A Healthy Sex Life After Prostate Cancer

While most men will face some issues in the bedroom after prostate cancer treatment, these problems are often temporary or treatable.

You might feel frustrated at first, but be patient. With time and the right treatments, you can likely have a fulfilling sex life after prostate cancer.

What to Expect

Your prostate is next to key nerves, blood vessels, and muscles that help you have an erection. Surgery and radiation to treat your cancer can damage these areas, making it more difficult to get an erection or have an orgasm. (If you were having trouble getting an erection before your treatment, you probably still will.)

Hormone therapy lowers the amount of testosterone in your body, which won't help your sex drive and performance.

The most common complaint after certain treatments -- for about 8 out of 10 men -- is erectile dysfunction (ED). This means you can't get or keep an erection that's hard enough for penetration. But even if you have ED after your treatment, you can still have an orgasm. In fact, most men can have one without an erection.

You may also have:

  • Dry orgasms, when you don't release semen
  • A smaller penis
  • Less interest in sex

These issues may last several weeks or much longer. It depends on the type of treatment you have and how you feel. Up to half of men who have nerve-sparing prostate surgery or radiation therapy see improvement in having sex within a year after their treatment.

Penis Rehab

Penile rehabilitation is a way to get your penis back into shape after surgery or radiation. The idea is use it so you don't lose it.

While there's not a lot of data behind the theory of penile rehabilitation, supporters say frequent erections can raise oxygen levels and improve blood flow, which can keep your penis healthy.

If you want to try this, you'll need to commit to regular penis stimulation. ED treatments can also help with this process. Ask your doctor if rehab might work for you.

Medical Treatments

Medications : Well-known drugs like sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), and vardenafil (Levitra, Staxyn) are pills you can take to improve blood flow to your penis. These can help ED if you've had prostate cancer, but only when your nerves aren't damaged by surgery or radiation.

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You can put a small pellet of alprostadil (Caverject, Edex, Muse) into the opening at the tip of your penis. This medicine also gets more blood flowing to your penis without it being stimulated.

Another way to have an erection without sexual stimulation is by giving yourself a shot of medicine in the base of your penis.

Devices: A vacuum, or "penis pump," pulls blood into your penis. These tools work best for men who can get an erection but can't keep it.

Or a surgeon could place implants in your penis to help you have an erection.

Oxytocin: You put this medicine under your tongue about 10 minutes before sex to help you have an orgasm.

Supplements: Some men take herbs and other substances to improve sexual desire and function such as dehydroepiandrosterone (DHEA), L-arginine, ginkgo, ginseng, yohimbe, and zinc. Some of these can be dangerous, and others have no scientific studies to back up their claims, so be sure to check with your doctor before you take one.

Healthy Habits

Regular exercise, along with a diet rich in veggies, fruits, whole grains, and fish, can lower your chances of ED.

If you smoke or drink heavily, it might be harder to get an erection.

Kegel exercises help strengthen your pelvic floor muscles. Building those muscles may also improve your ability to have an erection.

Stress and anxiety can trigger your body to make adrenaline, which gets in the way of having sex. The more you worry, the worse the struggle. So find ways to manage your stress, and give yourself a break.

Your Approach to Sex

Probably most important: Talk about it with your partner. Have an honest chat about your fears and expectations when it comes to sex. Don't assume your partner knows how you feel.

It might sound basic, but make sure you're aroused in the moment. Think about a sexual fantasy or feelings of pleasure. Let your partner delay your excitement if you feel like you might have an orgasm.

Try other forms of intimacy, too. Sex doesn't have to be just the usual sex. Kissing, touching, oral sex, and manual sex are some other things you might enjoy. You can also use a vibrator on the head of your penis to stimulate nerves and send more signals to your brain.

If it's just not working, a professional sex therapist can help you and your partner figure out ways to improve your sex life.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on January 17, 2018

Sources

SOURCES:

Prostate Cancer Foundation: "Erectile Dysfunction."

UCLA Urology: "Prostate Cancer: Dealing with Erectile Dysfunction."

Albaugh, J. Reclaiming Sex & Intimacy After Prostate Cancer: A Guide for Men and Their Partners. Anthony J. Jannetti, Inc., 2012.

Harvard Prostate Knowledge: "Achieving orgasm after radical prostatectomy."

Patient Advocates for Advanced Cancer Treatments: "Life After Prostate Cancer Treatment; Sexual Healing."

Harvard Health Publishing: "Penile rehabilitation after prostate cancer surgery," "5 natural ways to overcome erectile dysfunction."

Mayo Clinic: "Erectile dysfunction," "Dietary supplements for erectile dysfunction: A natural treatment for ED?"

American Cancer Society: "Treating Sexual Problems for Men with Cancer."

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