Just connected a bunch of dots between urinary symptoms and erections and I’m kind of blown away. I always thought “BPH = plumbing issue, ED = blood flow/psych,” but I keep seeing hints that lower urinary tract symptoms (LUTS) and erections move together. Sometimes my stream/urgency are worse and my erections are flatter the same day. Coincidence or is there a real link?
Things I noticed or came across that made me curious:
- Daily tadalafil supposedly helps both ED and BPH/LUTS. Anyone here see a two-for-one benefit in real life?
- Alpha-blockers (tamsulosin, alfuzosin, etc.) can change ejaculation; do they impact erection quality for you?
- 5-alpha-reductase inhibitors (finasteride/dutasteride) are reported to affect libido/ED in some people-did anyone mitigate that (dose changes, timing, stopping)? Did benefits for urinary symptoms outweigh sexual side effects?
- Nocturia wrecks sleep. On nights I pee 2-3 times, morning wood is almost absent. Has anyone tracked nocturia vs morning erections or testosterone labs?
- Pelvic floor tension: relaxing exercises and slow breathing before bed seem to reduce urgency for me and I swear erections are better the next day. Has pelvic floor PT helped both issues for anyone?
- Procedures: UroLift, Rezūm, iTind, TURP, PAE-most marketing says erections are “preserved,” but did anyone actually notice erections improve or decline after? Ejaculation changes are common, but I’m curious about erection firmness and sustainability specifically.
- Overlap with sleep apnea: OSA can cause nocturia and ED through different pathways. Anyone see both improve after CPAP?
- Blood pressure angle: stacking alpha-blockers with PDE5 inhibitors can drop BP. If you’re on both, how did you time doses to avoid dizziness while still getting benefits? (I’ll ask my clinician too-just curious about lived experience.)
- Inflammation vs enlargement: anyone diagnosed with chronic pelvic pain/prostatitis who had LUTS and ED improve with anti-inflammatories, heat, or antibiotics-even without classic infection?
Would love to crowdsource:
- Your LUTS severity (even a rough “mild/mod/severe”) vs erection quality on the same days
- What changed after starting/stopping: alpha-blocker, 5-ARI, PDE5 inhibitor, or a procedure
- Whether better sleep lowered nocturia and improved morning wood
- Any wins with pelvic floor downtraining, bladder retraining, or timing fluids/caffeine
If there’s a hidden “common driver” like sympathetic overactivity, endothelial function, or sleep fragmentation, dialing that in might be a game-changer. What’s worked (or backfired) for you?