Sex after prostate cancer
September is both prostate cancer awareness month and sexual health awareness month. Here’s what you should know about sexual function after treatment for prostate cancer.
- ⅓ to ½ of men already experience sexual dysfunction at the time of prostate cancer diagnosis. Age and other health problems play a significant role.
- All current treatments for prostate cancer result in increased rates of sexual dysfunction, which can include decreased desire, decreased semen volume, fertility issues, erectile dysfunction, decreased body satisfaction and relationship issues.
- Men who rate their degree of distress about sexual dysfunction as greater, report poorer quality of life following prostate cancer treatment.
How does treatment affect sexual function?
Erectile DysfunctionDifferent types of prostate cancer treatment affect sexual function in different ways. Surgery, hormone therapy, external beam radiotherapy, brachytherapy, high-intensity-focused ultrasound and cryotherapy can damage nerves and blood vessels, resulting in erection problems.
Sexual DesireHormone therapy causes decreased sexual desire (libido), due to a drop in testosterone.
Weight gain, breast swelling and penis shrinkage can occur following treatment. Consequently, some men struggle with negative body image, which can diminish sexual desire.
Also, it’s common to feel tired, stressed and “down” during cancer treatment and post-treatment. These feelings can affect relationships and libido.
OrgasmOrgasms are still possible following treatment, but they may feel different.
During and after treatment, patients sometimes notice a decrease is semen. Men undergoing radical prostatectomy will no longer ejaculate during orgasm, as the prostate and seminal vesicles responsible for making some of the fluid in the semen are removed. This is called “dry orgasm”.
Patients having surgery for an enlarged prostate (transuretheral resection of the prostate or radiotherapy) may find that semen isn’t ejaculated immediately during orgasm, but rather is passed later during urination.
Other changes may include pain during orgasm, leakage of urine during orgasm, and shortened erections and orgasms.
InfertilitySome men experience infertility for the reasons listed above or because radiation therapy has affected their ability to produce sperm. Patients who want to have children in the future may wish to store sperm, so that it can be used later for fertility treatment.
Getting help for sexual dysfunctionMany treatment options and supports are available for sexual problems. The best outcomes occur with a combination of treatment for erectile dysfunction and counselling to improve coping skills and your relationship with your partner.
Your urologist will be able to prescribe and advise you on treatment options for erectile dysfunction. Also, the Prostate Cancer Centre offers support groups and information for men dealing with sexual dysfunction following prostate cancer treatment.