Sex and Prostatitis: We Answer Your Burning Questions

Highlights:

• Sex and prostatitis research is incomplete and ongoing. If you suffer from this painful condition, you probably have questions. We have the (sometimes unexpected!) answers.

• Prostatitis is an inflammation of the prostate caused by infection or other factors.

• The causes of nonbacterial prostatitis are still being studied.

• Anything that irritates the pelvis or bladder should be avoided while dealing with a bout of prostatitis, but research finds some surprises here.

• Read on for answers to your burning questions.

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Q: What Is Prostatitis?

A: Prostatitis is an inflammation of the prostate. It generally breaks down into four categories:

• Acute prostatitis, or acute bacterial prostatitis. This is a bacterial infection of the prostate and needs immediate medical treatment.
• Chronic bacterial prostatitis. An uncommon condition that mostly means you get more urinary tract infections (UTIs) than usual.
• Inflammatory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), or nonbacterial prostatitis. This is usually diagnosed when pain is reported and there’s evidence of inflammation but no evidence of infection.
• Noninflammatory CP/CPPS. Similar to the above but without any evidence of inflammation.
• Asymptomatic inflammatory prostatitis. Rare, with evidence of inflammation but no symptoms.

Q: What Are the Symptoms of Prostatitis?

A: The majority of prostatitis cases — 90% to 95% — are inflammatory or noninflammatory CP/CPPS. Look for the following signs and symptoms:

• Pain or burning when you urinate
• Difficulty urinating
• Frequently urinating, particularly at night
• A sudden need to urinate
• Cloudy or bloody urine
• Pain in the abdomen, groin or lower back, perineum, penis, or testicles
• Painful ejaculation

Bacterial prostatitis may also have flu-like symptoms in addition to these. Asymptomatic prostatitis, as the name implies, typically has no symptoms at all. 

Q: What Makes Prostatitis Worse?

A: While it may be a bit more awkward, there’s really no difference between an inflamed prostate and another part of your body feeling inflammation.

Avoid positions and activities that might irritate your prostate, like extended sitting or exercise that moves the pelvis repetitively. Skip caffeine, alcohol, and anything else that might irritate your bladder.

If you have bacterial prostatitis, drink more non-caffeinated fluids to help flush bacteria out. Cranberry juice probably won’t help, although if you enjoy it, feel free. It can’t hurt.

Q: Can Prostatitis Be Transmitted Sexually?

A: Since any bacteria that can inflame the prostate can be a cause of prostatitis, it’s possible that both bacteria and common STIs, such as gonorrhea and chlamydia, can be a cause. However, that only applies when a bacteria is implicated, and that’s relatively rare among prostatitis cases.

It can also be caused by any situation where bacteria might be introduced into the urethra, such as with catheter use, a surgical procedure, injury, or urinary blockage.

Q: Does Having An Enlarged Prostate Cause Prostatitis?

A: While having benign prostatic hyperplasia (BPH), also called an enlarged prostate, doesn’t lead directly to prostatitis, it is a risk factor. An enlarged prostate might make it more difficult to urinate, possibly leading to more UTIs.

This can be a particular concern if you use a catheter regularly. Talk to your doctor about proper technique and preventing infection. Also worth remembering is that prostatitis can cause an enlarged prostate as well.

Q: Can Abstinence Cause Prostatitis?

A: Contrary to locker room talk about “backed-up pipes,” abstinence doesn’t have much to do with prostatitis. In fact, one study found that frequency of ejaculation had nothing to do with prostate health one way or the other. It was age that was the real factor, according to their analysis.

That said, the causes of prostatitis without any sort of bacterial infection aren’t clear, and there may be benefits to ejaculation during prostatitis.

Q: Does Ejaculation Aggravate Prostatitis?

A: One of the most common symptoms of prostatitis is pain when you ejaculate, so you might wonder if sex and prostatitis even mix in the first place.

The answer is usually no, and to understand why, we should review how the prostate works. Your prostate generates a fluid, and when you ejaculate, smooth muscle in and around the prostate contracts, forcing that fluid out and into the urethra, where it mixes with sperm cells to become semen.

When the prostate is inflamed, this squeezing can be painful in the moment, but you might feel relief afterward. In fact, it might be beneficial to remove some fluid from the prostate to ease discomfort. A study of a small sample of abstinent men found that men who ejaculated regularly experienced at least some relief from their symptoms.

This doesn’t have to take the form of ejaculating, either. You can receive medical (or partner) prostate massage, which drains the ducts in the prostate gland. The fluid is then emptied out of the urethra with your urine flow.

Q: Does Prostatitis Affect Sperm or Fertility?

A: Having prostatitis won’t affect your sperm cells, as sperm are manufactured in the testicles. However, there may be some fertility issues.

The fluid generated by the prostate is designed to nourish and protect sperm, among other functions. An inflamed prostate might reduce the volume of fluid or change its composition, and that might cause problems for your sperm.

There’s also a more practical issue: It’s harder to get in the mood when you’re in pain. And this can have other impacts on your sex life.

Q: Can Prostatitis Cause Erectile Dysfunction (ED)?

A: Prostatitis, and treating prostatitis, is going to have an effect on your sexual function. For example, men who experience premature ejaculation (PE) and have bacterial prostatitis may find that antibiotics cause delayed ejaculation instead.

And it is possible prostatitis may cause ED indirectly. As the body fights off infection, damage to nerves and erectile tissue is possible, depending on the spread of the bacteria and what treatment you receive.

More likely, however, you’re simply not in the mood. Pain is notoriously hard on anyone’s libido, and you may be in pain at various points of your body during prostatitis. If ejaculation is painful, it may be difficult to feel like having sex.

Chronic pain may also cause of depression, which can be a factor in ED.

Be Your Own Best Advocate

Knowing your body and speaking out about your health are key to better outcomes. So talk to your doctor, be clear about your symptoms and concerns, and stay informed.

For the latest evidenced-based research on men’s health issues, follow the eDrugstore blog.

If you’re struggling with erectile dysfunction, check out our medication guide, then get your free consultation with a U.S.-licensed physician. They will write your prescription and ship your medications right to your door. At eDrugstore, virtual health visits and shipping are always free.