Prostatitis & Sex

The prostate gland's main function is to produce semen, the fluid that helps nourish and transport sperm. When this inflammation occurs it can cause a variety of symptoms, including a frequent and urgent need to urinate and pain or burning when urinating, often accompanied by pelvic, groin or low back pain. Studies have shown that sex is almost impossible when you have prostatitis because the erections and ejaculations are extremely painful.

Incidence

Prostatitis can affect men of all ages. Prostatitis is one of the most common diseases seen in urology practices in the US, accounting for over 1 million visits per year. Chronic and nonbacterial prostatitis are being most frequently diagnosed. According to the National Institutes of Health, prostatitis may account for up to 25% of all office visits for complaints involving the genital and urinary systems from young and middle-aged men. 

Symptoms and types of prostatitis

There are several characteristic symptoms for each an every type of prostatitis.

Some of the most common are:

Acute bacterial prostatitis

Signs and symptoms of this form of prostatitis usually come on suddenly and may include:

• Fever and chills
• A flu-like feeling
• Pain in the prostate gland, lower back or genital area
• Increased urinary urgency and frequency,
• Difficulty or pain when urinating,
• Inability to completely empty the bladder
• Blood-colored urine
• Painful ejaculation

Acute prostatitis is a serious condition and requires urgent medical attention.

Chronic bacterial prostatitis

The signs and symptoms of this type of prostatitis develop more slowly and usually aren't as serious as those of acute prostatitis.

The most common symptoms of chronic bacterial prostatitis include:

• A frequent and urgent need to urinate
• Pain in the lower back and genital area
• Difficulty starting to urinate, or diminished urine flow
• Occasional blood in semen or in urine (hematuria)
• Pain or a burning sensation when urinating (dysuria)
• Pain in the prostate
• Excessive urination during the night (nocturia)
• Painful ejaculation
• Recurring bladder infections

Chronic nonbacterial prostatitis

Chronic nonbacterial prostatitis is the most common form of prostatitis. In general, the signs and symptoms of nonbacterial prostatitis are similar to those of chronic bacterial prostatitis. The major difference is that common bacterial tests will not detect any bacteria in patient’s urine or in fluid from prostate gland. 

Asymptomatic inflammatory prostatitis

There are such cases when the patient does not complain of pain or discomfort but has infection-fighting cells in his semen. Doctors usually find this form of prostatitis when looking for causes of infertility or testing for prostate cancer.

 

Possible causes of prostatitis

The mechanism trough which the prostate becomes infected is still not completely understood. It is known that the bacterial prostatitis is caused by bacteria such as E. coli, Klebsiella, Proteus, Pseudomonas, Enterobacter, Enterococcus, Serratia, and Staphylococcus aureus. Most of the experts believe that the bacteria that cause prostatitis may get into the prostate from the urethra by backward flow of infected urine or stool from the rectum.

There is also a theory that claims that prostatitis is a sexually transmitted disease, but more recent research suggests that only a small number of cases it is passed on through sex. Other causes may include autoimmune disease.

Causes of non-bacterial prostatitis are much more difficult to determine. Most experts believe that it could be some of the following things:

Other infectious agents
Some experts believe nonbacterial prostatitis may be caused by an infectious agent that doesn't show up in standard laboratory tests.

Heavy lifting
Lifting heavy objects while your bladder is full may cause urine to back up into your prostate.

Certain occupations
Occupations that subject your prostate to strong vibrations, such as driving a truck or operating heavy machinery, may play a role.

Physical activity
Although regular exercise, especially jogging or biking, is great for the rest of your body, it may irritate your prostate gland.

Pelvic muscle spasm
Urinating in an uncoordinated fashion with the sphincter muscle not relaxed may lead to high pressure in the prostate and subsequent symptoms.

Structural abnormalities of the urinary tract
Narrowing of urethra may elevate pressure during urination and cause symptoms.

Risk factors for developing prostatitis

Certain conditions and medical procedures increase the risk of developing prostatitis. You are at higher risk for getting prostatitis if you:

• Recently have had a medical instrument, such as a urinary catheter (a soft, lubricated tube used to drain urine from the bladder) inserted during a medical procedure
• Engage in rectal intercourse
• Have an abnormal urinary tract
• Have had a recent bladder infection
• Have an enlarged prostate

Prostatitis, sex and sexual transmission

Sexual transmission

Several studies have shown that the chronic bacterial form of prostatitis is sometimes experienced by men whose sex partners have a bacterial infection of the vagina. This means that prostatitis is a sexually transmitted disease. Gonorrhea, a common sexually transmitted disease, may sometimes cause prostatitis. Tuberculosis may also spread to the prostate. Other parasites and fungi may infect the prostate gland. Sometimes, a formation called granuloma in the prostate tissue can cause prostatitis. It is still not wether viruses can cause prostatitis.

Effects on sex life

The most common symptoms are discharge from the penis after sex and the widespread distribution of the pain. Men may also complain of pelvic pain, pain during ejaculation, and pain with sexual intercourse. This is making sex almost impossible. The good news is that patient will not lose sex drive altogether, and that with specialist help patient’s sex life may still be enjoyed.

Sex during the treatment

It is best to avoid sex during any treatment. If a sexually transmitted infection is found to be the cause, all sexual partners will need to be treated at the same time or the infection will just keep coming back.
 

Diagnosis of prostatitis

Physical examination

Most often the symptoms and physical findings are enough to form a diagnosis of prostatitis. The best diagnostic tool is an exam called digital-rectal exam. During the exam, a doctor inserts a finger in the rectum and the swollen prostate can be felt. Patient should also know that it may be extremely tender when probed. Squeezing the gland slightly will produce a few drops of fluid that may be cultured to learn whether bacteria are present.
 
Examining and culturing urine samples

Many patients with chronic bacterial prostatitis also have recurring urinary tract infections which could be an important clue to the diagnosis.

Cystoscopy
 
The urologist may also insert a special instrument called a cystoscope through the penis to view the prostate directly from inside and see whether it looks inflamed or not.

Possible prostatitis complications

Prostate cancer
There is still no evidence that having acute or chronic prostatitis increases the risk of prostate cancer.
However, it is proven that it may increase the level of prostate-specific antigen which is a substance naturally produced in your prostate gland, and high levels in your blood may sometimes be a sign of prostate cancer.

Sterility
Because prostatitis interferes with the development of semen and proper ejaculation, it can sometimes affect fertility.

Other complications
In addition, untreated acute prostatitis can lead to an inability to urinate, and in severe cases may result in bacteria in your bloodstream. 

Treatment of prostatitis

Medications

Depending on the type of prostatitis you have, certain medications may help rid or control your symptoms. These medications include:

• Antibiotics – Ciprofloxacin® is one of the commonly used medications
• Alpha blockers - Tamsulosin® and Alfuzosin® are commonly used
• Pain relievers
• Muscle relaxants

 
Physical therapy

Several researches done in the past have proven that special exercises and relaxation techniques can improve symptoms of prostatitis in some men. Common techniques include:

• Exercise
• Ice - placing a small ice cube in the rectum, may relieve pain for hours.
• Biofeedback
• Sitz baths
• Prostate massage

Surgical procedures

Sometimes, a doctor may recommend surgery to open the blocked ducts if a patient has a bacterial form of the disease in which antibiotics couldn’t improve symptoms or fertility is severely affected.
 
Other treatments

Finasteride is a drug that lowers hormone levels in the prostate.