Find out how radiotherapy might affect your sex life and fertility and what you can do about it.
Sex and radiotherapy
If you are having external radiotherapy treatment it is fine to have intercourse if you want to.
If you have had a certain type of internal radiotherapy (brachytherapy), where radioactive seeds are inserted into the prostate, you need to use condoms during intercourse. You only need to do this for the first month after treatment. This is in case a radiotherapy seed gets misplaced and comes out in the semen but this is very unlikely to happen.
Possible problems with sex
It is common for men having radiotherapy to have some problems with sex. You might have some of the following issues.
Loss of interest in sex
Losing interest in sex for a while can be caused by worries about your illness or the future. Or it may be because the treatment makes you too tired for sex.
This might take you some time to recover from when the treatment has ended.
Sharp pain when you ejaculate
During and for a short time after radiotherapy treatment to the tummy (abdomen), you might have a sharp pain when you ejaculate. This is because the radiotherapy can irritate the tube that leads through the penis from the bladder (the urethra). The pain should ease off a few weeks after the treatment ends.
Problem getting an erection
Radiotherapy to your pelvic area can cause erection problems by affecting the nerves in that area. The problems might be short term or permanent.
Some medicines or medical devices can help you to get an erection if you have problems after radiotherapy. Talk to your doctor if you think you need to try medicines.
Talking about sexual difficulties
It helps to talk openly with your partner about your problems. You can also ask the radiotherapy staff about any problems you have.
Although you might feel embarrassed to talk about such personal issues, the staff are used to discussing them. They can help you find ways of coping and can refer you to specialists in sexual problems if needed.
Your fertility after radiotherapy
Radiotherapy usually doesn't affect your ability to father children. Many healthy babies have been born to parents who have had radiotherapy.
Research suggests that there is usually no increased risk of abnormalities in babies born to men who have had radiotherapy treatment.
But your doctor will advise you to use effective contraception for some time after treatment if you have radiotherapy to the lower tummy area (pelvis). Some doctors recommend 6 months and others for up to 2 years. This is because sperm produced so soon after treatment might still be fertile but could be damaged. This could cause abnormalities in a child conceived soon after pelvic radiotherapy.
Radiotherapy to both testes is rarely used in cancer treatment but can lead to a temporary or permanent inability to father children (sterility). Before you have such radiotherapy, your radiotherapy specialist (clinical oncologist) discusses this risk with you. They will ask you to sign a form saying that you agree to have the treatment and understand the risks.
This can be a very worrying time, especially if you are a young man planning to have children. Talk to your specialist about the possibility of losing your fertility.
Ask your partner to join in the discussion if you have one. It gives you both a chance to talk about your fears and worries.
You might want to store some of your sperm in a sperm bank if your radiotherapy treatment is likely to cause infertility. You will need to give several sperm samples over a few weeks.
The samples are frozen and stored. Sperm banking is not always available on the NHS and there may be a charge for it.
The samples are thawed and used to inseminate your partner if you and your partner later want a baby. The pregnancy can carry on normally.
It is important to talk to your doctor about the risk of infertility before starting radiotherapy treatment so that you can make decisions about whether to use a sperm bank.