Sex after prostate cancer

It requires persistence and patience

Sex after prostate cancer can be deeply satisfying, but it may be different than it was before.

If your loved one didn’t have any erection problems before treatment, he was probably able to become aroused without any touching or direct stimulation. That may change after treatment.

Sexual recovery often takes time.  Despite what doctors may tell you, it can take up to 4 years for men to see the most improvement in sexual function after prostate cancer surgery.  Try not to get discouraged or give up altogether.  We can tell you from experience that it helps to keep trying, even if you don't experience the results that you want right away.  


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What can you expect? 

The ability to have penetrable sex after prostate cancer treatment depends on:

  • The type of treatment and whether one or both nerve bundles are removed or damaged
  • Whether a man had erection problems (called erectile dysfunction) prior to treatment
  • Age (impotence may become more of an issue as men get older)

Following a nerve-sparing radical prostatectomy, recovery from impotence generally happens slowly over time.  A man will have dry orgasms (some call it dry sex) because the prostate and seminal vesicles have been removed.

Following radiation therapy, if impotence is a problem, it typically develops over time.

It may encourage you to know that a man does not need an erection to have an orgasm.

Don’t give up completely on sex after prostate cancer treatment 

 Experts say that you should not stop having sex after prostate cancer treatment, even if your man is not be able to get or maintain a “stuffable erection” (a lousy term, we know) for sexual intercourse.

It may help to approach sex after prostate cancer treatment:

  • Without any expectations
  • By being open to experimenting
  • By discussing what works and what doesn't
Studies show that it may take several years for men to see the most improvement in sexual function after prostate cancer surgery.

Hear what experts have to say

  • Continuing to have regular sex after prostate cancer treatment is important even if men cannot get or maintain an erection. Professionals call this penile rehabilitation and it can actually help men recover sexually. Read more
  • Nervous about having sex for the first time after prostate cancer treatment?  It's very understandable.  Fortunately there are some actions you can take to make your first time less stressful. Read more
  • Men can experience a myriad of feelings about impotence. Read our revealing interview with Rhonda Fine, PhC, ARNP, MSN, who is a Board Certified Clinical Sex Therapist.
  • You can have intimacy despite impotence, stress Ralph & Barbara Alterowitz, who are authors of the book Intimacy with Impotence. Read more
  • There are other ways to be intimate without having sexual intercourse, such as sensate focus exercises. Read more
  • Self-pleasuring may be a way to re-engage your sex life if intercourse is difficult.  Alicia B. Saunders, PhD, Board Certified Sex Therapist and Clinical Sexologist offers some excellent advice. Read more
  • Struggling with the loss of the ability to have penetrative sex? Dr. Jo-an Baldwin Peters offers her thoughts for coping.  Read more
  • Loss of libido during hormone therapy is quite common and you may interested in learning what men feel about it.  Read more
  • Are orgasms the same after surgery for prostate cancer? Some men say "no they're not."  Read more
  • Leaking urine during sex can be an unwanted surprise, but it's more common than you may think.  Read more
Watch Memorial Sloan Kettering Cancer Center sexual health specialist and author John Mulhall, MD's excellent presentation about penile rehabilitation here.
Try not to get discouraged if you don’t see the results you want right away. There are many ways to satisfy your partner other than intercourse.

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Options to help improve erectile dysfunction

Your man will probably need a drug or device to be able to have sex after surgery for prostate cancer.  You may need to experiment a bit and if one option does not work, ask your doctor about trying another.

There are several different erectile dysfunction (ED) drugs that many men find effective.  They are not all the same and you may need to try more than one drug before you find one that works best for youRead more

While some men may be initially squeamish about using needles, self-injected drugs may be helpful if ED drugs are not working the way you want them to.  Read more

If your man is totally against needles, he can still get a similar medication by using urethral pellets.  Read more

Another less invasive option are vacuum pump devices. They require a little education and some practice. Read more

Some men who want a permanent option and miss spontaneity may look to penile implants, which are surgically inserted. Read more

Considering natural remedies?  Beware before you buy and learn which ones have been clinically proven to work.  Read more

If you have tried everything without any success, there is still one more option to consider: a strap-on penile prosthesis.  Read more

Updated 7/14



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Discuss information from this website with a medical professional

References:
American Cancer Society. Ways of dealing with sexual problems. http://www.cancer.org. Accessed September 1, 2008.

American Cancer Society. Effects of cancer treatment on male sexuality. http://www.cancer.org. Accessed September 1, 2009.

Rubin Wainrib B, Haber S. Men, Women, and Prostate Cancer. Oakland, CA: New Harbinger Publications, Inc.;2000.

Walsh PC. Guide to Surviving Prostate Cancer. New York, NY: Time Warner Book Group; 2001. 

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