Men's sex life and fertility

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

You might lose interest in sex because you're worried about your illness or the future. Or it may be because the treatment makes you tired, or due to medication you've been prescribed. 

This might take some time to recover from when the treatment has ended.

Sharp pain when you ejaculate

Having a sharp pain when you ejaculate can be a side effect of radiotherapy to the abdomen or pelvis. Radiotherapy can irritate the tube that goes through the penis from the bladder (the urethra). The pain should ease off a few weeks after the treatment ends.

Erection problems

Radiotherapy to your pelvic area can cause erection problems.  This is because it can affect 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.

Talk to your clinical team if you have any erection problems that concern you. 

Sex and radiotherapy

It's fine to have sex if you're having internal or external pelvic radiotherapy. But you or your partner should use contraception during treatment. And for some time afterwards.

Your doctor will explain this to you before you start treatment. This is because sperm made during and after treatment might still be fertile but could be damaged. This could cause abnormalities in a child conceived soon after pelvic radiotherapy.

It's important to use condoms if you've had a type of internal radiotherapy that involves radioactive seeds being inserted into the prostate permanently. You need to use condoms even if you or your partner is using another form of contraception. This is in case the seed becomes loose and comes out in your semen. Your doctor will advise you how long you need to use condoms for. 

Your fertility after radiotherapy

Radiotherapy to your lower tummy area (abdomen) or pelvis can affect your fertility. This can be temporary or permanent and means you might not be able to father a child in the future. 

Before you have radiotherapy, a member of the health care team 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 upsetting time, especially if you were planning to have children in the future. Talk to your specialist about the possibility of losing your fertility. They can talk to you about the possibility of storing your sperm (sperm banking).

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.

Sperm banking

Sperm banking is the name for the collection and storage of semen. Semen is the fluid that contains sperm. Sperm banking is also known as sperm cryopreservation or semen storage.

Collecting sperm before treatment means you might still be able to have children in the future if you want to. The sperm is frozen and stored until you decide you want to use it to have a baby.

In some areas of the UK, sperm banking is available free on the NHS. In other areas, you have to pay for it. The National Institute for Health and Care Excellence (NICE) recommend that sperm storage is available to men who might become infertile because of cancer treatment. But each area can choose whether they store sperm for free or whether you need to pay.

It is important to talk to your doctor about the risk of infertility before starting radiotherapy treatment. This is so that you can make decisions about whether to use a sperm bank.

Talking about difficulties

It helps to talk openly with your partner about your problems. You can also ask your radiotherapy team about any problems you have.

You might feel embarrassed to talk about such personal issues. However the team are used to discussing them. They can help you find ways of coping and can refer you to specialists in sexual problems if needed.

  • Human Fertilisation and Embryology Authority website
    Accessed March 2019

  • Guidelines on Male Sexual Dysfunction: Erectile dysfunction and premature ejaculation
    K Hatzimouratidis and others
    European Association of Urology 2015

  • Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer
    I White and others 
    International Journal of Clinical Practice, 2015. Vol 69, Issue 1, Pages 106-123

  • The Natural History of Erectile Dysfunction After Prostatic Radiotherapy: A Systematic Review and Meta-Analysis
    T Gaither and others 
    The Journal of Sexual Medicine 2017 Volume 14 Number 9, pages 1071-1078

  • Survival and Complications Following Surgery and Radiation for Localized Prostate Cancer: An International Collaborative Review
    C Wallis and others 
    European Urology 2018 Volume 73 Number 1 pages 11-20

Last reviewed: 
10 Apr 2024
Next review due: 
10 Apr 2027

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