Sex, relationships, and prostate cancer

How can prostate cancer affect relationships?

If you have a partner, coping with prostate cancer and its side effects may have changed your relationship and the way you have sex.

Some couples find that dealing with cancer strengthens their relationship and brings them closer together. While others may experience some or all of the following.

• Your normal pattern of having sex might change. Some men will avoid sex or any kind of closeness as they worry their partner will expect full (penetrative) sex.

• Dealing with cancer sometimes means relationships can change from romantic or sexual to something more like a close friendship, or patient and carer.

• You’ll probably be facing other changes in your relationship, such as changing priorities and life plans together.

Even though your sex life might not be the same as it was, there are still many ways of experiencing pleasure, closeness and fun together. Try to be flexible in your approach. It doesn’t have to be all about full penetrative sex. Being physically close in other ways can help to support or even improve your relationship during this time.

What are some practical tips for me and my partner?

Give the treatments a go

If you’re having erection problems, try the available treatments. You may need to stick with a treatment for a while before you see results. And you might need to try different treatments - or a combination - to find out what works for you.

Treatments for erection problems work for some men but not everyone. Don’t be put off if you know a treatment hasn’t worked for someone else – everyone is different.

Talk about it

If you have a partner, talking about sex and your thoughts and feelings will help you both deal with any changes. Some men worry about the effect these changes are having on their partner. Try not to guess how your partner is feeling, as guesses can often be wrong. And encourage them to get support too.

It’s not always easy to talk about sex and relationships, even if you’ve been together a long time. Some men find it hard to talk about their emotions, as they feel that being emotionally strong is part of what makes them a man. And sometimes, couples who are struggling to cope with the changes in their relationship will put off talking about it. They might think the other partner doesn’t mind the changes, feel embarrassed or not want to upset their partner.

Talking to each other, even if you need help to do so, can help you come to terms with the changes to your sex life. Communication can bring you closer together and make you feel more confident about facing the challenges.

 If you find it difficult to talk, it may help to write a letter to your partner or see a relationship counsellor. Your nurse or GP can talk to you about counselling. You could also try contacting organisations such as Relate or the College of Sexual and Relationship Therapists.

Stay close in other ways

Try different, non-sexual ways of being close. This could be as simple as holding hands or going out and trying new hobbies together.

Some couples plan an an evening out together every few weeks. Where possible, try to have time alone together, whatever your situation. If you’re in a hospital, hospice or have carers coming to your house, make sure they know when you need private time.

Some men say they just miss having a hug with their partner – so having a regular cuddle can help keep you close.

Focus on pleasure not erections

Take the spotlight off performance. Remember – having sex is not just about having erections and penetration. Men can feel sexual pleasure and have orgasms without an erection or ejaculating, and some get pleasure from pleasuring their partner.

• Find a space to be together that is warm and comfortable, and take some time to be physically close.

• Try some mutual massage sessions. You could start with a massage that avoids the sexual parts of the body, and then add some genital touching if and when it feels right.

• Many areas of the body can feel sexual pleasure, not just the genitals. These are called erogenous zones and are similar in men and women. Examples of the zones include lips, neck, ears, nipples, and inner thigh. Try gently touching, pressing or massaging these areas.

• Take things slowly, and later add in a session when you spend more time touching each other’s genitals. If you relax and use all your senses, you may be able to have an orgasm with a soft penis.

Have fun and experiment

It’s easy to fall into familiar sexual routines. Think of this as an opportunity to refresh your sex life. There’s no one way to have sex or experience sexual pleasure.

• You could try activities such as massages, mutual masturbation, oral sex, watching erotic films or reading erotic books. 

• Consider experimenting with sex toys. These include lubricants, vibrators, dildos, strap-ons and external penile prostheses (also called hollow dildos or penis sleeves). You can buy these in pharmacies, some supermarkets, high street lingerie and sex shops, or online.

You can make these changes gradually. Start off with holding hands or kissing if you don’t normally do this, and move on to new sexual activities when you feel comfortable.

Get some advice

If you have questions or concerns about sex, speak to your doctor, nurse or other healthcare professional. Some couples need more than just medical treatment for erection problems. Trying both medical treatment and seeking advice and support at the same time can help.

Sex therapy

Sex therapy (sometimes called psychosexual therapy or sexual counselling) normally involves a series of counselling sessions that include getting to know you and your sex life and may suggest exercises for you and your partner to work through at home. You can go by yourself or with your partner.

Sex therapists (or psychosexual therapists or sexual counsellors) have training in the causes and treatments of sexual problems, and may have a background in medicine, nursing or psychology.

What happens in sex therapy sessions?

The first appointments will focus on the therapist getting to know you and finding out about your sex life. You and your partner may have joint and separate appointments.

You may find the conversations with the therapist uncomfortable at first, but this should improve as you get more confident. Remember, therapists talk to people about sex all the time so are used to having these types of conversations.

At the end of these first few sessions, the therapist will give you some brief information and advice, and talk to you about whether further therapy might be useful. They may refer you for couples counselling, or other psychological services or treatment.

If you have further sex therapy, it will often involve more discussion of sexual problems, as well as specific activities to try and ways to work through them. You might have ‘homework’, such as:

• a series of exercises to help you and your partner get to know each other’s bodies and how they respond sexually

• finding ways to communicate more effectively

• experimenting with different ways of being close.

The therapist will work with you, at your own speed, to help find solutions that work for you.

There are many different options to try, and only you and your partner can make those decisions. Sometimes just having someone listen to how you’re feeling helps you find your own answers.

There are some myths about sex therapy that can cause anxiety; however, you'll never be asked to undress or do anything sexual in the therapy room.

How can I get sex therapy?

Sex therapy is available on the NHS in some areas, or you can pay for it privately. For NHS services, you will usually need a referral from your GP or other healthcare professional.

Check that any sex therapist you see is registered with the College of Sexual and Relationship Therapists, the British Association for Counselling & Psychotherapy or the Institute of Psychosexual Medicine.

If you're gay or bisexual

Prostate cancer affects gay and bisexual men in many of the same ways as heterosexual men, but there can be some other issues too. Not all gay or bisexual men have anal sex – but if you do, then the the effects of erection problems and bowel problems can have an impact.

If you're the penetrative partner

If you prefer being the penetrative partner during anal sex, then you normally need a strong erection, so erection problems can be a particular issue.

Try using a constriction ring around the base of your penis together with another treatment, like PDE5 inhibitor tablets, to help keep your erection hard enough for anal sex. You can buy constriction rings in pharmacies, sex shops or online.

If you're the receptive partner

If you receive anal sex, then bowel problems or sensitivity in the anus may be an issue after radiotherapy.

• If you’ve had external beam radiotherapy, your doctor may suggest you avoid receiving anal sex while you're undergoing treatment and at least two months after you've finished treatment.

• If you’ve had permanent seed brachytherapy, there's a risk in the first few months that your partner might be exposed to some radiation during sex. Your doctor may suggest you avoid receiving anal sex or anal play for the first six months after your treatment. Talk to your doctor or nurse for further advice.

• If you’ve had high dose-rate brachytherapy and have bowel problems after treatment, your doctor may suggest avoiding receiving anal sex or anal play for two months after treatment.

Try using a condom and extra anal lubrication. Cleaning yourself before sex may also make you feel more comfortable, but douching can irritate the lining of your back passage. This makes it more likely to get infections, so you may prefer to just clean the outside area.

If you’re receiving anal sex, a lot of the pleasure comes from the penis rubbing against the prostate. This is why the prostate is often referred to as the male g-spot. You can find out more in The Love Tank's 'Little backpocket guide to prostate pleasure and health'.

Some men who receive anal sex find that their experience of sex changes if they have surgery to remove their prostate (radical prostatectomy).

As with all sexual changes, you may be able to find ways to work through this, to give and receive pleasure, and to remain close or intimate.

Talking to healthcare professionals

Some men find that their doctor or nurse assumes they are heterosexual. Healthcare professionals don’t normally record people’s sexuality. It can help to tell your doctor or nurse about your sexuality, particularly if you have specific issues you want to talk about. Seeing a counsellor or sex therapist may help if you find it difficult to talk to your nurse or doctor.

Find out about how prostate cancer and its tests and treatments can affect gay and bisexual men, and talking about your sexuality to health professionals here.

Prostate Cancer UK’s support services are open to everyone, whether you’re gay, bisexual, trans, heterosexual, single or in a relationship. Partners can also use our services. There are several support groups for gay and bisexual men and trans women living with prostate cancer. To find your nearest support group, visit Tackle Prostate Cancer’s website. 

Sex when you're single

Being sexually active and feeling attractive can be just as important if you’re single. All the treatments for erection problems and sexual support are available to you if you’re single – whether you want to be able to masturbate, have sex, or start a new relationship.

Starting a new relationship

If you’re starting a new relationship, then sexual problems and other treatment side effects, like urinary or bowel problems, can be a particular concern. Some men especially worry that their erection problems will affect their chances of having a new relationship.

Fear of rejection is natural and everyone worries about this, whether or not they’ve had cancer. If you’re single, you may want time to accept any changes prostate cancer has caused before you start having sex or dating. Try talking about your worries with someone you feel comfortable with. This could be a friend, or a counsellor or sex therapist, if you’d prefer talking to someone you don’t know.

If you’re sexually active but not in a relationship, or if you want to start dating or start a new relationship, these tips may help.

• Be upfront. Pick the right moment to talk about your sexual problems – wait until you feel comfortable with the person and trust them. Choose a time when you are on your own together and are both relaxed.

• Take your time. You may not want to try full (penetrative) sex with a new partner straight away, especially if you have erection problems. You could wait for a while and focus on getting to know each other first.

Rejection can happen, but many people will accept sexual differences and be understanding and supportive.

Support for partners

If you’re a partner of a man with prostate cancer, it’s likely you will also be affected by changes to your relationship and sex life.

Some partners feel distressed and may become anxious and depressed. You may go through:

• worries about the future, such as what will happen if your relationship breaks down or your partner dies

• changes to how you feel about yourself – if your partner has a low sex drive this might make you feel less desirable or attractive

• feeling frustrated or unsatisfied if your sex drive is higher than your partner’s or you’re having less sexual contact

• anger or sadness at the loss of how things used to be

• guilt for still having sexual feelings.

 How can prostate cancer affect partners?

Your own desire for sex may change after your partner’s diagnosis and during treatment. For example, feeling anxious, changing roles in the relationship, or dealing with your own health or sexual problems can affect how you feel about sex.

Some men who are living with prostate cancer avoid being physically close to their partners. This might be because they feel uncomfortable with changes to their bodies or sex drive. Or they may do this because they feel under pressure to perform sexually. This doesn’t mean they no longer care for you.

If your partner is using treatments for erection problems, try finding out more about the treatments yourself and how to use them. It can make it easier to fit them into your sex life.

Many partners don’t talk about their feelings because they want to protect the person they love. But it’s important to get some support for yourself, perhaps without your partner. Talking to other partners who are experiencing the same thing, or getting some counselling, may also help.

Talking about sex can be difficult, even if you’ve been together for a long time. If you or your partner find it difficult to talk about sex, it may help to see a sex therapist.

Getting support is important for your own wellbeing. Men with prostate cancer often worry how changes to their sex lives are affecting their partners, so it could also help your partner to know you’re also getting support.

Explore what support is available for the partners, family and friends of men with prostate cancer. Or you can call our Specialist Nurses on 0800 074 8383, or chat to them online. Our Specialist Nurses are here for you too.

References and reviewers

Updated: March 2026 | Due for Review: March 2029