Sex and prostate cancer

Changes in your sex life

Prostate cancer and its treatment can affect your sex life and your mind, body and relationships. Treatment can affect:

• your ability to get an erection, ejaculate and have an orgasm

• your desire to have sex (libido)

• your ability to have children (fertility)

• how you feel about your sexuality

• how your body looks

• your relationships.


Erection problems and loss of interest in sex

As you get older, it usually gets more difficult to have and maintain an erection. Adding the effects of prostate cancer treatment, it can be even more difficult.


For some men, difficulty gaining an erection might not be a big concern for them or their partners. For others it may be very important.


You may want to try different ways to achieve a non-penetrative orgasm, either with or without a partner. It will probably take longer to reach orgasm, which means there will be more time to enjoy the pleasure of intimate body contact. Keep in mind that no matter what kind of cancer treatment you have, you will almost always be able to feel pleasure from touching.


Going through treatment and coping with the effects of changes on your hormones can have big effects on how you feel about yourself and your interest in sex.


Talking about how you are feeling

If you have a partner, talking together about how you are both feeling can be very helpful.


If you find changes in your sex life upsetting, or you (or your partner) are finding it difficult to share your feelings, it may be helpful to discuss this with your treatment team. They may be able to refer you to someone who can help.

It could be worthwhile talking to a counsellor about the changes that you (or your partner) are experiencing and the effects on your life.


There may be an erectile dysfunction service in your area. Some specialist services are available through physiotherapists, or are attached to urology private practices.

Talking to other men who have experienced changes in their sexual function due to prostate cancer can be helpful. You can contact the Cancer Society’s Cancer Connect Service by phoning 0800 CANCER (226 237) and asking them about any prostate cancer support groups in your area.


“After being impotent for 18 months, the fitting of a penile implant gave me back my confidence and brought back the intimacy to my relationship.”



Infertility and dry orgasms

Men who have treatment for prostate cancer can expect to be infertile. Talk to your treatment team about sperm banking before treatment if you wish to have children in the future.


Managing problems with erections


There are practical ways to help overcome erection problems.

vacuum pumpPhysical devices                               

Physical devices such as vacuum pumps use suction to draw blood into the penis and can help you to 
strengthen and keep a natural erection. They are either manual or battery operated.
After the pump is removed a constriction ring can remain in place for up to 30 minutes to help you keep an erection.
Constriction ring.constriction ring

Oral medications and injections   


bottle pack injection2Oral medications such as Viagra, Cialis and Levitra are options to discuss with your GP. These 
medications cannot be used if you take nitrate-based medicine for heart problems.
Make sure you take these as prescribed for best effect.
Injections given straight into the penis are available on prescription. You will be provided with 
syringes that are pre-filled with medication, and you will be taught how to use them. The needle is 
very fine and usually does not cause much discomfort. The medicine makes the blood vessels of your penis expand. The vessels fill with blood, creating an erection that can last up to an hour. Most men find this works for them.

Penile implants

penile implant 001Penile implants are usually only used when other treatments are not effective.
Flexible rods or  small, inflatable cylinders are put into your penis during a short operation. Whilst effective, implants may be expensive.
penile implant 3


If rods are inserted, they are placed into the part of your penis that becomes erect. Your penis will remain erect but the rods have joints that allow you to position your penis.
If you have inflatable cylinders inserted, an erection is achieved through a small pump that is placed in your scrotum.

Sex therapy 


Getting an erection also relies on your thoughts and feelings, so tackling any worries or relationship issues, as well as
having medical treatment for erection problems, often works well.

Self help


Keeping a healthy weight, stopping smoking and doing pelvic floor exercises may help improve your erections.

Other resources

Websites that will be helpful:

You may find also the Cancer Society’s booklet, Sex and Cancer/Hokakatanga me te Matepukupuku helpful.

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