Dr. Jo-an Baldwin Peters has a BSc. in Physiotherapy (Physical Therapy), a MSc. in Epidemiology and Biostatistics, and a PhD in Health Care Administration. Her dissertation was titled: The loss of normal intercourse after treatment for prostate cancer. The impact on the sexuality of both partners.
She is the wife of a prostate survivor and came out of retirement in response to the inadequate information provided for men with prostate cancer and their partners. The dissertation was the beginning of her personal commitment to the cause.
Now retired again, she was an independent, unfunded researcher, published articles for prostate cancer survivors and their partners, and did presentations to prostate cancer support groups in Canada and the US.
My dissertation evaluated how impotence, as a result of prostate cancer treatment, impinges on both partner's sexuality. If you are looking for reality from the woman’s point of view, the answer is that it shouldn't have to. Then how does it affect our partner with prostate cancer?
Again it doesn't have to.
If this is examined rationally and honestly, the major physiological function of penetrative sex is for procreation. However, the bonding of partners during sexual intercourse is a major component of intimacy and is extremely important.
My study group for my dissertation consisted of 12 married couples; the men having undergone a variety of treatments for prostate cancer. The couples were asked to rate the impact that post-treatment erectile dysfunction had on them and their partner. One of the most important findings was that the women thought their male partners were less upset by their erectile dysfunction than they were.
The men, on the other hand, believed that their female partners were more bothered than they actually were.
Examining the facts: a man can have an orgasm without an erection, without penetration, and without ejaculation.
As for women, clitoral orgasms are much more intense than "so called" vaginal orgasms, which are weak at best. Why then were women less bothered by their partner's erectile dysfunction?
Several issues arise. We as women have been culturally programmed to believe that there is something wrong with us if we don't experience vaginal orgasm. Research shows that 70% of women never experience a vaginal orgasm. Women are traditionally in tune with their bodies and are able to position their bodies in such a way as to enable a clitoral orgasm. Many women may be not even be aware that they are not having a vaginal orgasm.
There is absolutely nothing to stop one from having a wonderful experience cuddling and caressing whilst naked and successfully bringing one another to orgasm. This is sharing an intimate experience. We constantly share experiences with our partners; sports, dancing, and many enjoyable past times.
I have come to think that there are multiple issues as to why women are less bothered by their partner's erectile dysfunction. Could it be because they are relieved to have a partner who is still alive? Or is intimacy in other forms, such as hugging, holding hands, cuddling, caressing whilst naked, and sharing intimate experiences more important? Or do they realize that penetrative sex isn't the only way to reach an orgasm together? Or that women do not feel that their partner's manliness and masculinity has been decreased?
All the women in the study group mourned, to a lesser or greater extent, the loss of penetrative sex, but were to the greater extent, happy with the solutions they had arrived at.
The million dollar question is: why are men more bothered by erectile dysfunction than their female partners think they should be?
This is puzzling given the fact that about 58% of men over the age of 75 have problems with impotence. Obviously traditional gender and masculinity ideals are closely linked to sex.
As the wife of a prostate cancer survivor, it has been an unsolved puzzle. So I asked some questions within our study group. Here are a few insights:
The first question was: "Do you feel the results of your treatment deprived you of your manliness or masculinity?"
One man's answer: "Erectile dysfunction doesn't make me feel less of a man but it isn't something you want everyone to know. If this is a masculinity issue so be it." As a wife I'd say that this is merely a personal privacy issue as most of us do not discuss our intimate issues.
My next question was: "Why do you miss penetrative sex?"
One man’s answer: "Penetrative sex is more fun; you can do more with it, it adds variety to love making and finally the body to body contact adds to the intimacy."
My study group requested that treating physicians, who are the unhappy harbingers of the news about the diagnosis and treatment of prostate cancer, provide more information. Surely they should ask about sexual practice and provide the relevant information on female sexual preferences. The myth that "getting it up" can be fixed should be minimized, and the fact that intercourse after treatment will be different and will need patience and time for adjustment. The aids, drugs like Viagra, pumps, penile injections, intra-urethral pills, and penile implants are invasive, unnatural, and may not be necessary, required or desired.
Never lose sight of the fact that "fixing" impotence or erectile dysfunction is a multi-billion dollar industry so the truth remains veiled.
The most important issue is communication, communication, communication. Communicate like you have never done before, be totally honest, and do not be fearful that the truth will hurt; it won't.
Hisprostatecancer thanks Dr. Peters for contributing this article on penetrative sex after prostate cancer.
Always consult a medical professional.