People who are having or have had treatment for prostate cancer sometimes have problems with sexual intercourse. These include a loss of interest in sex, inability to get an erection, and fertility issues.
Prostate cancer is the most common non-skin cancer in men in the United States. It affects around
While prostate cancer may not directly affect a person’s sexual ability, treatments, including radiation therapy, surgery, or hormone therapy, can
In this article, we explain how prostate cancer can affect sex and provide some tips on how to maintain a healthy sex life during this time.
It is not unusual to feel anxious and depressed following a cancer diagnosis and during treatment. Anxiety can also lead to relationship stress.
Prostate cancer causes several physical changes that can affect a person’s sexual confidence. These may include:
- bowel problems and urine leakage
- difficulty getting an erection
- reduced semen production
- reduced fertility
These issues can affect sexual desire and performance.
Sometimes, surgery is necessary to remove cancerous tissue or the entire prostate gland.
Nerves that help control an erection run close to the prostate gland. During surgery, the surgeon will try to protect the nerves from damage while treating the nearby prostate gland. However, erectile dysfunction is one of the main
Surgeons may reduce the risk of surgery-induced erectile dysfunction through several measures.
- Nerve-sparing prostatectomy: This aims to preserve the nerves that control erections.
- Biopsy: This can help a doctor determine if cancer is present on only one side of the prostate. If this is the case, surgery may spare the nerves on the other side.
- Cryotherapy: This is a less invasive procedure in which doctors use probes to freeze prostate cancer cells. However, there is also a risk of nerve damage with this type of treatment.
Radiation therapy kills cancer cells, but can also affect the surrounding healthy tissue and possibly the rest of the body. Radiation therapy may help treat cancer cells in the prostate but can affect other sexual organs. This can
A more focused type of radiation therapy called brachytherapy may have a lower risk. This treatment involves implanting radioactive seeds into the prostate, and it is less likely to affect other parts of the body. However, this is typically only applicable to those with
Androgens, such as testosterone, are necessary for reproductive and sexual function, but they also
One way of treating prostate cancer is to block or reduce the production and use of these hormones. It might be possible to do this using various drugs or surgically removing one or both testicles.
However, hormonal therapy can also have some
Different cancer treatments, including medications, chemotherapy, radiation therapy, and hormone therapy, can affect fertility.
For those who wish to have children in the future, one option is to store sperm in a sperm bank before starting prostate treatment.
If loss of sexual function occurs after prostate cancer treatment, several options can help a person find pleasure in sex again or return to previous sexual function.
One choice to make is whether to pursue an active sex life or if the individual and their partner are happy to pursue new forms of intimacy.
This could involve experimenting with:
- new ways of touching
- vibrators and other aids
- the use of videos
Those in a relationship may find their partner happy to enjoy nonsexual intimacy. Open communication with a partner makes it easier to agree on expectations and share concerns. In some cases, a lower sex drive will not bother the partner. Others may enjoy finding new ways to be intimate.
Explore new sexual techniques
A partner who is usually insertive, or top, during sex may want to consider changing to receive anal penetration, as sex may be difficult without a full erection.
In the case of a prostatectomy, a partner who usually receives penetration may find that sex is less pleasurable, as the prostate gland usually contributes to the sensation.
Set aside time for physical stimulation. It may take extra physical and mental stimulation to get and sustain an erection.
Several treatments can help a person achieve an erection, including:
- oral drugs, such as avanafil (Spedra), sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
- cream to apply to the penis, such as alprostadil (Vitaros)
- other drugs that come in injection or pellet form
- vacuum pumps that can draw blood into the penis before sex
- an inflatable implant may be an option if medications or other treatments are not effective
Learn more about the medications for erectile dysfunction here.
Getting enough exercise
Learn more about specific exercises to reduce erectile dysfunction here.
A 2016 study assessing whether frequent ejaculation protects against prostate cancer concluded that ejaculating more often lowers the chances of prostate cancer.
However, the authors called for further research because other factors, aside from ejaculation, could account for the results. They could not confirm that ejaculation protects against prostate cancer.
There are several links between prostate cancer and sexual function. For example,
Prostate cancer and erectile dysfunction carry similar risk factors, and
Treatments for prostate cancer, including surgery and radiation therapy, can also