Health and Fitness

Can I stop prostate pills making me impotent? DR MARTIN SCURR answers your health questions 


For years I used to be on three tablets — tamsulosin, finasteride and a bladder relaxant — to assist with signs attributable to an enlarged prostate.

They made no distinction, however a TURP operation in February 2019 did. Nevertheless, the tablets have left me borderline impotent for about ten years. Is that this aspect‑impact reversible?

Identify and tackle withheld.

Thanks for writing a few delicate topic, which many males discover nice problem in discussing overtly.

Almost all males expertise some signs of benign (non-cancerous) enlargement of the prostate gland with age.

The prostate sits like a doughnut across the urethra (the tube via which urine leaves the physique) — and because the gland grows as we grow old, it places stress on the urethra and the bladder, inflicting issues with urination.

The principle urinary signs of an enlarged prostate — a situation known as benign prostatic hyperplasia, or BPH — are poor move, nocturia (needing to stand up greater than as soon as at evening for the john), elevated frequency and hesitancy (problem beginning). Medicines often known as alpha blockers, equivalent to tamsulosin, assist by stress-free the bladder and prostate muscle groups to enhance the move of urine.

Thanks for writing a few delicate topic, which many males discover nice problem in discussing overtly

These medicine have made such a distinction since their introduction that far fewer males have wanted the keyhole process you had — transurethral resection of the prostate (TURP) — to chop away the surplus tissue.

Nevertheless, the medicine have a possible main side-effect, with some males experiencing retrograde ejaculation, the place the semen is handed backwards into the bladder. This have to be weighed towards the advantages of decreasing the urinary signs.

Not all males with BPH reply to alpha blockers, however there’s one other class of medication that may assist: 5-alpha reductase inhibitors, equivalent to finasteride.

These medicine shrink the prostate by blocking the results of testosterone. However impotence is a possible side-effect, together with lowered intercourse drive.

You have been unlucky in that tamsulosin and finasteride didn’t enhance your BPH and, as you say in your longer letter, it took years for a call to be made concerning whether or not it’s best to have surgical procedure.

In a minority of circumstances, finasteride can result in erectile difficulties that linger even after the affected person is not taking the drug. It’s not clear why.

I recommend that you ought to be prescribed tadalafil, a therapy for erectile dysfunction that may additionally enhance the urinary signs related to BPH.

The prostate sits like a doughnut around the urethra (the tube through which urine leaves the body) ¿ and as the gland grows as we get older, it puts pressure on the urethra and the bladder, causing problems with urination

The prostate sits like a doughnut across the urethra (the tube via which urine leaves the physique) — and because the gland grows as we grow old, it places stress on the urethra and the bladder, inflicting issues with urination

An everyday low dose of this drug can enhance blood move to the penis. When you reply properly you’ll, nonetheless, nonetheless expertise minimal ejaculation on account of the surgical procedure to take away among the prostate tissue.

I hope that your GP will conform to a trial of tadalafil which, if efficient, provides you with noticeable advantages inside every week or two.

For the previous couple of years, if I’m mendacity sideways in mattress, I wake with pins and needles and a sense of stress down my arm, hand and fingers. I additionally get again ache and a pointy ache within the crease of my arm after holding the cellphone. Am I proper in pondering that is nerve ache? I’m 76.

Carol Petteford, Bristol.

This does sound like nerve ache. One doable rationalization is that you’ve got a situation known as ‘cervical ribs’, which implies you have been born with further ribs behind the collarbone, simply above the primary rib.

Over time these further ribs can irritate nerves operating out of your neck to your arms. The situation is uncommon, affecting fewer than one in 100 individuals, and it by no means causes signs usually.

One other doable rationalization is that poor sitting posture down the years has irritated elements of the brachial plexus, a community of nerves extending from the bottom of the neck into the arms.

I recommend you ask your GP for a referral for a chest X-ray to verify for cervical ribs. Remedy normally entails physiotherapy to ease stress on the nerves.

But when the X-ray is obvious, you might have to be referred for a nerve conduction examine, the place a light electrical present is utilized to the pores and skin to measure the velocity at which it passes via the nerve.

That is executed to verify if a nerve is trapped at its root — sometimes as a consequence of cervical spondylosis (age-related put on and tear affecting the spinal discs in your neck).

Therapies for this differ however normally begin with physiotherapy.

In my opinion: Our food regimen is chopping our lives quick

What would you slightly, a protracted life or a wholesome life? I’d go for the latter, however some individuals within the UK spend an excessive amount of of their life in ailing well being.

And there are big variations throughout the UK — a girl born in Blackpool is predicted to stay 23 fewer years in good well being than one born in Orkney.

Whereas clearly earnings, housing and training can have an effect on the variety of wholesome years lived, one other main issue is food regimen, and the shift to ‘subsistence residing’ on extremely processed snacks and meals overloaded with sugar and salt.

I used to be shocked to see a scientist talking on behalf of the Meals and Drink Federation boasting that the trade had lower salt ranges by 16 per cent previously 5 years, and that corporations are investing in new strategies to scale back ranges with out compromising product security.

Leaving ranges the place they’re now’s, in itself, compromising meals security. Till we sort out the truth that an excessive amount of of our food regimen entails a mix of extremely processed substances that provide little in the way in which of vitamin, bar energy, I concern the years we spend in good well being won’t ever rise.



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