The effect of α-blocker and 5α-reductase inhibitor intake on sexual health in men with lower urinary tract symptoms


Al B. Barqawi, Section Urologic Oncology, Anschutz Cancer Pavilion, 1665 N. Ursula St., Suite 1004, Aurora, CO 80010, USA. e-mail:


Associate Editor

Michael G. Wyllie

Editorial Board

Ian Eardley, UK

Jean Fourcroy, USA

Sidney Glina, Brazil

Julia Heiman, USA

Chris McMahon, Australia

Bob Millar, UK

Alvaro Morales, Canada

Michael Perelman, USA

Marcel Waldinger, Netherlands


To assess the effect of tamsulosin on the Sexual Health Inventory for Men (SHIM) score in men diagnosed with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).


Analysis from the national database of a programme of the Prostate Cancer Educational Council identified 7974 men who completed the American Urologic Association Symptom Score (AUA-SS) and SHIM questionnaires. The patients were divided into three groups; group 1, men taking tamsulosin; group 2, men on other prescription medications for treating BPH symptoms; and group 3, men not currently taking any BPH medications. Linear regression was used to assess the association of tamsulosin and other α-blocker prescriptions for treating BPH symptoms with the decline in SHIM score. The interaction terms between AUA and the intake of tamsulosin was also adjusted for in the final analysis.


The median age of the men was 60 years. In groups 1, 2 and 3, (234, 291 and 7449 men, respectively) the mean (sd) AUA-SS was 13.0 (7.2), 12.1 (7.2) and 6.9 (5.8), and the mean SHIM scores 11.7 (6.8), 12.7 (6.5) and 15.9 (6.0), respectively. Adjusting for the AUA-SS, men in group 1 on tamsulosin had a significantly higher SHIM score with increasing AUA-SS score than men on other medications (P < 0.01), offsetting the negative correlation between the AUA-SS and SHIM (P < 0.01). Moreover, men in group 1 were more likely to have a higher AUA-SS and lower SHIM score than men in the other two groups, suggesting more severe symptoms in these men.


Men taking tamsulosin to treat LUTS appear to be at an advantage over men taking other α-blockers when the effect of LUTS on sexual health is considered. Furthermore, this effect was more profound in patients with more severe LUTS than those with mild and moderate symptoms. Future prospective trials are warranted to confirm this effect.