A lot of men ask us what their sex life will be like after prostate cancer treatment. Here Lorraine Grover, a clinical nurse therapist in sexual wellbeing, answers some of the most frequently asked questions.
In reality, the answer to this is different for every man and depends on what treatment you’ve had, whether you’re feeling up to it, and whether you’ve had any sexual problems in the past. It is common for men to have difficulty getting an erection but this can improve with time and treatment. Many men will be able to have sex again but it is likely to be quite different. Remember, you can have orgasms without having an erection or ejaculating. And sex doesn’t have to be about penetration. You could try different things like massage, mutual masturbation, oral sex, vibrators or dildos. And you can get treatment on the NHS to help with erections - like tablets or a vacuum pump.
Yes, sex can feel quite different. You’ll still have feeling in your penis and you should be able to have an orgasm but it may not feel the same. If you’ve had surgery you won’t ejaculate when you orgasm, but you will still get the feeling of an orgasm. If you’ve had other treatments, including hormone therapy, you may notice that you produce less semen and your sexual desire may not be the same. Again, you should still be able to have an orgasm but it may feel different.
There are a number of different treatments for erection problems, such as tablets, pellets, injections, pumps and implants and different treatments will work for different men. These are not always a ‘quick fix’, and you often have to stick with them or try different ones to see what works best for you. Research shows that men who try more treatments are more likely to find one that works. For some treatments you need to have a desire for sex (libido) but others, like pumps, injections and pellets will work without this.
Hormone therapy reduces or blocks the effect of the testosterone that gives you your sex drive. Not having a sex drive may make you feel less confident about your masculinity and physical changes such as putting on weight, hot flushes or breast swelling, may have the same effect. There are ways to tackle this. Try focusing on the things you like about yourself, do activities you are good at, or try something new. Being physically active can lift your mood and keep you in shape. Making changes to your diet can help with losing weight. It could help to talk to someone who has been there – use our telephone peer support service, join a support group or our online community.
Dealing with cancer and side effects can put a strain on your emotional and physical relationship. Being open and honest about how you’re feeling can help. You could also try some of the medical treatments for erection problems or explore new ways of being close sexually. Don’t forget your partner may also benefit from support. Take time to be together. This could just be going for a walk or having dinner together at home. If you are in a hospital, hospice or have carers coming to your house make sure they know when you need private time. If you are finding it difficult to talk you could see a relationship counselor. Relate provides counseling and a range of other support services. A sex therapist can also help you communicate about sex
Find out more about sex and prostate cancer