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. This is because the 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 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 clinical team if you have any erection problems that concern you.
Voice over: Radiotherapy can cause many different side effects, such as tiredness. The side effects you get will depend on the area you're having treatment to.
This video is about the side effects you might have if you are a man having radiotherapy to the pelvis or abdomen.
Louise: The abdomen, the tummy, can be affected by radiotherapy, but it depends on which particular part of that we are treating as to what side effects you may experience. If we are treating the upper part of your abdomen and we are irritating your stomach, sometimes you can experience a little bit of nausea, potentially a little bit of vomiting.
This would normally start quite early on if it is going to be a problem and the doctor would prescribe you some medication to help with that.
If your bowels are being irritated by the radiotherapy, you may find you end up a little bit more gassy. Flatulence might be a bit of an issue and sometimes you can find you can end up with some diarrhoea.
Keith: Digestion seemed to be quicker and I was having to go to the loo more. Everything seemed weaker.
Louise: If you do find that you are having some issues with your bowels, always consult with the team before you take any action. It might be they recommend you make some small dietary changes to help with this, cutting out foods which are very high in fibre or very spicy foods.
If you're having issues with diarrhoea, they may also recommend some particular medication to help with that.
Keith: They gave me a course of Fybogel to take, which did help. I still have to take that now and again. Before the radiotherapy I was having problems anyway, but they became a bit more acute afterwards. If I needed to go to the toilet, I needed to go. We went on a holiday to Cornwall and it became the toilets of Cornwall tour.
Louise: Some radiation treatments to the pelvis may also cause some irritation to your bladder, so you might find you need to pass urine more regularly. It may also be more urgent with you passing smaller volumes. Sometimes you may find that there's a little pain or discomfort when you're urinating or you can't fully empty your bladder like you would do normally.
Keith: I don't drink coffee anywhere near as much. Alcohol, maybe I have 4 units a week. I was advised to drink cranberry juice. Tea as normal. I drink water through the day.
Louise: We would highly recommend during your radiotherapy that you stay well hydrated. We would recommend you drink up to 2 litres of water or squash a day to ensure that this happens. Drinks to avoid would include anything containing caffeine, so any kind of tea or coffee or decaffeinated drinks, fizzy drinks and alcohol as they all naturally aggravate your bladder.
Another symptom that some men might find as a result of the radiotherapy is that they have issues with erectile dysfunction. If this is the case, please do alert the radiotherapy team. There's a lot of support out there for gentlemen with this particular issue.
Keith: After the radiotherapy things were not the same. I was put on a course of a kind of a Viagra type of thing, but also on ejaculation I got a lot of pain.
Louise: Radiotherapy can cause infertility. If this is a concern for you and you would like to consider having children in the future, before you start a course of radiotherapy, it is best to discuss your options with the team. One of the options may be sperm banking.
It's always best to be open with partners when you're going through any kind of treatment, especially as this may have an impact on them too. It means that you can work through the problems together.
Voice over: If you're experiencing a side effect that hasn't been covered in this video, you can find more information on the Cancer Research UK website.
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 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.
Although you might feel embarrassed to talk about such personal issues, 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.
