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Sex and prostate cancer

Treatment for prostate cancer can cause a variety of side effects. Any of these can affect your sex life, some more than others. Some men worry that they may pass the cancer to their partner but this is not true. Cancer is not infectious and can't be passed on to a sexual partner.

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.

You may feel too tired to want sex for some time after prostate cancer treatment. There is information about coping with tiredness in the coping physically section.

Radiotherapy, surgery and hormone treatment can lead to difficulty getting an erection (impotence). Erection difficulties can be temporary or permanent and can be very difficult to come to terms with. There are medicines that can help to give you an erection. There are also other ways of getting an erection if the medicines don't work. Your doctor can prescribe medicines. If you talk to your doctor or specialist nurse, they can refer you to a specialist counsellor or sex therapist.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Living with prostate cancer section.

 

 

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 have all the side effects mentioned on this page. The effects you have will depend on the treatment you have had.

You may not feel like sex at all while you are having your treatment, or for some time after you are diagnosed. Many people feel very low after they have been told they have cancer and don't feel interested in sex. But some people react to their diagnosis by feeling they should be packing as much into life as possible. If you feel like this, and treatment has caused erection problems, this may be hard to bear.

Whatever happens at first, remember that things will change. To see how your sex life will be affected, you will need to wait until at least the end of your treatment. And it is best to wait until you are feeling more back to normal.

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

The Prostate Cancer UK website has information for gay and bisexual men about side effects of treatment.

 

You cannot pass the cancer to a partner

Some men worry that they may pass on prostate cancer in their semen during sex. This is not true. Cancer is not infectious and cannot be passed on to another person in this way. But this can be a very real anxiety. It is important to understand how powerful this fear can be. Talking it through with a partner and getting reassurance from them can be helpful.

Some people find that they need outside help to discuss this issue. They may benefit from talking to a counsellor, the doctors and nurses at the hospital, or a sex therapist. These people are aware of the difficulties people have with cancer and can offer specialist advice and support.

 

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 section about coping physically with cancer.

 

Leakage of urine

If you have leakage of urine (incontinence) or a catheter into your bladder, you may feel embarrassed and that may put you off sex. You can get help with urine leakage from an incontinence advisor or your specialist nurse. Or you can contact any of the incontinence organisations on our prostate organisations page.

 

Less interest in sex

Being less interested in sex can be a side effect of surgery to remove the testicles (orchidectomy), or hormone treatment. Unfortunately, a lower interest in sex cannot be treated with testosterone injections or patches as it normally would. This is because the testosterone could encourage the cancer to grow or come back.

Lack of interest in sex and erection problems are less likely to occur with anti androgen drugs like bicalutamide, than other types of hormone therapy. So changing your hormone treatment may help. You would need to discuss this with your specialist.

The effects on your sex life can be difficult to live with. The way that the side effects affect you will depend on your own individual situation. It will also depend on your partner (if you have one) and how your sexual relationship has been in the past. It will help to talk things over with your partner and discuss the changes in your lives.

We have a page about sex and sex hormone symptoms in our hormone symptom section.

 

Hot flushes and sweats

Hot flushes and sweats can be a side effect of hormone therapy or removal of the testicles (orchidectomy). They may be at their worst when you have just started your hormone treatment, or have just had your testicles removed. The flushes and sweats 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 or specialist nurse. They can prescribe medicines to help.

There is information about coping with hot flushes and sweats in the hormone symptoms section.

 

Difficulty getting an erection (impotence)

Difficulty in getting an erection can be caused by the following types of treatment.

  • Radiotherapy to the prostate
  • Prostate surgery
  • Having both testicles removed
  • Most types of hormone therapy

Erection difficulties can be very difficult to come to terms with. After surgery you are very likely to have erection problems. This may be temporary, but if you have had the prostate gland removed (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, the erections may improve.

With radiotherapy, erection problems may start up to 2 years after your treatment because of nerve damage. It can take that long for nerve damage to show up after any radiotherapy. 

If you have erection problems, medicines such as sildenafil citrate (Viagra), vardenafil (Levitra) or tardenafil may help. If these treatments are started early they can sometimes help to prevent erection problems developing. Other forms of treatment include gels (MUSE), injections (Caverject) or vacuum devices to give an artificial erection.

There is detailed information about ways of managing erection problems in the sex and cancer for men section.

Talking about your erection problems

Erection problems can be permanent or temporary. And they can be affected by your mood and feelings. If you are having problems, they may sometimes be caused by anxiety and not the effects of treatment. You may find it difficult to talk about this both with your doctor and with your partner. 

Remember that your doctor and specialist nurse will have treated many other men with the same problem so there is no need to feel embarrassed. If they cannot find treatments to help you, they can refer you to specialist sexual therapy advisors. 

If you are worried about talking to your partner, it may be because you are afraid that they might reject you, or be angry with you in some way. But your partner may be wanting to talk things over. 

If you would like to talk to someone outside your own friends and family, look at our list of prostate cancer organisations for organisations you can contact. To find out more about counselling look in the counselling section.

 

Infertility and prostate cancer treatment

Treatment for prostate cancer will mean that you cannot father children in the future. This is called infertility. This can be very hard to accept, especially if you were hoping to have children. You and your partner need to discuss this with your doctor before you start treatment, particularly hormone treatment or radiotherapy. Some men may want to collect and store sperm before they start treatment.

After surgery to remove the prostate gland you don't produce semen. 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. In this situation, if you want to have children, it may be possible to take 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 detailed information about infertility in the section about sex and fertility for men.

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Updated: 26 February 2014