About ED & BPH

ED and symptoms of BPH coexist in many men

Among men presenting with symptoms of BPH at urologists’ offices, approximately 60% were diagnosed with ED by their physician1*

60% diagnosed chart

*A prospective, office-based study involving 500 German urologists who evaluated 8563 consecutive patients presenting with urinary symptoms suggestive of BPH. Diagnosis of ED was based on the urologist's clinical judgment, including the use of the "Cologne assessment of male erectile dysfunction" (KEED) questionnaire.

Approximately half of all men with ED may also have symptoms of BPH2†

Half of men chart

Retrospective claims study of comorbid conditions in men with ED (N=301,994). Comorbid BPH symptoms were identified in the 12 months before and 6 months after the ED diagnosis. Cases of ED were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) codes. Cases of BPH symptoms were identified using a combination of ICD-9CM codes, procedure codes based on Current Physician Terminology codes, and National Drug Classification codes for alpha-blockers and 5-alpha reductase inhibitors.

Prevalence of ED and BPH

Prevalence of ED as men age

The overall prevalence of ED in a cohort of men 40 to 70 years old was 52%; by age 70, the prevalence may be as high as 67%3

Prevalence of BPH as men age

Approximately 40% of men show histologic evidence of BPH by age 60, and this may increase to approximately 80% by age 804‡
In a retrospective cohort study, the overall prevalence of diagnosed urinary symptoms due to BPH was 10.3% and ranged from approximately 3% to 24% in men 46 to 90 years of age5

Retrospective analysis of 10 independent studies in which a combined total of more than 1000 prostates were examined at autopsy or after prostatectomy from patients with urinary obstructive symptoms. Prevalence rates do not represent symptomatic BPH.

Patterns of sexual activity vary

~1/3 of respondents had no set pattern of intercourse6

pie chart
  • 69% of men reported that they had no set pattern as to whether they engaged in sexual activity on weekdays or the weekend

The Men's Attitudes to Life Events and Sexuality (MALES) phase 2 study was a multinational cross-sectional study of 2912 men, aged 20 to 75 years, who reported ED. A subgroup of these men consented to have their female partner contacted for participation in the Female Experience of the MALES (FEMALES) study. These data are based on the responses of 293 men who agreed to participate in the FEMALES study.6,7

Noninvasive treatment approaches for symptoms of BPH

  • Watchful waiting is appropriate for men with mild BPH symptoms or who are not bothered by their symptoms8
  • The benefits and risks of medication should be discussed with men who have bothersome or moderate to severe symptoms8
  • FDA-approved pharmacologic approaches to treat BPH symptoms include:
    • Alpha-adrenergic receptor blockers8
    • 5-alpha reductase inhibitors (if there is evidence of prostate enlargement)8
    • CIALIS 5 mg for once daily use, a phosphodiesterase 5 inhibitor8,9
  • Combination therapy with an alpha-blocker and a 5-alpha reductase inhibitor can be considered for the treatment of BPH symptoms in men who have an enlarged prostate8


  1. Hoesl CE, Woll EM, Burkart M, Altwein JE. Erectile dysfunction (ED) is prevalent, bothersome, and underdiagnosed in patients consulting urologists for benign prostatic syndrome (BPS). Eur Urol. 2005;47:511-517.

  2. Cameron A, Sun P, Lage M. Comorbid conditions in men with ED before and after ED diagnosis: a retrospective database study. Int J Impot Res. 2006;18:375-381.

  3. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994;151:54-61.

  4. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132:474-479.

  5. Verhamme KMC, Dieleman JP, Bleumink GS, van der Lei J, Sturkenboom MCJM. Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care—the TRIUMPH project. Eur Urol. 2002;42:323-328.

  6. Fisher WA, Rosen RC, Eardley I, Sand M, Goldstein I. Sexual experience of female partners of men with erectile dysfunction: the Female Experience of Men's Attitudes to Life Events and Sexuality (FEMALES) study. J Sex Med. 2005;2:675-684.

  7. Fisher WA, Rosen RC, Eardley I, et al. The multinational Men's Attitudes to Life Events and Sexuality (MALES) study phase II: understanding PDE5 inhibitor treatment seeking patterns, among men with erectile dysfunction. J Sex Med. 2004;1:150-160.

  8. Sarma AV, Wei JT. Benign prostatic hyperplasia and lower urinary tract symptoms. N Engl J Med. 2012;367:248-257.

  9. Cialis [package insert]. Indianapolis, IN: Eli Lilly and Company; 2017.