Prostate cancer is the second most commonly occurring cancer in men and the fourth most commonly occurring cancer overall. Affecting over 47,500 men yearly in the UK alone, the psychological effects on sexuality both physically and mentally can be significant. From the side effects of treatment to the mental toll of a diagnosis, there are many ways prostate cancer changes intimacy and sex. But there are ways for cancer survivors and their partners to reclaim their intimacy and return to having a healthy sex life with therapies and innovative solutions. If you are a cancer survivor or the partner of one, here are the things you should know about prostate cancer, sex and intimacy.
How can prostate cancer change intimacy?
Mental challenges
Experiencing cancer and facing your own mortality can hugely affect you mentally. With your mind preoccupied it is easy to ignore your sexual and intimate needs. However, it is important to remember that your sexual health contributes to your overall well-being and recovery.
Dealing with body changes after treatment for prostate cancer can cause unwanted stress and anxiety specifically for men who may be dealing with erectile problems. If these feelings are severe it may be helpful to see a professional who specializes in sexual problems (sex therapist) or cancer after-care.
Erectile dysfunction
After prostate cancer surgery and treatment, around 85% of men will experience erectile dysfunction (ED), which is the inability to get or keep an erection long enough to satisfy penetrative sex or sexual activity. This is because prostate surgery can damage the nerves and muscles responsible for erections.
Performance challenges
After major treatment it is likely your performance in the bedroom will be affected at least temporarily, whether this is because of the physical side effects or mentally. Getting intimate can bring up a range of complex emotions as you get used to your body working differently.
Orgasm challenges
Another major change can be the orgasm experience. With many treatments changing your semen production it is common for people with penises to experience dry orgasms; whereby the feeling is still there but there is no ejaculation. This can feel very different from the experience prior treatment with many individuals finding the feeling of orgasm more intense.
How different prostate cancer treatments affect your sexual function
The prostate gland plays an essential role in sexual function in men. It produces a fluid that helps transport sperm during ejaculation. Treatment for prostate cancer can damage the nerves and blood vessels that control erectile function, leading to sexual side effects. The degree of sexual dysfunction depends on several factors, including:
- The type of treatment received (surgery, radiation therapy, hormone therapy, or a combination of these)
- The patient's age and overall health
- The patient's sexual function before treatment
Sexual function can improve over time after treatment, but it may take months or years for some men to regain their sexual function fully. Below is how the different types of prostate cancer treatments might affect your sexuality, keeping in mind everyone’s body and circumstance will vary.
Hormone therapy
With hormone therapy patients are likely to experience changes to sexual function including a decrease in libido and semen production. This treatment works through lowering your testosterone levels, something that is needed to have a healthy sex drive. These side effects last throughout and a few months after hormone therapy but generally are seen to improve with time.
Hormone therapy can also affect your body due to a decrease in muscle tissue and an increase in body fat; this can change your relationship to your body and how you perceive yourself. Just remember these changes are completely normal and take each day as it comes.
Radiation therapy
Radiotherapy can damage blood vessels and the nerves that control erections, resulting in problems with erectile function. This can improve over time or through additional treatments that can help treat erectile dysfunction.
Due to the changes in semen production many people are still able to orgasm but experience ejaculation differently with little semen production.
Surgery
A radical prostatectomy can have side effects that impact your sex life. This includes erectile dysfunction (ED), shorter penis and orgasms without producing semen. Due to the inability to produce semen having children naturally is not possible, however, it is possible to store sperm before surgery for future fertility treatments.
High-intensity focused ultrasound
Risks of side effects include problems maintaining and achieving an erection however this is a relatively new treatment whose long-term side effects haven't been studied yet.
When can you have sex after prostate cancer treatment?
The timeline for resuming sexual activity after treatment varies from patient to patient. You should consult your doctor to avoid any damage or complications. Below are estimates of when you can have sex based on the treatment you received.
Partial or radical prostatectomy
Patients who undergo surgery to remove the prostate gland typically need to wait four to six weeks before resuming sexual activity. This period allows the body to heal and reduces the risk of complications. You may experience decreased sexual function after surgery, including erectile dysfunction and decreased sex drive.
Radiation therapy
If you receive radiation therapy, you may experience fatigue and other side effects that can affect sexual function. The timeline for resuming sexual activity varies, depending on your response to treatment. Some may be able to resume sexual activity within a few weeks of completing treatment, while others may need to wait several months.
Hormone therapy
This is often used to treat cancer that has spread to other body parts. This treatment can reduce testosterone levels, leading to decreased sex drive and erectile dysfunction. Patients may be able to have sex during hormone therapy, but it may be more challenging to achieve an erection.
Combination therapy
Some patients receive a combination of treatments for prostate cancer, such as surgery followed by radiation therapy. The timeline for resuming sexual activity after combination therapy depends on the type and extent of treatment.
Ways to navigate intimacy challenges after prostate cancer
Whether your intimacy issues stem from physical, emotional, or likely a combination of both, there are various treatment options available to help men and couple’s reclaim intimacy.
Communicate with your partner
Create an open dialogue with the people around you. This could initially be your doctor who can offer advice on how to look toward intimacy. They can help you feel more positive and in control of the next steps in your life. Highlighting treatments that can be started in the weeks and months after cancer treatments to help with intimacy.
Communicate then with your partner about new insecurities that you may have. After going through life-changing events your relationship with yourself is likely to have changed and evolved. A great way to heal is by discussing how changes affect you both physically and mentally. By rediscovering intimacy and desire with your partner you may find you feel closer to your partner than ever.
Make time for intimacy
Healing can be a long process, so celebrate every small victory especially when it comes to intimacy and feeling good. Put time aside weekly to enjoy getting close again to your partner, this doesn’t have to mean sex but rather intimacy such as kissing, cuddling and holding hands. This can rebuild your sexual relationship with yourself and your partner, making you feel more connected and restore some normalcy after cancer.
Get plenty of rest
Tiredness is a common side effect of all treatments for prostate cancer, this can cause you to lose interest in sex or quite simply not have enough energy. Take time to relax and unplug so you can re-energize.
Try medical ED devices & sex toys
ED devices and other sexual aids, like vibrators can be a helpful tool for patients who experience sexual dysfunction after prostate cancer treatment. Many types of sex toys are available that can help patients achieve and maintain an erection, like the medical male vibrator Tenuto 2.
This doctor-recommended vibrator is clinically proven to improve ED and performance anxiety in men. It uses localized vibrational therapy with 4 anatomically placed motors that boost blood circulation, resulting in a firmer erection and increased arousal – two major issues during and after prostate cancer. And because intimacy is a two-person experience, Tenuto 2 was designed to enhance pleasure for both partners during sex, making it a climactic experience for both partners.
Another common ED device is a vacuum erection device also known as VED. They use suction to draw blood into the penis, creating an erection. They are helpful for patients who have difficulty achieving an erection on their own.
You should always consult your doctor about what kind of aids and sex toys are safe to use before using them after surgery. Some types may not be suitable for patients with certain medical conditions.
Connect with other cancer survivors & your community
Talking about these changes with people in your support network such as partners, other cancer survivors and doctors can help you navigate your new norm after physical changes and the emotional toll. Don’t underestimate the power of your community to help you.
Takeaway
After prostate cancer and subsequent treatment, getting back to your daily routine can be difficult, but not impossible. While sexual function can be affected by prostate cancer treatment, survivors have many options to improve their sexual function and health, from medical vibrators to VEDS. Patients should discuss the timing of sexual activity and ask which sex toys they can use with their doctor to avoid complications. It may be awkward, but working with them will help you regain your quality of life after prostate cancer treatment. Take control of your sexuality and take steps to start enjoying sex and intimacy again.
Additional resources
- Signs of prostate cancer
- Prostate cancer uk
- Cancer.org
- Fertility and sexual side effects of treatment
- Real life stories
