This information is for all men with prostate cancer, whether
you are single or in a relationship. Or whether you are
heterosexual, gay, bisexual or transgender. Partners of men with
prostate cancer may also find it useful.
You can also watch men's
personal stories about sex after prostate cancer.
Contents
How can treatment for
prostate cancer affect my sex life?
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.
Some common worries
- It is not possible to pass cancer through sex.
- Having sex will not affect your cancer or the success of your
treatment.
- Erections are safe even if you have your catheter in.
Back to contents
How can I get treatment and
support?
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)
clinic.
Men with prostate cancer can get free medical treatment for
problems with erections or other sexual problems on the NHS. Your
GP or doctor or nurse at the hospital can prescribe treatment if
you want help getting erections for masturbation or sex. There's no
age limit for getting treatment but there may be a limit on how
much your GP can prescribe.
If you start treatment and find that you need it more regularly
or the treatment has not worked, go back and let your GP know. They
may review your treatment or refer you to a specialist.
Back to contents
Erection
problems and treatment
After treatment for prostate cancer you may have difficulty
getting or keeping an erection. This is also known as erectile
dysfunction (ED) or impotence. Many men get problems with their
erections and this is more likely to happen as men get older.
Causes of erection problems include one or a combination of the
following: treatment for prostate cancer, other health problems,
certain medicines and depression or anxiety.
Treatments include:
- tablets
- injections
- pellets
- vacuum pump
- surgical implant
- sex therapy.
Because getting an erection also relies on your thoughts and
feelings, tackling any worries or relationship issues as well as
having medical treatment for erection problems, often works
well.
Keeping a healthy weight, being physically active, stopping
smoking and trying pelvic floor muscle exercises may also help
improve your erections. Read more about diet and physical activity or pelvic floor muscle
exercises.
If you are on hormone therapy then you may have lost your desire
for sex, so treatments that only work when you have desire, such as
PDE5 inhibitor tablets like sildenafil (Viagra®), are
unlikely to work. However injections, pellets, vacuum pumps and
surgical implants should be able to give you an erection as you
don't need to have sexual desire for them to work.
Read more about treatments for erections
problems.
Watch Paul's story: Find out more about trying different
treatments for erection problems.
Watch other
men's personal stories about sex after prostate cancer.
Back to contents
How does prostate cancer
affect your desire for sex?
Prostate cancer and its
treatment can affect your desire for sex. Hormone therapy for
prostate cancer will change your sex drive and may mean you have
much less interest in sex. This is because of the decrease in
testosterone, which is the hormone responsible for giving you your
sex drive. You could ask your doctor or nurse specialist team about
the option of 'intermittent hormone therapy'. Desire for sex should
return to normal after hormone treatment is stopped, but it can
take up to a year. Read more about the side effects of hormone therapy.
You might want to try treatment for erection problems, even if
your sex drive is reduced. Some of the treatments for erection
problems may work for you.
Other things that effect your sex drive include: feeling
depressed or anxious feeling tired and dealing with other physical
side effects such as urinary, bowel problems and physical changes
after hormone therapy, such as putting on weight, or breast
swelling.
Read more about dealing with these changes in the booklet, Prostate cancer and your sex life.
Watch Bruce's story: Find out how he dealt with changes to his
sex drive.
Watch other
men's personal stories about sex after prostate cancer.
Back to contents
Will prostate
cancer treatment affect the size of my penis?
Some men find that their penis is shorter after surgery (radical
prostatectomy). Men may be less likely to experience these changes
if the surgeon has been able to save the nerves that control
erections during surgery (nerve sparing surgery).
Other types of prostate cancer treatment such as radiotherapy
and hormone therapy may also cause changes to the size of your
penis.
Encouraging blood flow to the penis after surgery may improve
erections and prevent your penis becoming smaller. In particular
using a vacuum pump after surgery may stretch the tissue and help
maintain your penis size.
Dealing with these changes can be difficult, read more about the
support that is available to you below.
Back to contents
Will prostate cancer treatment
affect my orgasm and ejaculation?
After surgery (radical prostatectomy) you will not be
able to ejaculate, as the prostate gland and seminal vesicles,
which store and transport semen, are removed during the operation.
Instead you may have a 'dry orgasm' where you have the feeling of
orgasm but semen does not come out of your penis. If you have had
radiotherapy, brachytherapy
,high
intensity focused ultrasound (HIFU) or hormone
therapy you may produce less semen during and after
treatment.
If you have had surgery called TURP (transurethral resection of the prostate)
you may have a retrograde ejaculation. This is when you orgasm and
the semen does not come out straightaway, but is passed out of the
body the next time you pass urine. It is not harmful and should not
affect your enjoyment of sex but it may feel quite different to the
orgasms you are used to.
| Some men leak
urine when they orgasm,or experience some pain.Others find they
don't last as long during sex and ejaculate too quickly. Read more
about this and ways to manage these issues in our booklet: Prostate cancer and your sex life. |
Back to contents
Will prostate cancer
treatment affect my fertility?
Prostate cancer treatment can affect your ability to produce
sperm or ejaculate and can lead to infertility. If you've had
surgery then the prostate gland and seminal vesicles, which produce
some of the fluid in semen, are removed during surgery. The cells
that make semen can also be damaged during other treatments such as
radiotherapy. Brachytherapy may have less of an effect on fertility
than other treatments for prostate cancer but we still need more
research into this. You may notice that you produce less fluid when
you ejaculate but it is possible that you are still fertile.
If you are planning to have children you may be able to store
some sperm before treatment so that they can be used later in
fertility treatment. Sperm banking is usually available on the NHS,
but this varies. Ask your doctor or nurse about what fertility
treatment is available locally.
Changes to your sperm during radiotherapy, brachytherapy and
chemotherapy could affect any children you may conceive during this
time but the risk of this happening is very low. You may wish to
avoid fathering a child during treatment and for a while after
having treatment.
Macmillan Cancer Support and Infertility Network UK produce more information
about fertility treatments
Back to contents
Sex and
relationships
If you have a partner, 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 pleasure, closeness or
fun together. Keeping some kind of physical closeness alive, in
whatever ways possible, can protect or even improve your
relationship.
Some couples find it useful to see a relationship counsellor. The
charity Relate provide relationship counselling and a
range of other relationship support services. Sex therapy is
available on the NHS or privately.
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.
Watch Ally's story: Find out about communicating as a
couple.
Watch other
men's personal stories about sex after prostate cancer.
Back to contents
Gay and
bisexual men
Prostate cancer affects gay and bisexual men in many of the same
ways as heterosexual men, but there can be some other separate
issues too.
If you give anal sex you could try using a constriction ring
around your penis, together with another treatment like PDE5
tablets, to help keep your erection hard enough for anal sex. If
you receive 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. If you are experiencing bowel problems or
sensitivity in this area then wait until these side effects have
subsided before trying vigorous anal play or sex. Talk to your
doctor or nurse for further advice.
Some men who receive anal sex find that if they have they had
surgery to remove their prostate then their experience of sex
changes. As with all sexual changes, you may be able to find ways
to work through this and find new ways of giving and receiving
pleasure.
There is more information about talking to health professionals
about your sexual orientation in Prostate cancer and your sex life.
Watch Martin's story: For one gay man's experience.
Watch other
men's personal stories about sex after prostate cancer.
Back to contents
Sex when you're
single
Being sexually active and feeling attractive can be just as
important if you are a single man. Remember all of the treatments
and tips that have been described here are available to you if you
are single
If you are starting a new relationship, sexual problems and
other side effects like urinary or bowel problems could be a worry.
Some men worry that having problems with erections will affect
their chances of having a new relationship in the first place. Fear
of rejection is natural, and everyone has their own hang-ups
whether they have had cancer or not. If you are single, you may
want time
Read Prostate cancer and your sex life for more
tips.
Back to contents
Tackling your thoughts and
feelings
Dealing with sexual problems can make you feel depressed,
worried, unsatisfied, angry and as if you've lost a part of
yourselves. But there are ways to tackle your issues and find
solutions that work for you.
If you are feeling very down you may need to deal with this
before you can address any sexual issues. Counselling can help some
men. Counsellors are trained to listen and work with you to
understand your feelings and find your own answers. Your GP can
refer you to a counsellor or you can see a private counsellor. British Association for Counselling and
Psychotherapy. Other organisations such as the Sexual Advice
Association and the College of Sexual and Relationship Therapists
can also help.
There are also other ways to face these challenges:
Read more about what you can do to help yourself in our booklet:
Prostate cancer and your sex life.
Back to contents
Questions to ask your
doctor or nurse
- How could my treatment for prostate cancer affect my sex
life?
- How soon after prostate cancer treatment can I masturbate or
have sex again?
- What are the treatments for erection problems and which will be
best for me?
- What happens if the treatment does not work? Are there other
treatments I can have?
- Which treatment can I get from my local NHS?
- What other support is available to me?
- Can my partner also get support?
Back to contents