Sex After Prostate Treatment: How To Restart Your Sex Life
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If you've been diagnosed with prostate cancer or are undergoing any form of treatment, it can be difficult to know how exactly it'll affect your life. Patients often worry about the side effects it might cause, especially in the bedroom––but it's important to remember that there are treatments and methods that can help in getting back on the saddle, so to speak.
We believe that communication is key––so we've put together a guide to help you understand what to expect for your sex life.
Common Side Effects:
The prostate is situated in close proximity to the key nerve, blood vessels, and muscles that are used to facilitate an erection. During surgery or radiation treatment, these areas can be negatively impacted, making it hard to get an erection. This is likely something your doctor mentioned to you.
Hormone therapy can also lead to a decrease in testosterone levels, which can further reduce your sex drive and performance.
The most common side effect of surgery or radiation is erectile dysfunction (ED)––an inability to get or maintain an erection. About 8 out of 10 men experience erectile dysfunction (ED) after treatment.
During a study, men also reported diminished orgasm intensity subsequent to loss of ejaculation from radical prostatectomy.
Other side effects can include
-Dry orgasms (no semen released)
-A decrease in penis size
-Decreased interest in sex
-Incontinence
While ED and related prostate surgery complications are a huge roadblock, it's important to remember that most men can still have an orgasm without an erection. What's more, up to half of men who have nerve-sparing prostate surgery or radiation treatment can see an increase in their sex life within a year of their treatment.
Penile Rehabilitation:
As the saying goes, ‘Use it or lose it.’ Rehabilitation may assist after surgery or radiation. You will need to look specifically into penile rehabilitation techniques.
There is still a lack of research on this, but its supporters believe that having frequent erections can help in increasing oxygen levels and blood flow.
Please note that all penile rehabilitation methods have potential side effects, and some have to be taught under medical supervision.
ED treatments can also be coupled with this process, and your doctor will be able to advise if penile rehabilitation would be useful for you.
Tips for supporting a partner doing penile rehabilitation
There are medications, devices, and supplements that can help you in your journey of getting back to a satisfying sex life.
You may be familiar with drugs such as sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), and vardenafil (Levitra, Staxyn). Unfortunately, these can only assist if there is no nerve damage from surgery or radiation.
Alprostadil (Caverject, Edex, Muse) is another alternative. It's available as a pellet that can be inserted in the opening at the tip of the penis and assists in increasing blood flow.
Alternatively, you could opt for a shot of medication in the base of your penis instead.
Vacuum devices or ‘penis pumps’ also exist to pull blood into the penis (for those who can get but struggle to keep an erection).
Lastly, you could have implants placed in your penis to help with the erection process. You will need surgery for this procedure.
For those wanting to use supplements as a way to increase sexual desire and performance, we are strong advocates for seeking advice from a qualified GP. Some supplements may decrease the efficiency of other medications, so an expert medical opinion is needed.
Healthy Habits:
There are various things you can do to help increase your chances of getting an erection in the future, including living a healthy lifestyle.
Regular exercise in tandem with a healthy diet with plenty of vegetables, fruits, whole grains, and fish can help to reduce ED symptoms.
If you're a smoker or partake in heavy drinking, it may be harder to achieve an erection.
Kegel exercises
Another thing you could do to reignite your sex life is Kegel exercises, which strengthen your pelvic floor muscles, and in turn, improve your ability to have an erection. They are also proven to reduce incontinence.
Do NOT do any Kegel exercises if you have a catheter in your penis.
New to Kegel exercises? First, it is important to make sure you are exercising the right muscles. One way to find your pelvic floor muscles is to try to stop and start your urine stream while you stand at your toilet to urinate. Try to do this two or three times. The muscles you use to stop your urine flow are your pelvic floor muscles.
The following Kegel tips (pelvic floor exercises) are courtesy of Prostate Cancer UK.
Slow exercises
Slowly tighten the muscles as hard as you can so you feel a lifting sensation.
Try to hold this lift for 10 seconds. Keep breathing normally.
Slowly relax the muscles and rest for 10 seconds.
Aim to repeat the lift and rest up to 10 times.
You might find that you can’t hold the lift for 10 seconds to start with. Just hold it for as long as you can and try to build up to 10 seconds. It’s more important to do the exercises properly than to do them for the full 10 seconds
Fast exercises
Repeat the same action but this time, try tightening the muscles as quickly as possible.
Hold the lift for one second, and then let go.
Try to do up to 10 of these short, fast lifts.
Try to concentrate while you’re doing the exercises. Remember to breathe normally. If you don’t do them properly, they might not help.
Aim for three sets of exercises a day.
For a list of continence nurses and pelvic floor physiotherapists, search the directory at Continence Foundation of Australia or call the National Continence Helpline on 1800 33 00 66.
Rethinking Your Approach to Sex:
It's important that you're aroused in the moment, so explore your sexual fantasies or other pleasurable thoughts to make the experience more enjoyable.
Otherwise, you can still explore other forms of intimacy, such as kissing, touching, oral sex, and manual sex. A vibrator* can be used on the head of the penis to stimulate nerves and send more signals to the brain.
Don't forget to be patient with yourself and your partner during this process. After prostate treatment, it can be daunting to entertain the thought of having sex again, but it's possible to get back to an enjoyable sex life.
Understand Your Emotions:
It's not easy dealing with emotions after being diagnosed with prostate cancer or going through treatment. Your treatment can have a huge impact on your emotional wellness.
Adrenaline can be triggered when we experience stress and anxiety, which can make it harder for us to experience intimacy. If you’re part of a couple, it’s important to have an honest and open conversation about any fears and expectations surrounding sex. You can both help to support one another through this process.
Another way to take charge of your emotions is to speak with a mental health professional. They can not only provide helpful strategies to cope with the situation, but can also prescribe helpful medications such as antidepressants and anti-anxiety drugs to help manage your emotions.
MensLine Australia is a professional telephone and online counselling service offering support to Australian men. Call 1300 78 99 78, 24 hours/7 days a week, chat online, or organise a video chat.
Beyond Blue aims to increase awareness of depression and anxiety and reduce stigma. Call 1300 22 4636, 24 hours/7 days a week, chat online, or email.
Finding a support group is a great way to have the chance to speak with others in the same situation and may help you in different ways. One of our members suggested support meetings affiliated with the Prostate Cancer Foundation.
Having sex post-prostate treatment can be difficult, but it's not impossible. With the right treatments and dedication, you can take steps towards getting your sex life back and enjoy satisfying moments again.
Most of all, you should know you’re not alone.
Some of our members have bravely shared their stories. I have kept their identities anonymous for privacy purposes.
One member shared, ’I have had surgery for cancer. A Radical Prostatectomy, which is complete surgical removal of my prostate. Yes, with every cancer there are side effects and you'll never be exactly the same afterwards. My best advice is to be your own advocate. Sometimes your General Practitioner cannot spend the time to answer all your questions. Research and listen to all advice, most advice is good advice. Up to the individual to take the pieces of advice that fits your needs and if in doubt, always seek clarification from your health professionals. For me, I attend support meetings affiliated with the Prostate Cancer Foundation. Men tend not to seek out help as much. Great info, support and you hear that others are going through similar journeys. Good luck in your health journey and may your sexual health be a pleasant part of it.’
Another member shared, ‘Sadly, after hubby had radiotherapy & brachytherapy for prostate cancer things went downhill from there. Added to that a catheter in hospital that was pulled out (ouch) by a trainee nurse without deflating it has damaged the nerves at the end of his penis. He doesn't get the brain signals for sex anymore and it has to be me asking to even make him aware that we should try other things. Viagra doesn't help at all.’
Interested in reading more? The Cancer Council website features two personal recounts that you can read here.
You might also be interested in our article: Reigniting the Spark: How to Maintain a Fulfilling Sex Life During and After Cancer Treatment.
Now, this article is not a replacement for qualified medical advice, and you should always consult with your GP before undertaking any new lifestyle or treatment choices. We do, however, hope this is able to assist and spur a further journey towards a fulfilling new phase of life.
MensLine Australia is a professional telephone and online counselling service offering support to Australian men. Call 1300 78 99 78, 24 hours/7 days a week, chat online or organise a video chat.
We believe that communication is key––so we've put together a guide to help you understand what to expect for your sex life.
Common Side Effects:
The prostate is situated in close proximity to the key nerve, blood vessels, and muscles that are used to facilitate an erection. During surgery or radiation treatment, these areas can be negatively impacted, making it hard to get an erection. This is likely something your doctor mentioned to you.
Hormone therapy can also lead to a decrease in testosterone levels, which can further reduce your sex drive and performance.
After diagnosis or treatment, it can be difficult to understand all of the options available. Credit: Shutterstock
The most common side effect of surgery or radiation is erectile dysfunction (ED)––an inability to get or maintain an erection. About 8 out of 10 men experience erectile dysfunction (ED) after treatment.
During a study, men also reported diminished orgasm intensity subsequent to loss of ejaculation from radical prostatectomy.
Other side effects can include
-Dry orgasms (no semen released)
-A decrease in penis size
-Decreased interest in sex
-Incontinence
While ED and related prostate surgery complications are a huge roadblock, it's important to remember that most men can still have an orgasm without an erection. What's more, up to half of men who have nerve-sparing prostate surgery or radiation treatment can see an increase in their sex life within a year of their treatment.
Penile Rehabilitation:
As the saying goes, ‘Use it or lose it.’ Rehabilitation may assist after surgery or radiation. You will need to look specifically into penile rehabilitation techniques.
There is still a lack of research on this, but its supporters believe that having frequent erections can help in increasing oxygen levels and blood flow.
Please note that all penile rehabilitation methods have potential side effects, and some have to be taught under medical supervision.
ED treatments can also be coupled with this process, and your doctor will be able to advise if penile rehabilitation would be useful for you.
Tips for supporting a partner doing penile rehabilitation
- Remind your partner to keep up with their penile rehabilitation exercises.
- Offer encouragement and emotional support.
- Try using erectile aids during sexual activity.
There are medications, devices, and supplements that can help you in your journey of getting back to a satisfying sex life.
You may be familiar with drugs such as sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), and vardenafil (Levitra, Staxyn). Unfortunately, these can only assist if there is no nerve damage from surgery or radiation.
Alprostadil (Caverject, Edex, Muse) is another alternative. It's available as a pellet that can be inserted in the opening at the tip of the penis and assists in increasing blood flow.
Alternatively, you could opt for a shot of medication in the base of your penis instead.
Vacuum devices or ‘penis pumps’ also exist to pull blood into the penis (for those who can get but struggle to keep an erection).
Lastly, you could have implants placed in your penis to help with the erection process. You will need surgery for this procedure.
For those wanting to use supplements as a way to increase sexual desire and performance, we are strong advocates for seeking advice from a qualified GP. Some supplements may decrease the efficiency of other medications, so an expert medical opinion is needed.
Healthy Habits:
There are various things you can do to help increase your chances of getting an erection in the future, including living a healthy lifestyle.
Regular exercise in tandem with a healthy diet with plenty of vegetables, fruits, whole grains, and fish can help to reduce ED symptoms.
If you're a smoker or partake in heavy drinking, it may be harder to achieve an erection.
Kegel exercises
Another thing you could do to reignite your sex life is Kegel exercises, which strengthen your pelvic floor muscles, and in turn, improve your ability to have an erection. They are also proven to reduce incontinence.
Do NOT do any Kegel exercises if you have a catheter in your penis.
New to Kegel exercises? First, it is important to make sure you are exercising the right muscles. One way to find your pelvic floor muscles is to try to stop and start your urine stream while you stand at your toilet to urinate. Try to do this two or three times. The muscles you use to stop your urine flow are your pelvic floor muscles.
The following Kegel tips (pelvic floor exercises) are courtesy of Prostate Cancer UK.
Slow exercises
Slowly tighten the muscles as hard as you can so you feel a lifting sensation.
Try to hold this lift for 10 seconds. Keep breathing normally.
Slowly relax the muscles and rest for 10 seconds.
Aim to repeat the lift and rest up to 10 times.
You might find that you can’t hold the lift for 10 seconds to start with. Just hold it for as long as you can and try to build up to 10 seconds. It’s more important to do the exercises properly than to do them for the full 10 seconds
Fast exercises
Repeat the same action but this time, try tightening the muscles as quickly as possible.
Hold the lift for one second, and then let go.
Try to do up to 10 of these short, fast lifts.
Try to concentrate while you’re doing the exercises. Remember to breathe normally. If you don’t do them properly, they might not help.
Aim for three sets of exercises a day.
For a list of continence nurses and pelvic floor physiotherapists, search the directory at Continence Foundation of Australia or call the National Continence Helpline on 1800 33 00 66.
Rethinking Your Approach to Sex:
It's important that you're aroused in the moment, so explore your sexual fantasies or other pleasurable thoughts to make the experience more enjoyable.
Otherwise, you can still explore other forms of intimacy, such as kissing, touching, oral sex, and manual sex. A vibrator* can be used on the head of the penis to stimulate nerves and send more signals to the brain.
Don't forget to be patient with yourself and your partner during this process. After prostate treatment, it can be daunting to entertain the thought of having sex again, but it's possible to get back to an enjoyable sex life.
Understand Your Emotions:
It's not easy dealing with emotions after being diagnosed with prostate cancer or going through treatment. Your treatment can have a huge impact on your emotional wellness.
Adrenaline can be triggered when we experience stress and anxiety, which can make it harder for us to experience intimacy. If you’re part of a couple, it’s important to have an honest and open conversation about any fears and expectations surrounding sex. You can both help to support one another through this process.
Another way to take charge of your emotions is to speak with a mental health professional. They can not only provide helpful strategies to cope with the situation, but can also prescribe helpful medications such as antidepressants and anti-anxiety drugs to help manage your emotions.
MensLine Australia is a professional telephone and online counselling service offering support to Australian men. Call 1300 78 99 78, 24 hours/7 days a week, chat online, or organise a video chat.
Beyond Blue aims to increase awareness of depression and anxiety and reduce stigma. Call 1300 22 4636, 24 hours/7 days a week, chat online, or email.
Finding a support group is a great way to have the chance to speak with others in the same situation and may help you in different ways. One of our members suggested support meetings affiliated with the Prostate Cancer Foundation.
Having sex post-prostate treatment can be difficult, but it's not impossible. With the right treatments and dedication, you can take steps towards getting your sex life back and enjoy satisfying moments again.
Most of all, you should know you’re not alone.
Some of our members have bravely shared their stories. I have kept their identities anonymous for privacy purposes.
One member shared, ’I have had surgery for cancer. A Radical Prostatectomy, which is complete surgical removal of my prostate. Yes, with every cancer there are side effects and you'll never be exactly the same afterwards. My best advice is to be your own advocate. Sometimes your General Practitioner cannot spend the time to answer all your questions. Research and listen to all advice, most advice is good advice. Up to the individual to take the pieces of advice that fits your needs and if in doubt, always seek clarification from your health professionals. For me, I attend support meetings affiliated with the Prostate Cancer Foundation. Men tend not to seek out help as much. Great info, support and you hear that others are going through similar journeys. Good luck in your health journey and may your sexual health be a pleasant part of it.’
Another member shared, ‘Sadly, after hubby had radiotherapy & brachytherapy for prostate cancer things went downhill from there. Added to that a catheter in hospital that was pulled out (ouch) by a trainee nurse without deflating it has damaged the nerves at the end of his penis. He doesn't get the brain signals for sex anymore and it has to be me asking to even make him aware that we should try other things. Viagra doesn't help at all.’
Interested in reading more? The Cancer Council website features two personal recounts that you can read here.
You might also be interested in our article: Reigniting the Spark: How to Maintain a Fulfilling Sex Life During and After Cancer Treatment.
Now, this article is not a replacement for qualified medical advice, and you should always consult with your GP before undertaking any new lifestyle or treatment choices. We do, however, hope this is able to assist and spur a further journey towards a fulfilling new phase of life.
MensLine Australia is a professional telephone and online counselling service offering support to Australian men. Call 1300 78 99 78, 24 hours/7 days a week, chat online or organise a video chat.
