In many ways, prostate cancer and other prostate problems are
the same for men whatever their sexuality – gay, bisexual or
But if you are gay, bisexual or a man who has sex with men, you
might have some specific questions or concerns.
On this page there’s some information that may be more relevant
to you as a gay or bisexual man, or a man who has sex with men -
there are also lots of links to the other more detailed information
on our website.
Everyone is different, so if the information here is not quite
right for you then you should be able to find what you need on our
pages. If you have any other questions or need more support,
get in touch with our Specialist Nurses on our confidential helpline.
problems and prostate cancer
The three most common prostate problems
For some men, problems urinating could be a sign that they have
a prostate problem, usually an enlarged prostate. Or
it might be an infection or inflammation of the prostate, called prostatitis.
Early prostate cancer
doesn't usually cause problems urinating.
Problems with urinating could also be caused by another health
problem, such as diabetes, or by any medicines you are taking, such
If you've got symptoms, get them checked out by your doctor.
Find out more about symptoms
to look out for.
There’s no evidence that gay or bisexual men are more likely to
get prostate cancer or
problems. But prostate cancer is the most common cancer in
men in the UK. About 1 in 8 men will get prostate cancer at some
point in their lives. Older men, men with a family history of
prostate cancer and Black men have a higher risk.
Find out more about your risk of prostate cancer.
If you are over 50, a Black man, or have a close relative who
has had prostate cancer - or if you have symptoms such as problems
peeing - you might want to get further advice or a check-up at your
Testing for prostate
There is no single test to diagnose prostate cancer, but there
are a number of tests which can be used to see if you have a
prostate problem. These include a blood test known as the PSA test,
physical examination of your prostate (called a digital rectal
examination or DRE), and a prostate biopsy.
Read more about tests for
prostate problems and prostate cancer.
The PSA test
The PSA test measures the total amount of prostate specific
antigen (PSA) in your blood. PSA is produced by the prostate. It’s
normal to have a small amount of PSA in your blood, and the amount
rises as you get older.
A PSA test alone can’t tell you whether you have prostate
cancer, and there are pros and cons to having one. If you’re
thinking about having a PSA test, it’s important to find out more
about it first, so you know the facts before you decide.
Certain things might cause the PSA level to rise for just a
short while – and make the test results misleading. This includes
being the receptive partner (the ‘bottom’) during anal sex or
stimulation of the prostate, so it might be wise to avoid this in
the week before a PSA test.
Find out more about the PSA
test and what else can affect your PSA levels.
Digital rectal examination (DRE)
The DRE is a common way of helping to diagnose a prostate
problem. Your doctor or nurse feels the prostate gland through the
wall of the back passage (rectum). Find out more about the DRE
If your test results suggest you may have a problem with your
prostate, your GP will refer you to a hospital specialist who will
then decide if you need further tests, such as a biopsy. A prostate
biopsy takes tiny pieces of the prostate to look at under a
microscope for signs of cancer. The biopsy involves having a probe
inserted into the rectum (back passage).
There are some short-term effects of a biopsy. One side effect
is blood in your semen - some men have a bit of blood, others have
a lot. Your semen may look blood-stained. Wear a condom if you are
having sex during this time.
Read more about the
biopsy and the other side effects.
If you are the receptive partner (‘bottom’) during anal sex,
ideally wait for around six weeks after a biopsy before having sex.
Ask your doctor or nurse at the hospital for further advice.
Read more about speaking with health
Treatments for prostate
Your treatment options will depend on whether your cancer
is contained within the prostate gland (localised), has spread just
outside of the prostate (locally advanced) or has
spread to other parts of the body (advanced).
You may have a choice of treatments. Your doctor or specialist
nurse will explain all your treatment options, and help you to
choose the right one for you.
Each treatment has its own advantages and disadvantages. Your
personal preferences are very important – think about how the
treatment and its side effects will fit into your life.
You might find it helpful to get support, information and advice
Read more about the treatments for
Side effects of
prostate cancer treatment
Depending on what treatment you have, side effects can include
problems with erections, urinary
problems (for example leaking urine),
bowel problems and
You’ll have your own reasons for considering one treatment over
another, including how side effects could affect your lifestyle.
For example, if you are the receptive partner (‘bottom’) during
anal sex you might want to find out about different types of
radiotherapy or a treatment called
brachytherapy, which aim to reduce the risk of damage to areas
around the prostate – including the bowel and the back passage. Not
everyone will be able to have these treatments, so speak to your
doctor or nurse to find out more or read more about choosing
As well as discussing your treatment options with your partner,
family or friends, it’s worth talking the decision over with your
health professionals. Consider letting them know about your
sexuality and lifestyle so they know how treatment could have an
impact on you and so they can give you specific information and
Find out more about speaking with health
Find out more about treatment side effects and ways to manage
them on our living with prostate cancer
Sexual side effects
Having treatment for prostate cancer can affect:
- how you feel about yourself sexually
- your desire to have sex (libido)
- your ability to get an erection (erectile function)
- your ability to ejaculate and have an orgasm
- your sexual satisfaction
- your fertility
- the appearance of your body
- your relationships.
For more detailed information on the risks of sexual problems
for each different prostate cancer treatment, read our treatment pages.
The way that sexual side effects affect you could depend on your
approach to sex, sensuality and intimacy. Not all gay and bisexual
men have anal sex – but if you do, then the impact of side effects
will depend on whether you identify as a ‘top’, a ‘bottom’ or
Experience of sex
If you have a partner or you are sexually active then coping
with cancer and side effects may have changed your relationship and
the way you have sex.
Your sex life is unlikely to be the same as it was before cancer
- but you don't have to give up on having closeness, pleasure or
fun. Keeping some kind of physical closeness alive, in whatever
ways possible, can protect or even improve your relationship.
Prostate cancer and
your sex life provides practical tips to help with your
sex life, further information about sex therapy and specific
information for partners.
If you’re the receptive partner (‘bottom’) during anal sex a lot
of the pleasure comes from the penis rubbing against the prostate,
and for this reason it is often referred to as the male g-spot.
Some men who are the receptive partner during anal sex find that if
they have surgery to remove their prostate (radical prostatectomy)
or radiotherapy, their experience of sex changes.
With all sexual changes you may be able to find ways to work
through this and find new ways of giving and receiving pleasure and
keeping closeness or intimacy alive.
Find out more about
prostate cancer, sex and relationships.
Watch Martin’s story, for one gay man’s
experience of dealing with the impact of prostate cancer on sex and
To be the active partner (the ‘top’) during anal sex you
normally need a strong erection, so erection problems can be a
particular issue. You could try using a constriction ring around
your penis together with another treatment like tablets (such as
Viagra), to help keep your erection hard enough for anal sex.
There are also other treatments for erection problems such as
vacuum pumps, injections and pellets.
Speak to your GP or doctor or nurse at the hospital to find out
more about treatments for sexual problems. They might refer you to
a specialist service such as an erectile dysfunction (ED)
Find out more about speaking with health
Bowel problems and anal sensitivity
If you are the receptive partner (‘bottom’) during anal sex,
then bowel problems after radiotherapy may be a particular issue.
Some men also find that the skin inside their anus is more
sensitive after radiotherapy.
If you are experiencing bowel problems or sensitivity in this
area then wait until these issues have subsided before trying anal
play or sex. Although short-term problems in the back passage
usually settle down within six weeks of finishing treatment, there
can be some permanent changes in the anal canal.
It’s wise to be cautious and perhaps less adventurous than you
were before your treatment. Talk to your doctor or nurse for
Find out more about speaking with health
Use a condom and try extra lubrication once any sensitivity
settles down. Use water soluble or silicone-based lubricants; never
use oil-based lubricants such as body lotions, massage oils or
Vaseline, as they can cause the condom to break.
Cleaning yourself before sex can make you feel more comfortable,
but douching can irritate the lining of your back passage, making
it more vulnerable to infections. So you may prefer to just clean
the external area, rather than cleaning inside. GMFA provide
more general advice about douching.
Find out more about managing
Ejaculation and orgasm
surgery for prostate cancer (radical prostatectomy) you will no
longer be able to ejaculate semen, although you will still be able
to have an orgasm. Some men say that this also changes their
experience of sex, but after time some men can adapt to it.
HIV and prostate cancer
HIV (human immunodeficiency virus) doesn’t only affect
gay and bisexual men, but as a population gay and bisexual men are
more likely to be affected by HIV. This information answers
particular questions that gay and bisexual men have asked us about
HIV and prostate cancer.
There is evidence that some cancers – such as anal cancer, lung
cancer and some lymphomas – are more common in people living with
HIV. Researchers have looked at whether men with HIV are more
likely to develop prostate cancer. At the moment, we don’t know for
sure. But there is research that shows that men with HIV can still
benefit from treatments for prostate cancer like surgery and
radiotherapy. And these men don’t seem to get increased side
Some medicines used to treat cancer can interact with medicines
to treat HIV or conditions associated with HIV. If you do have HIV
and prostate cancer, it’s important that health professionals
specialising in HIV and cancer discuss the best treatment options
for you. It is also very important that your doctors know about all
the medication you take, including over-the-counter and herbal
remedies and any recreational drugs.
Speaking with health
Some men find that their doctor or nurse assumes that they are
heterosexual. Health professionals don’t record people’s sexuality
as a standard. But it can help to let your doctor or nurse know
about your sexuality and bring your partner to appointments. It can
be helpful if you want specific information or support, and
including your partner or loved one can mean you feel more
supported during appointments.
Most health professionals will have equality and diversity
training and the NHS has a legal duty to treat people fairly, which
means it’s illegal to discriminate against you because of your
sexual orientation. It is your right to have the same standard of
care and treatment as heterosexual men.
But if you feel your rights are not being respected, you can
complain. If you live in England contact your nearest Patient
Advice and Liaison Service (PALS) at your local hospital or through
Choices. Find out more about raising concerns or complaints
about healthcare in Scotland, Wales or
Ireland. Or contact Stonewall’s
You could also seek advice about the impact on your sex life at
a Genito-urinary Medicine (GUM) clinic or sexual health clinic.
They know a lot about sexual issues, and may be able to advise
about what can help.
Including your partner
If you are in a civil partnership then you have the same
healthcare rights as a married couple. A civil partnership also
gives your partner the right to be your nearest relative. This
means that they can be involved in decisions about your
If you're not in a civil partnership but do have a
partner or boyfriend, then you can nominate them as your point of
contact or ‘next of kin’. Next of kin can be anybody in your social
or family network. Staff must respect your wishes about who this
If you give permission, your partner, boyfriend or friend
- be involved in medical appointments
- be included in discussions about your diagnosis, treatment and
- make sure your wishes are represented.
Getting more support
All Prostate Cancer UK services are open to everyone, whether
you are gay, bisexual, transgender, heterosexual, single or in a
relationship. Partners can also use our services.
There are other men who’ve been through similar experiences, and
you might find it helpful to be in touch with them through our peer support service. Let us
know if you’d prefer to talk to a gay or bisexual man.
You may also want to talk to gay and bisexual organisations such
as The Lesbian and Gay
Foundation, GMFA, Stonewall, Health with Pride, LLGS Helpline and Malecare.
The Canadian Cancer Society have also produced a
series of films about gay men confronting prostate cancer.
Out with Prostate Cancer is a prostate cancer support group for
gay and bisexual men. The group meets on the first Saturday of
every month at the Lesbian and Gay Foundation in Manchester between
2-4pm. The group offers a safe and confidential environment to
discuss your concerns and experiences with other gay and bisexual
men who deal with the same problems. Although the group meets in
Manchester, it is keen to offer support to gay and bisexual men
throughout the country.
For more information email email@example.com
or visit the Out With Prostate
More support groups for gay and bisexual men may be set up in
the near future, look out for information on our support groups