Sex and prostate cancer

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Sex and prostate cancer


This page tells you about sex and prostate cancer. You can find information on
Effects of prostate cancer treatment
Diarrhoea
Tiredness
Urinary incontinence
Lowered interest in sex
Hot flushes and sweats
Difficulty in getting an erection (impotence)
Infertility
Effects of prostate cancer treatment
Treatment for prostate cancer can cause a variety of side effects. Any of these can affect your sex life, some more than others. You will not get all the side effects mentioned on this page. Which ones you have will depend on the treatment you have been given.

You may not feel like sex at all while you are having your treatment, or for some time after you are diagnosed. Mostly, people feel very low after they have been told they have cancer. Feeling depressed is not likely to do much for your sex life. Or you may be one of those people who react to their diagnosis by feeling they should be packing in as much 'life' as possible.

If you feel like this, the disruption to your usual sexual activities may be even harder to bear. Whatever happens at first, remember that things will change. To see how you will be affected permanently, you will need to wait until at least the end of your treatment. And until you are feeling more 'back to normal'.

Some of the side effects listed here are temporary. Tiredness and diarrhoea, for example, are side effects of radiotherapy and will wear off some weeks after your treatment has finished.


Diarrhoea
Some men get diarrhoea during radiotherapy and for some time afterwards. This can be unpleasant and tiring and may put you off wanting to have sex. It will gradually go back to normal after a few weeks though.

Tiredness
You may feel too tired to want sex for some time after prostate cancer treatment. There is information about coping with tiredness in the symptoms and side effects section of CancerHelp UK.

Urinary incontinence
If you have incontinence or a urinary catheter, you may feel embarrassed and that may put you off sex. You can get help with incontinence from an incontinence advisor or your specialist nurse. Or some of the incontinence organisations on our prostate organisations page.

A lowered interest in sex
Being less interested in sex can be a side effect of
Orchidectomy
Hormone treatment
Unfortunately, a lowered interest in sex cannot be treated as it normally would - with testosterone injections or patches. This is because the treatment is designed to either

Stop you producing testosterone (the male sex hormone) or
Block the effects of testosterone
So giving you replacement hormones would be pointless and could encourage the cancer to grow.

Lack of interest in sex and impotence are both less likely with anti-androgens like bicalutamide, so changing your treatment may help. You would need to discuss this with your specialist.

These side effects can be difficult to live with. How it is for you will depend on your own individual circumstances. It will also depend on your partner (if you have one) and how your sexual relationship has always been.

It will help to talk things over with your partner. You both need to come to terms with changes in your lives.

If you do not have a regular partner, it may be even harder for you to accept your lower sex drive, as you will not have someone who can adapt with you.

Hot flushes and sweats
These symptoms can be a side effect of hormone therapy and orchidectomy. Hot flushes and sweats may be at their worst when you have just started your hormone treatment, or have just had your testicles removed. They may get better with time. They may become less frequent or stop altogether. Or you may not be troubled by them at all. Everyone reacts to cancer treatment in different ways, both emotionally and physically. If you are having problems with sweats and flushes talk to your doctor, who may be able to help.

There is more information about hot flushes in the section on hormone therapy for prostate cancer. There is also information about dealing with sweating in our symptoms and side effects section.

Difficulty in getting an erection (impotence)
Difficulty in getting an erection can be caused by

Radiotherapy to the prostate
Prostate surgery
Having both testicles removed
Most hormone therapy
Erection difficulties can be very difficult to come to terms with. After surgery you are likely to experience impotence. This may be temporary, but if you have had a radical prostatectomy, it is more likely to be permanent.

Hormone therapy can also affect your ability to have an erection. If you stop the injections or tablets, erections may improve.

With radiotherapy, erectile difficulties may come on up to two years after your treatment because of nerve damage. (It can take that long for nerve damage to show up after any radiotherapy.)

There is information about ways of managing erectile difficulties in Living with Cancer: Sex and cancer for men

Talking about your erection problems
Erectile difficulties can be permanent or temporary. And they can be affected by your mood and feelings. If you are having problems, they may be caused by anxiety and not your treatment at all. You may find it difficult to talk about this both with your doctor and with your partner. If you can manage to take a deep breath and mention it at the hospital, you may find they have a specialist counsellor or sex therapist you can be referred to. Treatments such as Viagra may help, especially if you get partial erections.

Remember - your doctor is likely to have treated many other men with the same problem. Try not to feel embarrassed.

If you would like to talk to someone outside your own friends and family, look in our help and support section for counselling organisations. To find out more about counselling look in the what is counselling section.

If you are worried about talking to your partner, it may be because you are afraid they might reject you, or be angry with you in some way. But you are probably more worried about this than you need to be. Your partner will probably be relieved that you want to talk things over. They may have been trying to find the right time to raise the subject themselves.

Infertility
Treatment for prostate cancer will cause infertility. This can be very hard to accept, especially if you were hoping to have children. You and your partner should discuss this with your doctor before you start treatment, particularly hormone treatment or radiotherapy.

If you have had a TURP operation, you will probably have retrograde ejaculation after surgery. Retrograde ejaculation means that when you orgasm, your sperm goes backwards into your bladder, rather than out through your penis. This is because there is a valve that normally shuts off the route to the bladder when you climax, and this is damaged in the TURP operation. If you want to have children, it may be possible to harvest sperm directly from your testicles. The sperm can be used to fertilise your partner directly or with the “test tube baby” technique (in vitro fertilization or IVF).

There is more about infertility in the section about sex and fertility for men in the general radiotherapy side effects section.






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Last updated 20 December 2007

CancerHelp UK is not designed to provide medical advice or professional services and is intended to be for educational use only. The information provided through CancerHelp UK is not a substitute for professional care and should not be used for diagnosing or treating a health problem or a disease. If you have, or suspect you may have, a health problem you should consult your doctor.