BPH, retrograde ejaculation and mental health (newbie post)

[Danny234]

Hi guys, this is my first post.

I was diagnosed with benign prostatic hypersplasia last year and have been on several treatments since then, in an attempt to avoid their respective side effects. At the moment I'm on a combination of finasteride and prazosin, with a view to phasing out the prazosin once the finasteride starts taking effect. Previously I have been on tamsulosin and alfuzosin, separately.

I have told my GP that I am suffering from moderate to severe fatigue, which I am, and which sometimes makes holding down a full time job extremely difficult, especially one in which I am required to be physically active. I feel certain that this fatigue is a side effect of the drugs that I've been taking. But this is not even my biggest problem.

I'm finding it intensely difficult to deal with retrograde ejaculation, and I wondered if anyone else feels the same. I actually don't even want to think about spending the rest of my life being unable to ejaculate properly. What little I do produce is a watery dribble, and the majority of that has to be squeezed out after orgasm because I'm not shooting it. I don't know if other guys take this in their stride but I'm really struggling with it.

I'm also dealing with long term mental health issues relating to anxiety and depression. These have been around for many years but I have been seeing a therapist, on and off, for over a year. I was beginning to hope I might find a way of getting on top of it before the BPH kicked in. I have really tried to count my blessings, to consider how much worse things could be, and it works for maybe a few minutes, before my mind slips back into this feeling of despair that I can't shake off. I try to be logical about it, I try to tell myself that it's not the end of the world if I can't ejaculate, but I can't convince myself. I just can't handle it at all. I have mentioned it to my GP but I'm reluctant to do it again because he dismisses my feelings about it; he thinks it's only an issue if I want more children, which I don't, so he doesn't see it as a problem.

All my life I've never really made a habit of seeing my GP, and this past year or so I feel like I've never been away. Every time I go I think it may be my last visit there because I'm beginning to feel like a nuisance, wasting valuable GP time with something trivial and insignificant. But I'm going out of my mind and I feel totally alone with this. It seems retrograde ejaculation is both a symptom of BPH and also a side effect of treatment. Sometimes, especially when combined with the fatigue, I feel I don't even want to be around if this continues.

Please tell me there are others here who can relate to how I feel.

[drno]

I have had retrograde ejaculation for many years. what it means to me is that I can become sexually aroused but when the climax is near I am not able or even have the desire to continue, what should be the climax is the opposite of that, a disappointment and a feeling of inadequacy, I am not able to enjoy an orgasm.

[drno]

I made an appointment to see my Dr about retrograde ejaculation, I had put it off for along time thinking he would regard as something I shouldn't be bothering him about, that it was just vanity or egotism on my part. He wasn't sympathetic and gave me a prescription for Viagra.

[drno]

It's difficult to make most people understand how something like retrograde ejaculation can be such a big problem, I went to my doctor about it and afterwards wished I hadn't, According to what I'd read on the internet there was treatment for it, if not a cure but it wasn't available on the NHS and my doctor clearly thought, as most people do, that it wasn't a serious problem. But it is for me and it's left me unable to enjoy sex. I can't imagine having a physical relationship with someone, I can become sexually aroused but when the climax is in sight I lose the desire and the ability to go on. When I am able to have an orgasm (about once every three weeks) it's the opposite of what is should be, not a pleasurable experience and a feeling of inadequacy.

[Uneasy10 in reply to drno]

Sorry if this post is old, but I have a similar situation. Understand people's concerns. Had a similar situation with an NHS urologist and a GP. It seems that they don't want to prioritise something like this because of budgets. That would be my guess. Out of interest what was the treatment that was referred to?

[drno]

He's one person who can relate very closely to your post. I'm not able to explain to my doctor the difficulty I have coming to terms with retrograde ejaculation. When I went to see him about it I was nervous and self conscious and put the point across very badly, the point is that what should be the best part of sex is actually the opposite, an anti-climax, so it's something to be avoided even though I have normal sex drive.

[Leroy_HUL]

I was diagnosed with BPH a few years ago and was prescribed tamsulosin. It made me dizzy, and the retrograde ejaculations were depressing. My wife had a harder time dealing with it than me. Someone online recommended beta sitosterol. I stopped taking the tamsulosin. I rarely have to get up at night to relieve myself. Fortunately, it works for me, maybe not as good as the tamsulosin in the beginning, but good enough.

Last October, I had a core sample biopsy. The biopsy seems to have left me with a mild, permanent problem. I'm not quite as engorged as I was before but am adequate for the task at hand. The result of the biopsy was a diagnosis of the mildest grade of cancer. The urologist prescribed finasteride. The sole purpose of the finasteride is to moderate my PSA levels, making it easier for the urologist to detect changes that might indicate that the cancer is advancing. It dropped my PSA level from 18.5 to 6.5. It seems to work. For me, I can't tell that it has any side effects, other than the balding spot on the crown of my head has more hair 😀.

I'm not a believer in supplements, but the beta sitosterol worked for me. I hope you find a way to deal with your issues.

[Danny234]

Thanks guys for your replies. A lot has happened since I first posted, and I feel like I've learned quite a bit, so just thought I would give you an update.

All the drugs I took for BPH affected my ejaculation. The worst, by a mile, was finasteride. I stopped taking anything in the hope that things might improve. That was definitely my best move.

Then I began to notice a difference with my erections. I still got them, but they were more difficult to maintain for as long as I would have liked, and morning glory became much less frequent. My GP prescribed sildenafil, and suggested this may also help with my ejaculation. I was surprised to hear this and I took it with a pinch of salt. I knew sildenafil wasn't an ejaculation treatment.

However, I was surprised to find that my ejaculation did seem to be slightly better than without sildenafil. I spent a few months testing this out, just to make sure it wasn't coincidence, and now I'm pretty sure it helped slightly - but I'm convinced there are also other factors, such as how horny I am, how long since the last ejaculation, if I can manage to "pool" enough in the seconds before ejaculation, and I'm sure there is quite a bit of luck involved as well.

Also, I now regularly take zinc and saw palmetto supplements every day, and gradually - and I do mean very gradually - these seem to have helped. But even if I'm wrong and it's wishful thinking, I figure they can't hurt.

I resent my GP for being unsympathetic to my mental health, also for not warning me about the BPH treatment side effects. Had he warned me I would never have started treatment. I'm also pretty annoyed that he thought fertility was all that mattered and had no intention of understanding me. I'm gay, and gay guys get off on ejaculation outside of the body, but my GP was never going to understand that. He was old school with outdated ideas about sex and sexuality.

I spoke to another GP in my practice, a young woman, and she totally and completely understood where I was coming from. When I told her of my previous experiences she rolled her eyes in disbelief.

If I could offer any advice about BPH, it would be to avoid treatment unless it's absolutely necessary. Why take anything if it's just a minor inconvenience? If it's more than a minor inconvenience then obviously treatment might be a good idea. But I would say don't jump at it in the first instance.

Since last summer, sex has been a no go area anyway, partly because of the pandemic and partly because I have been dealing with prostatitis since last July/August, and during that time I have developed Peyronie's just for good measure. I can honestly say prostatitis is the worst thing I've ever had to deal with and I wouldn't wish it on my worst enemy. I think the only reason the Peyronie's is not pushing me over the edge is that the prostatitis seems to finally be easing and my life is returning to something I can finally handle. I actually believed I was going to be in pain for the rest of my life.

My next plan is to try and get someone to help me with the Peyronie's - I know it is treatable so I hope my concerns are not dismissed as they have been in the past.