function with an ensuing impact on quality of life. Here we review a total of 73 papers on medical therapies for BPH with a focus on the effects of different pharmacological agents on sexual function. For example, certain α1-adrenergic receptor blockers may improve erectile function; however, ejaculatory dysfunction with one of these agents, tamsulosin, occurs at a rate of 4–18%, rising to 30% with long-term use. In addition, treatment with the 5α-reductase inhibitor finasteride is associated with problems of ejaculation (2.1–7.7%), erection (4.9–15.8%), and libido (3.1–5.4%). Such significant and undesirable complications in relation to sexual function produce a well-documented negative impact on quality of life. Thus, optimal treatment for men with BPH requires the use of agents that demonstrate efficacy and safety with fewer sexual side effects.