Sex is important. Without reproduction we would eventually cease to exist. The survival of the human race depends on sex. This means that biologically as adults we are all at some level sexual beings, even if we are not in a sexual relationship. As thinking beings though (with large brains) there is for all of us a more complicated social side to sex.
How prostate cancer affects sex
The prostate gland sits snugly around the base of the bladder and so is right in the middle of the nerves and blood supply needed for an erection. This means that surgery and radiation therapy for prostate cancer can have a direct effect on a man’s ability to get or maintain an erection. There are plenty of easy to find booklets and web pages that outline exactly how and why this happens, but this is the nub of it. A man might find after treatment that he is unable to get or keep a hard erection, or that his erections are unreliable. This can be devastating.
If a man has radiation therapy for a time orgasms might be painful and for all men who have had treatment, the amount of ejaculate will lessen or after surgery to remove the prostate be completely dry. If a man is on hormone blocking treatment, he will find his desire for sex reduces as well as his erections, making it even more difficult to keep an active, pleasurable sex life.
It is important to be clear about this: these are physical treatment effects. They are not ‘in your head’ and to solve them, you will probably need to use medical treatments. There are a range of pills, medicines that can be injected into the penis, sexual aids like vacuum pumps, and even surgery to put a penile implant (pump system) inside a man’s body. The main point is that this is something that will require medical help. As well, many doctors now advise that getting the blood flow back to the penis early in recovery is important for long term erectile function. So thinking about this sooner rather than later is a good idea.
There is a psychological side as well though. The worry of a cancer diagnosis itself can reduce sexual interest, just as you might have found when other tough things have happened in your life. Many men report feeling that if they can’t get an erection they are not sexually interesting or capable and that this stops them from even thinking sexy thoughts.
Finally, sex after prostate cancer needs more planning, understanding, and communication within a couple, as well as medical help. If lovemaking doesn’t work so well in the early days some couples find they feel less inclined to persist in trying and they just give up.
This is really up to you. Some couples do say that they had become less interested in sex before the cancer anyway and that they have talked it over now and decided it was time to give away having sex. For these couples, physical closeness, affection and comfort stays an important part of their lives with cuddling, kissing and lots of hugs becoming their main way of keeping physically close and connected.
For other couples, keeping an active sex life matters. If you want to stay sexually active, or you can see that your partner is frustrated about sex, there is lots you can do. The key things are to talk about it, be informed, be patient with each other, flexible in your approach and open to new things — and to start early. The sooner you get to work on this the more likely you will be to succeed.'
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