Sex expectations after prostate cancer treatment

It is one thing for a man to get a diagnosis of prostate cancer with the worry of his survival, but another concern for men is their sex life.  How will the treatments affect sex, especially prostate surgery, and will sex be the same as before prostate cancer?

The question of what kind of an impact prostate cancer will have on sex life needs to be addressed upfront from the beginning.  A man may or may not feel comfortable broaching the topic but it is an important aspect of his well-being and at some point, either the doctor or man should approach this subject.  Knowing what to expect in regards to sex can ease a man’s mind about his sexual recovery from prostate surgery.  Here are some areas of a man’s sex life that can and may be affected:

·      Impotence and erectile dysfunction (ED) after prostate surgery

It is to be expected that most men will likely experience ED but fortunately it is temporary. Nerves damaged during surgery may result in erectile dysfunction which is why a nerve-sparing prostatectomy may reduce the chances of nerve damage.    While a man recovers from surgery, he can use Viagra or Cialis to keep active in his sex life.  A man should not hesitate to ask for these medications when experiencing ED.  These medications can actually speed up recovery and are often only needed temporarily.

Besides prostate surgery, other forms of treatment for prostate cancer can affect a man’s sex life. Radiation therapy – brachytherapy, external beam radiation or stereoactic body radiation therapy, can each have somewhat different side effects. About half of all prostate cancer patients who undergo any of these types of radiation therapy are likely to develop erectile dysfunction.

Prostate cancer may also be treated with hormone therapy.  This reduces the level of male hormones in the body or to stop them from fueling prostate cancer cells.  Hormone therapy may cause a loss of libido (sex drive) for some but not all patients. Some men may find that they maintain their desire for sex but are unable to get an erection or are unable to reach orgasm. Hormone therapy may also reduce the amount of semen released at ejaculation.

If a man is treated with chemotherapy drugs they may experience a temporary loss of sex drive and have difficulty achieving an erection.

Factors that may determine how each man is affected include a man’s age and overall health that can greatly influence their ability to return to an active sex life after treatment. Generally, the younger a man is, the more likely he is to regain sexual function.

·      Orgasm

Orgasms after prostate surgery are possible and enjoyable.  Some men who may be experiencing ED may find that orgasms are possible even without an erection.  After surgery, men may also want to masturbate learning how his body will respond to stimulation and builds sexual confidence.  Also, practice makes perfect – once the doctor gives the go-ahead, a man should continue having sex as the sooner he tries, the sooner he will get back to enjoying an active sex life.

·      Ejaculation

One thing that will be different for men after prostate cancer is the fact that when the prostate gland is removed a man will no longer have ejaculations.  When there is no prostate gland or seminal vesicles present, ejaculations are not possible.  A man will still have pleasurable orgasms but they will feel different.

·      Leaking urine during sex

Temporarily after prostate surgery, some men will have some urine leakage during sex but it is harmless and will discontinue in time.  Practicing kegel exercises to work the pelvic floor can improve urinary control and orgasms.

·      Performance anxiety

Anyone going through a cancer diagnosis and treatments will have anxiety.  Prostate cancer brings along its own special concerns for men in their sexual performance.  This is normal for men to have worries about it and one way to relieve these concerns is to discuss it with their partner.  Having a partner involved to work through the physical and emotional intimacy of performance anxiety will help a man tremendously in gaining trust and belief that he will regain his sex life back.