Why sex can still be great during and after prostate cancer treatment

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Why sex can still be great during and after prostate cancer treatment

There is a myth circulating among men that prostate cancer treatment abolishes a man’s ability to achieve an erection leading to a sexless life.  The hard truth is men should prepare themselves for the possibility of erectile dysfunction (ED) for a period of time but most men will make a recovery enjoying a satisfying sex life.  Even if a man does develop persistent ED, it is possible to achieve satisfying orgasms without an erection.

How prostate cancer may affect a man’s sexuality in three areas

It is perfectly normal and natural for any man to have concerns about this very important part of his life – his sexual functioning.  Many men will question, “Will my sex life be the same?”  The short answer to this is no, as there will be changes.   But “no” does not mean it will forever be altered.  It helps if a man looks at three different ways how prostate cancer can affect a man’s sexuality – desire, erectile dysfunction, and orgasm.

Sexual desire

Before a man should even be thinking of the climax of sexual functioning or the ability to have an orgasm, he needs to address sexual desire.  Just the psychological impact of prostate cancer treatments can be significant, leaving a man tired and irritable and not in the mood for sex.  It is vital to move towards intimacy slowly and most men will find desire for sex will return back to normal.   

Common factors that may be reducing desire could be fatigue, emotions, self-image, or fear of not being able to perform.  By discussing this openly and honestly, many men will be relieved to find that their partners are more than willing to listen and to help.  Some men may find joining a support group helpful in talking with other men going through the same thing.  Others may gain insight by meeting with a counselor one-on-one.  The main thing is not to sweep it under the rug but rather to figure out the best way to feel amorous once again.

Erectile dysfunction

During and after prostate treatments, many men can experience ED but for most men it is temporary.  During recovery, medications like Viagra and Cialis will help.  A man should always discuss with his doctor about how any treatments will affect his ability to have sex and to opt for ones that have the least effect on nerves and blood vessels important in achieving an erection.

ED is common for many reasons one of which can be if a man has a radical prostatectomy.  When the entire prostate and surrounding tissues are removed, ED is likely to occur at first. Men who elect to use robotic prostate surgery have a very high chance of enjoying sex afterwards.  Radiation and hormone therapy can also have an effect on ED. Again, a thorough discussion with a man’s physician can help him understand what he can expect in terms of how likely ED will be and how can it be treated. 

Orgasm

The good news is the vast majority of men will still be able to have an orgasm following prostate cancer treatment and are pleasantly surprised to be experiencing pleasurable orgasms even without an erection.  Sexual pleasure does not depend on penetration. Yes, nerves and blood vessels that may be damaged by treatments can be the same ones necessary for achieving an erection but, they are not that important for having an orgasm.

One thing to be aware of is that the prostate gland produces most of the seminal fluid that makes up semen.  Therefore for men who have their prostate removed by surgery or destroyed by radiation, when they do have an orgasm, it will be nearly or completely dry – this is also known as a retrograde ejaculation

In conclusion

Restoring an enjoyable sex life after prostate cancer treatment is in part dependent on the type of treatment. When men and their partners know what to expect, they can accelerate recovery, experiment, and work together.  Sex-related activities should be resumed as soon as a man is ready but keep in mind some changes are temporary and some might be permanent.  However, the bottom line is that any problem encountered can be overcome.