When it comes to prostate cancer and impotence, we would never profess to understand how all men think.
But we can share insights about what men may be feeling when faced with partial or complete loss of erectile dysfunction (ED) and loss of libido (sexual desire) based on literature about recent research.
Setting the stage
It’s important to understand that men who are experiencing ED after surgery or radiation therapy generally do not lose their libido.
Men with advanced prostate cancer who are on hormone therapy (also called androgen deprivation therapy or ADT), however, typically lose both their desire for sex and their ability to have an erection. This depends, in part, upon which drug(s) they take.
These side effects are usually more severe with luteinizing hormone-releasing hormone analogs/agonists (such as Zoladex and Lupron). Other bodily changes that are drug-dependent, and have been found to be most bothersome to men, can include:
All of these side effects can be
challenging to both men and their partners. Some couples:
Studies also report that wives may experience greater levels of stress than their husbands, particularly when men refuse to discuss the problem of prostate cancer and impotence.
What follows is a summary of insights from various medical journals (most were reports from studies involving men with advanced prostate cancer on ADT).
Please note that this information does not represent all men with prostate cancer and some of these reactions may be extreme. But it may help you understand some of the feelings that your loved one may be experiencing.
Concerning bodily changes, men on ADT may:
Concerning sex, men on ADT may:
Also, a man’s sexual ability before prostate cancer may have been defined by his sense of “manhood.” Without it, he may feel less manly, and may become angry or withdrawn.
Men often use avoidance as a coping mechanism and they may:
Men on ADT may also:
How partners can cope
While there are no magical answers to solve problems caused by prostate cancer and impotence, women need to know that it doesn’t have to be this way.
If you and your loved one have good communication — and are willing to work and experiment together — you will be able to experience intimacy in ways that can be enjoyable for both of you.
You can find some suggestions on this website to help you cope with problems caused by prostate cancer and impotence.
Depression may be a factor
If your loved one is unwilling to discuss your sexual needs — or has completely shut you out — it’s important to determine if he’s suffering from clinical depression.
You can consider calling his doctor to express your concerns. This will alert the doctor to be more observant during your loved one’s next visit.
Hopefully, the doctor will ask the right questions and hopefully your loved one will answer honestly. If depression is diagnosed, there are many medications available to treat it.
You can also suggest joint counseling. Sometimes a third-party professional can be very helpful in getting couples to open up with each other.
It may also feel less threatening to your loved one when a suggestion comes from a professional. If your man refuses to go to counseling, you can consider going on your own to learn ways to cope with his prostate cancer and impotence.
Talk about prostate cancer and impotence
You may find great comfort talking to other women about prostate cancer and impotence.
The Prostate Cancer Forum for Ladies Only has a special forum called “intimacy” where women talk about impotence, intimacy, and sexual relationships.
They will welcome you with open arms — and will freely share their support and suggestions — because they understand what you are going through.
Many thanks to Richard Wassersug for his help in writing this article.
Boehmer U, Clark JA. Communication about prostate cancer between men and their wives. J Fam Pract. 2000;50:226-231.
Chapple A, Ziebland S. Prostate cancer: embodied experience and perceptions of masculinity. Sociology of Health and Illness. 2002;24:820-841.
Clark, JA, Wray N, Brody B, et al. Dimensions of quality of life expressed by men treated for metastatic prostate cancer. Social Science & Medicine. 1997:45:580-602.
Fitch MI, Gray R, Franssen E, Johnson B.
Men’s perspectives on the impact of prostate cancer: implications for
oncology nurses. Oncology Nursing Forum. 2000;27:1255-1263.
Herr HW, Kornblith AB, Ofman U. A
comparison of the quality of life of patients with metastatic prostate
cancer who received or did not receive hormone therapy. Cancer. 1993:71:1143-1150.
Heyman EN, Rosner TT. Prostate cancer: An intimate view from patients and wives. Urologic Nursing. 1996:16:37-44.
Jakobsson L, Hallberg IR, Loven L.
Experiences of micturition problems, indwelling catheter treatment and
sexual life consequences in men with prostate cancer. Journal of Advanced Nursing. 2000;31:59-67.
Kornblith AB, Herr HW, Ofman et al.
Quality of life of patients with prostate cancer and their spouses: The
value of a data base in clinical care. Cancer. 1994;73:2791-2802.
Lavery JF, Clarke VA. Prostate cancer: Patients’ and spouses’ coping and marital adjustment. Psychology, Health and
Navon L, Morag A. Advanced prostate cancer patients’ ways of coping with the hormonal therapy’s effect on body, sexuality, and spousal ties. Qual Health Res. 2003;13:1378-1391.
Always consult a medical professional.