Talking to the GP about your prostate - any Qs around sexual activity etc?

[jimf67]

Hi everyone

I'm a man "of a certain age" and it's time for a visit to the GP to get my prostate checked out.

My concern for this forum is the nature of any questions around this the GP might ask, like frequency of sex, sexual function etc.

Chances are the inital contact from the GP will be a phone call, and with me and the OH mostly working from home, there's the possibility of her overhearing my side or even both sides of the conversation (and of course I've nothing to hide that would make this a problem... :o )

Anyone got any experience they'd like to share around this please?

Many thanks.

[Jonestown]

I can't see the GP asking about your sex life in regard to your prostate. They will either want to do a manual inspection or send you for a PSA blood test, which will require you to abstain from sex for a few days.

[RandomGuy99]

I've done the whole prostate cancer journey and none of the doctors mentioned sex.

It was I had a urine infection and that is unusual for men, so I went to GP.

Led to finger up bum check by GP

Led to PSA blood test which showed higher than normal level

Led to being placed on emergency 2 week cancer pathway

Led to camera check of bladder for cancer - negative

Led to prostate biopsy where they fire 7 needles in one go into your prostate to gather samples (not as painful as you might think and you're pretty much back to normal straight after) - negative

Led to PSA blood test after 6 months - back to to normal levels.

Led to yearly PSA blood tests - all normal so far

Apparently a urine infection can cause a higher than normal PSA.

When I went for the biopsy there were lots of men 10 years older than me who had much higher PSA levels than me. They get you all sitting about in the same room while they fill you up with antibiotics in preparation for the biopsy, so you get chatting.

I think they'll only mention sex if they need to do surgery.

The prostate naturally enlarges I think with age, hence why older men may need to get up in the night to have a pee or struggle to fully empty their bladder. That doesn't mean it's cancer. It's just part of the natural aging process.

I suggest getting any problems checked out sooner rather than later.  It might seem embarrassing, but all the medical professionals involved have seen and heard it all before, so nothing can shock them and the camera and biospy wasn't that painful.  There's nothing to be afraid of and it's better getting it checked.

[Jonestown]

I can't see the GP asking about your sex life in regard to your prostate. They will either want to do a manual inspection or send you for a PSA blood test, which will require you to abstain from sex for a few days.

That's a DRE or Digital Rectal Examination, something that might be classified as an extra in punting land and incur an extra charge, but free at your local GP surgery.

[jimf67]

I've done the whole prostate cancer journey and none of the doctors mentioned sex.

It was I had a urine infection and that is unusual for men, so I went to GP.

Led to finger up bum check by GP

Led to PSA blood test which showed higher than normal level

Led to being placed on emergency 2 week cancer pathway

Led to camera check of bladder for cancer - negative

Led to prostate biopsy where they fire 7 needles in one go into your prostate to gather samples (not as painful as you might think and you're pretty much back to normal straight after) - negative

Led to PSA blood test after 6 months - back to to normal levels.

Led to yearly PSA blood tests - all normal so far

Apparently a urine infection can cause a higher than normal PSA.

When I went for the biopsy there were lots of men 10 years older than me who had much higher PSA levels than me. They get you all sitting about in the same room while they fill you up with antibiotics in preparation for the biopsy, so you get chatting.

I think they'll only mention sex if they need to do surgery.

The prostate naturally enlarges I think with age, hence why older men may need to get up in the night to have a pee or struggle to fully empty their bladder. That doesn't mean it's cancer. It's just part of the natural aging process.

I suggest getting any problems checked out sooner rather than later.  It might seem embarrassing, but all the medical professionals involved have seen and heard it all before, so nothing can shock them and the camera and biospy wasn't that painful.  There's nothing to be afraid of and it's better getting it checked.

Thanks very much indeed for sharing, that is really helpful and useful information. 

My problem is a gradual lowering of pee pressure, nothing drastic, but I'm now the same age as some colleagues who had similar probs and ended up having theirs removed (just the natural enlargement with age), so it is definitely a trip to the quacks for a DRE...

[RandomGuy99]

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Like I say the investigations aren't really painful. For the camera there is no pain. They just fill your bladder up with saline and put the camera in and have a look at the inside of your bladder. Takes 5 minutes.  For the biopsy they apply a local anaesthetic and it hurts as much as having a needle put in your arm. You're there for about 5 hrs while they put the antibiotics in to prepare you and then the biopsy literally takes 5 minutes and you're done. You get plenty of coffee and biscuits while you're waiting and everyone is very friendly. You get a bit of blood in your semen for a week or so while it heals and then you're back to normal.

[Thephoenix]

It's always worthwhile getting checked sooner rather than later.

I wasn't satisfied with the results of my first digital rectum exam so I asked for repeat tests every day for a fortnight.
Unfortunately Dr Samantha Snodgrass left the surgery soon after.

Seriously... The chances are it's just benign prostate enlargement which is very common.
However, even that shouldn't be ignored as it can lead to the formation of bladder stones and other problems as I can testify.

Your GP and/or urologist can rule out anything sinister, and arrange for further tests if required.
More often than not it's a case of watchful waiting, but your GP can prescribe meds if the symptoms are unmanageable.

Ps. At no time did Dr Snodgrass ask about my sex life and I refrained from asking about hers.
However I noticed in my online gp notes she'd entered the initials d.o.m. 
 

[NelsonH]

My GP does not really like PSA tests because they have quite a high rate of false positives.

[albsure69]

My GP does not really like PSA tests because they have quite a high rate of false positives.

Yeah lots of reasons for the level to be higher than expected - riding a bike or a recent orgasm are just 2 I was told

[RandomGuy99]

My GP does not really like PSA tests because they have quite a high rate of false positives.

They may not like them but they should be doing them.

My PSA level was 6 and that led to the testing. People in the biopsy waiting room had readings of 15.  Mine is now 0.6.

The normal PSA level depends on your age and there are other factors that can affect the level.

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[Jonestown]

My problem is a gradual lowering of pee pressure, nothing drastic, but I'm now the same age as some colleagues who had similar probs and ended up having theirs removed (just the natural enlargement with age), so it is definitely a trip to the quacks for a DRE...

The last thing you want is your prostate removed unless it is absolutely essential. You have probably just got an enlarged prostate which is a condition that can be managed with medication, if they are suspicious about the enlargement they will do a scan, then if there is still cause for concern they will do a biopsy. I wouldn't be harbouring thoughts of cancer at this early stage.

[sadolddeejay]

Led to finger up bum check by GP

Led to PSA blood test which showed higher than normal level

My G.P. arranged for blood test before a digital examination because he said that the digital exam can increase PSA level.

[scutty brown]

GP checked me out for an enlarged prostate a couple of years ago, put me on Tamsulosin. Didn't ask a single question about sex.


There is a possible side effect with Tamsulosin of dry orgasms, very confusing for girls

[RandomGuy99]

You could alway ask your GP about sex. They're probably over £250 ph though.

[RandomGuy99]

You could alway ask your GP about sex. They're probably over £250 ph though.

And you might have to wait 6 weeks for an appointment and by the time you get to see them you may no longer want sex.

[Thephoenix]

And you might have to wait 6 weeks for an appointment and by the time you get to see them you may no longer want sex.

.....and while you're waiting fap away, as particularly for older men it helps to reduce the risk of prostate cancer. 

[Harry Monk]

Had 2 checks never any mention of how active(or not) I might be.

First one GP popped her finger up my back door.
Second  one PSA test and sent for an ultrasound check so felt that was very thorough.

[scutty brown]

That's a DRE or Digital Rectal Examination, something that might be classified as an extra in punting land and incur an extra charge, but free at your local GP surgery.

As opposed to an Analog Digital Exam?

[Thephoenix]

As opposed to an Analog Digital Exam?

Or an analog rectal exam.

[scutty brown]

Or an analog rectal exam.

yeah I fucked that joke up.............

[Jonestown]

yeah I fucked that joke up.............

Wired up your DAC wrong

[B4bcock]

scutty, you need to join the DNA.

[sir wanksalot]

I asked about a prostrate exam a few years ago but my surgery didn't seem keen on doing it. I was asked if I had any symptoms which I hadn't (and still don't).

Is that the GP normal practice or should I be insisting on a check as routine healthcare?

PS..I'm over 50

[RandomGuy99]

I asked about a prostrate exam a few years ago but my surgery didn't seem keen on doing it. I was asked if I had any symptoms which I hadn't (and still don't).

Is that the GP normal practice or should I be insisting on a check as routine healthcare?

PS..I'm over 50

I think you only get one if you have symptoms.

I had digit up the bum because I had a urine infection.

Then the PSA blood test

Then I got an MRI or CT scan which showed some kind of mass in the prostate.

Then the bladder cancer check and the prostate biopsy.

Fortunately no cancer found and PSA back to normal range. Now I have annual PSA blood tests all in normal range so far.

You should be able to get a PSA blood test as it's pretty standard screening for men over 50.

[Jonestown]

I asked about a prostrate exam a few years ago but my surgery didn't seem keen on doing it. I was asked if I had any symptoms which I hadn't (and still don't).

Is that the GP normal practice or should I be insisting on a check as routine healthcare?

PS..I'm over 50

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The NHS website (link above) says if you are over 50 you can request a PSA test.

I would have thought a DRE was a usual component of an annual health check once your'd got to 50

[RandomGuy99]

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The NHS website (link above) says if you are over 50 you can request a PSA test.

I would have thought a DRE was a usual component of an annual health check once your'd got to 50

I've never had an annual health check at my GP.

[scutty brown]

I asked about a prostrate exam a few years ago but my surgery didn't seem keen on doing it. I was asked if I had any symptoms which I hadn't (and still don't).

Is that the GP normal practice or should I be insisting on a check as routine healthcare?

PS..I'm over 50

read the official guidance
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remember - there's few if anyone on this forum who can answer you

[RandomGuy99]

read the official guidance
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remember - there's few if anyone on this forum who can answer you

I had to remind my GP that I should be having annual PSA blood tests after my cancer scare and they printed me a blood test forn to get it done.

[scutty brown]

I had to remind my GP that I should be having annual PSA blood tests after my cancer scare and they printed me a blood test forn to get it done.

Fair enough
But if there are no symptoms there are very good reasons for NOT doing PSA tests
they're very unreliable

[RandomGuy99]

Fair enough
But if there are no symptoms there are very good reasons for NOT doing PSA tests
they're very unreliable

I'm supposed to have a hospital appointment in the next month or so to followup on my biopsy results and my PSA blood tests.

[RandomGuy99]

And now you can see what patients think of your GP surgery

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[jimf67]

Just thought I'd put an update in, in case anyone is interested:

Finally sorted out seeing the GP, she did a DRE and PSA test, some enlargement, but PSA negative.

So onto Alfusosin, then Tamsulosin, neither of which had much effect on the flow rate. Then we added Finasteride which still didn't help, but did give me dry orgasms and mood changes, not fun.

Back to the GP who agreed primary care wasn't solving this and referred me to urology.

Consultation with nice man in private hospital, he did a flow test and agreed it was (quote) "rubbish"! He told me to stop the Finasteride (which was a relief) and advised I'd need a TURP, which carries the risk of dry orgasms as a side effect.

The TURP was performed in Oct 25, some discomfort afterwards, but that eased after a week or so. The good news is flow rate is back to firehose levels, it's amazing! The bad (ish) news is orgasms are now dry and looking like they'll stay that way, which I'm coming to terms with, but is odd.

Had a follow up last week and was told the biopsy they took during the TURP was negative and I'm unlikely to need a repeat anytime soon.

[RandomGuy99]

It's good to hear that your flow is back to now jim. All the best.

My GP and urology department at hospital never asked a single question about my sex life. I was a little disappointed.

I've now completed 5 years of 6 monthly PSA tests and all were in normal range under 1, so I never had prostate cancer. I am now on annual PSA checks.

[Hoping]

There was a lot of publicity on TV etc of celebrities having prostate cancer so I went to GP to get checked out.  GP (locum) obviously did not want me to have a PSA test (why??) and went through loads of questions (family history/increased nocturnal peeing/pain, black ancestors etc etc).  Told her I wanted it due my age.  She eventually had to agree and PSA test arranged with nurse.  Following day GP rang me and said I was being referred to hospital as an emergency referral.  Hospital arranged MRI scan within two weeks and two weeks later a biopsy.  About a month later had meeting with cancer team - PSA showed a reading of 9.3 (anything over 5  rings bells) and the various treatments were discussed (biopsy had confirmed I had cancer) - do nothing, regular monitoring (quarterly PSA tests), radiotherapy or surgery.  Pros and cons of each were discussed.  Opted for monitoring.  Next PSA test showed a reading of 11.1.  I told nurse I wanted further treatment.  Discussed with radiologist - treatment would be carried out in a hospital about 15 miles away and I would need daily sessions every day for 28 days.  Discussed surgery with surgeon - he could do op (keyhole surgery) within a few weeks.  One night in hospital).  Opted for surgery.

Am now having 6 monthly PSA tests - reading less than 0.1.

Side effects - flow is weaker when peeing, having to get up more often in night, can't get erection (but am receiving treatment), penis is about 1cm shorter (wasn't very big to start with).  Recovery from surgery very quick, very little pain, just five holes in abdomen each requiring one dissolvable and glue.

You can never be sure what is the right treatment but if I had the chance of choosing again I think I would stick with surgery.

Hope that helps.

[RandomGuy99]

Depending on your age and how quickly the cancer is progressing, I think some consultants recommend do nothing as you're more likely to die of old age before the prostate cancer causes you a problem and thus you can avoid any side effects.

[Mr Garmin]

After my treatment my consultant asked me whether I was 'sexually active'  I answered yes with a little smirk on my face as I'd shagged my SB only that morning.

[scutty brown]

So onto Alfusosin, then Tamsulosin, neither of which had much effect on the flow rate. Then we added Finasteride which still didn't help, but did give me dry orgasms and mood changes, not fun.

Can you confirm you've got that right? My experience was that Tamsulosin gave me dry orgasms. Also Tamsulosin knocked me for six both mentally and physically - I was permanently tired, at risk of falling, extreme low blood pressure and unable to stand for more than a few minutes. I actually fell several times getting onto buses, once queuing in Wetherspoons to get served, several time while walking -once crossing the road. And my memory was cloudy and forgetful. Stopped the Tamsulosin, switched to Finasteride and all those problems went away. Additionally Finasteride has (according to a Thai girl with flexible fingers) noticeably shrunk and softened my prostate, whereas Tamsulosin didn't - it simply relaxes the sphincter muscle
Obviously different people react differently, but Tamsulosin is known to affect some badly like this. While I was taking it I got stopped several times by the police for erratic driving and I now think the Tamsulosin was at least in part responsible.

Another thing to think about with prostate problems is constipation - I've got Parkinson's disease and that can make me severely constipated. When that happens the prostate problems return and I need to take a pretty powerful laxative to sort it

[jimf67]

Yes, that's correct. The alpha blockers (alfa/tamsu-losin) were definitely first and had some impact on flow, but nothing to write home about. The Finasteride was later and produced the side effects that went away when I stopped it but remained on the Tamsulosin until the op 4 months later.

[Thephoenix]

I had benign prostate enlargement with poor flow for years which was largely ignored by GPs, which eventually resulted in a damaged bladder and bladder stones.

Tamsulosin and finasteride were prescribed.

Tamsulosin improved flow but caused severe acid reflux so stopped.
Finasteride only slightly improved flow so persevered as it takes a while to shrink the prostate.
Side effects included retrograde ejaculation, different orgasm and thicker hair.

Eventually opted for TURPs but I think by then the bladder was weakened and the surgery was not only unsuccessful but affected my ability to orgasm.
I probably shouldn't have bothered as I'm having to use intermittent catheterisation anyway.

[scutty brown]

three people, three completely different experiences with the same drugs.
Would be useful to get more comparisons as well