How Prostate Cancer May Affect Sexual Health

The prostate is a gland in the male reproductive system that surrounds the urethra and is about the size of a walnut. It is responsible for making seminal fluid, which is the fluid that sustains and carries sperm.

Aside from skin cancer, prostate cancer is the most frequently occurring form of cancer in American men. Like other forms of cancer, it is best treated when it is detected early, so in many cases, it may be a good idea to screen for it with blood tests or a physical examination.

Sometimes, men who have had or who are undergoing treatment for prostate cancer experience changes in their sexual function. Fortunately, there are things that prostate cancer patients and their health care providers can do to lessen the negative effects of prostate cancer treatment on sexual function and improve their sexual health.

What are the possible sexual side effects of prostate cancer and/or its treatment?

Both prostate cancer and its treatment options (surgery, radiation, and/or hormone therapy) can have possible sexual side effects. Here are some of the most commonly reported side effects of prostate cancer on an individual’s sexual function:

• Erectile dysfunction: Sometimes after having a prostatectomy (a surgery to remove the prostate) a man can experience difficulty getting or maintaining an erection.
• Loss of interest in sex: Dealing with a cancer diagnosis can be distressing and exhausting, so it is normal for a person to temporarily lose interest in sex as they are managing their diagnosis and undergoing treatment. Certain treatments such as hormone therapy can also reduce sexual desire.
• Problems with ejaculation: After prostate cancer treatment, men may experience a reduced or absent ejaculation. Orgasm may also feel differently compared to before treatment.
• Lack of confidence or sexual self-esteem: Experiencing difficulty with getting an erection, possible urinary incontinence (leaking urine), and/or reduced or nonexistent semen volume could contribute to feelings of sexual self-consciousness or performance anxiety.

What are some things a person can do for a healthy sex life after prostate cancer?

Being well-informed about the potential sexual health repercussions of prostate cancer and its treatment can help a person overcome such difficulties and regain a healthy sex life after cancer. Here are some ways a person can enhance their sex life after prostate cancer treatment:

• Penile rehabilitation: While the benefits of penile rehabilitation are currently debatable, improving erections during the first year after surgery may improve overall satisfaction and quality of life.
• Erection aids: There are several treatment options available for erectile dysfunction including medications, vacuum devices, and penile implants, which are devices that are surgically implanted into the penis to allow a man to achieve an erection on demand.
• Counseling or sex therapy: A person’s mental health is just as important as their physical health when it comes to sexual function. Individuals may consider speaking with a psychologist or sex therapist for support during a major life event such as a cancer diagnosis and treatment.
• Open communication: For a patient who is in a relationship, open, honest communication with a sexual partner is key. This can help both partners manage their expectations for their sexual relationship, relieve sexual performance anxiety, and lay a groundwork of trust for future intimacy.

Resources:

Centers for Disease Control and Prevention. (2021, August 23). What Is Prostate Cancer?
https://www.cdc.gov/cancer/prostate/basic_info/what-is-prostate-cancer.htm

Emanu, J.C., Avildsen, I.K., & Nelson, C.J. (2016). Erectile Dysfunction after Radical Prostatectomy: Prevalence, Medical Treatments, and Psychosocial Interventions. Current opinion in supportive and palliative care, 10(1), 102–107. https://doi.org/10.1097/SPC.0000000000000195

MacGill, M. Medically reviewed by Daniel Murrell, MD. (2018, December 13). How Does Prostate Cancer Affect Sex? Medical News Today. https://www.medicalnewstoday.com/articles/313194

Marks, J. Medically reviewed by Michael W. Smith, MD. (2021, May 12). A Healthy Sex Life After Prostate Cancer. WebMD. https://www.webmd.com/prostate-cancer/sex-life-after-prostate-cancer

Mayo Clinic. (2021, June 4). Prostate Cancer. https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087