Can an Enlarged Prostate Cause Erectile Dysfunction? 

While psychological factors can contribute to occasional problems getting an erection, erectile dysfunction can also be caused by physical conditions that affect blood flow or nerve functioning. For example, some types of prostate disorders, including having an enlarged prostate, can make it harder to get and maintain an erection.  

Below, we take a look at what causes an enlarged prostate, the relationship between prostate disorders and erectile dysfunction, and whether pills like Viagra can help.  

Three key takeaways 

• The side effects of certain prostate disorders can make it harder to be intimate in the bedroom.  

• Some medications and treatments used to treat prostate disorders can cause erectile dysfunction. 

• Evidence suggests that erectile dysfunction pills may help treat an enlarged prostate.  

What is an enlarged prostate?

The prostate surrounds part of the urethra (the tube through which urine and ejaculate leaves the body). An enlarged prostate can cause this tube to get blocked, resulting in problems with peeing and ejaculating, such as: 

• a weak stream  
• frequent urination  
• having an urgent need to pee
• waking up at night to pee 
• pain during peeing
• pain after ejaculating  
• pee that smells
• urinary incontinence

How common is an enlarged prostate? 

"Having an enlarged prostate is extremely common. In fact, almost all men get an enlarged prostate as they older. This is known as benign prostatic hyperplasia (BPH). By age 60, around 50% of people with a prostate will have some signs of BPH. This figure grows to 90% by age 85."

Ian Budd, Prescribing Pharmacist at Chemist4U 

Prostate disorders and erectile dysfunction explained 

Prostate disorders can cause erectile dysfunction in different ways, depending on their unique symptoms and treatments.

Benign prostatic hyperplasia 

BPH won’t directly cause erectile dysfunction, as it doesn’t affect blood flow or cause nerve damage. However, the symptoms of BPH can make it harder to be intimate, and in the long run may contribute to psychological ED. 

Without treatment, BPH can lead to a further blockage in your urethra and cause: 

• urinary tract infections (UTIs) 

• bladder stones 

• blood in your pee  

• kidney damage, if you pee backflows from your bladder up to your kidney and increases pressure on your kidney 

Some medications and surgical techniques used to treat BPH can also cause ED. These include: 

• Finasteride (Proscar) and dutasteride: these are 5-alpha reductase inhibitors that prevent testosterone from being converted into the hormone DHT, which can enlarge the prostate. A known side effect of finasteride and dutasteride is erectile dysfunction.  

• Transurethral resection of the prostate (TURP): a surgical technique used to remove the extra prostate tissue causing BPH if medication fails. ED is a relatively uncommon effect of this surgery, however, and tends to resolve after six months.     

Prostate cancer 

Prostate cancer itself does not cause erectile dysfunction, but some of the treatments can damage the nerves that you need to get an erection. They can also affect the levels of hormones you need to get and stay hard.  

Treatments for prostate cancer that can lead to erectile dysfunction include: 

• Radical prostatectomy: this is a surgery to remove the prostate gland and can damage the nerves you need to get an erection. Some men can get erections again after surgery, depending on the nerves that are affected and the extent of the damage. But this can take time. Others may need support or treatment to help with erections for the rest of their lives. It can take six to 18 months for your nerve fibres to recover from the trauma of a radical prostatectomy and for your sexual function to be restored. Radical prostatectomy can also lead to dry orgasms, when you do not ejaculate when you orgasm. 

• Hormone therapy: prostate cancer depends on the hormone testosterone to grow. So hormone therapy is often used to treat prostate cancer by lowering the amount of testosterone in your body. This can affect your ability to get and maintain an erection, cause less intense orgasms and a decreased sex drive. 

• Radiotherapy: this uses high energy waves to destroy prostate cancer cells. However, this can also destroy the nerves that control your ability to get an erection. 

Prostatitis 

Prostatitis is an inflammation of the prostate gland which can be caused by a bacterial infection. It causes symptoms like: 

• pain in your lower abdomen, genitals or perineum 

• a frequent urge to pee 

• painful urination 

• blood in your pee 

• blood in your semen 

• pain during sex 

• painful ejaculation 

This condition can also cause erectile dysfunction, either directly or as a complication due to the amount of pain it can cause. Put simply, finding sex and ejaculation painful is unlikely to turn you on. 

Can you take erectile dysfunction pills with an enlarged prostate? 

There is some research to suggest that tadalafil (also available as Cialis and Cialis Together) may provide relief from the symptoms of an enlarged prostate. One study found that men who took up to 5mg of tadalafil a day saw significant improvements in their prostate symptoms. If you are taking tadalafil for the treatment of an enlarged prostate, this must be prescribed by a specialist in this condition. 

Other pills like sildenafil (Viagra and Viagra Connect) and vardenafil (Levitra) can be used treat erectile dysfunction if you have an enlarged prostate but aren’t licensed to treat prostate disorders directly.  

Always speak to a medical provider before taking any erectile dysfunction pills if you have an enlarged prostate, as not all ED medications are suitable for everyone.  

Frequently asked questions about an enlarged prostate and ED 

Can an enlarged prostate be cured? 

While an enlarged prostate can’t be cured, there are a range of effective treatments available to help ease your symptoms.  

Does ejaculating help an enlarged prostate? 

There is some evidence to suggest that ejaculating can help reduce the risk of an enlarged prostate and prostate cancer and ease the symptoms of prostatitis.  

Sources

• Erectile dysfunction - Symptoms and causes. Mayo Clinic. [Accessed 8 September 2025]. 

• Erectile dysfunction (ED). Cleveland Clinic. [Accessed 8 September 2025]. 

• Erectile dysfunction (impotence). NHS Inform. [Accessed 8 September 2025]. 

• Sex and the prostate: Overcoming erectile dysfunction when you have prostate disease. (2009). Harvard Medical School. [Accessed 8 September 2025]. 

• Benign prostatic hyperplasia (BPH). Cleveland Clinic. [Accessed 3 September 2025]. 

• Does an enlarged prostate affect a man sexually?. Rezum. [Accessed 8 September 2025]. 

• Benign prostatic hyperplasia (BPH). MedlinePlus. [Accessed 8 September 2025]. 

• Can a swollen prostate cause erectile dysfunction?. Hims. [Accessed 8 September 2025]. 

• Difficulty getting an erection (erectile dysfunction). Cancer Research UK. [Accessed 8 September 2025]. 

• Hormone therapy for prostate cancer. Cancer Research UK. [Accessed 8 September 2025]. 

• Radiotherapy for prostate cancer. Cancer Research UK. [Accessed 8 September 2025]. 

• Prostatitis. Cleveland Clinic. [Accessed 8 September 2025]. 

• Relationship between prostatitis and erectile dysfunction. (2010). Korean Urological Association. [Accessed 8 September 2025]. 

• Prostate surgery: Everything you need to know. (2017). Medical News Today. [Accessed 8 September 2025]. 

• A review of the use of tadalafil in the treatment of benign prostatic hyperplasia in men with and without erectile dysfunction. (2014). PubMed. [Accessed 9 December 2025].  

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