Cancer of the prostate gland and its treatment can have a lasting, negative impact on sexual activity in men. Difficulties range from losing sexual desire to being unable to get an erection.

In this article, we look at how people can manage the potential effects of prostate cancer treatment on their sex lives. We also discuss the links between prostate cancer and sexual activity.

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Several strategies can help a person regain past levels of sexual function if prostate cancer treatment leads to problems achieving or maintaining an erection.

Medications

Some medications are beneficial in treating erectile dysfunction. These include:

Learn more about the different medications for erectile dysfunction here.

Non-drug treatments

Alternatively, people can try some physical or “mechanical” therapies. These include vacuum pumps and implants.

All these therapies mean rehabilitation is possible after treatment for prostate cancer. Rehabilitation can allow a person to regain an erection and engage in sexual activity and enjoyment.

Psychotherapy

It is common for people to experience anxiety, depression, anger, and stress when living with prostate cancer. These can all affect a person’s interest in sex or sexual performance.

Some people may also benefit from psychological support, for example, with a sex therapist. This may help if the effects of cancer and its treatment strain relationships. Couples therapy may support people in making adjustments to sex and other aspects of their relationships as they accommodate physical changes.

Understanding the likelihood of sexual dysfunction after prostate cancer treatment may help individuals cope with the changes they experience.

Can masturbation cut prostate cancer risk?

In this area of interest, a study that took information from 32,000 men found that more frequent masturbation and ejaculation might lead to a lower risk of prostate cancer.

A further 2017 study found that among men ages 20–29 who had 21 or more ejaculations a month, there were 2.39 fewer in every 1,000 who developed prostate cancer compared to those ejaculating 4–7 times a month.

Researchers also found that among men ages 40–49, 3.89 fewer people per 1,000 developed prostate cancer.

The reasons for these results are unclear, but one theory refers to prostate stagnation. This means that less frequent ejaculation allows prostate secretions to build up, possibly contributing to cancer.

The prostate gland produces fluid that comprises the majority of semen. As a result, removing a prostate gland and other prostate cancer treatments can stop a person from ejaculating seminal fluid at climax as previously.

However, people will still be able to feel sensations of pleasure and reach orgasm after prostate cancer therapy. People can reach climax without ejaculating semen. Instead, they may have a “dry orgasm.”

Some people may find these orgasms painful or less intense than before treatment. Passing urine when climaxing is also a potential side effect of some prostate cancer treatments.

Learn more about orgasms after prostate removal here.

While many men experience sexual issues following prostate cancer treatment, these issues are not often due to prostate cancer itself.

Treatment options with a risk of erectile dysfunction include:

  • Surgical removal: Surgical removal of cancer tissue or the prostate carries a risk of damaging nerves that control erections. Damage to these nerves can cause erectile dysfunction.
  • Cryotherapy: In this procedure, surgeons use probes to freeze prostate cancer cells. This treatment carries a high risk of erectile dysfunction.
  • Radiation therapy: Radiation exposure can damage blood vessels and nerves critical for achieving and maintaining erections.
  • Brachytherapy: In this procedure, surgeons plant radioactive seeds in the prostate gland. Brachytherapy has a lower risk of erectile dysfunction than other types of radiation therapy.
  • Hormone therapy: This treatment, which includes removing the testicles and using antiandrogen drugs, can cause erectile dysfunction, reduce interest in sex, and cause fertility problems.

Living with prostate cancer, and undergoing treatment, can cause psychological complications. Anxiety and depression are common in those living with prostate cancer, and this can often affect a person’s sexual desire and performance.

Some men may choose to manage very slow-growing prostate cancer with “watchful waiting” or “active surveillance.” If so, these treatment paths may not cause problems with sex.

The prostate gland is a male reproductive organ that sits around the urethra, the outlet tube for urine, just below the bladder. The gland’s surface is usually smooth and regular. The prostate is about the size of a walnut.

After skin cancer, prostate cancer is the most common cancer in men in the United States.

Learn more about prostate cancer in our dedicated hub.

Symptoms

Symptoms do not often occur with prostate cancer. When symptoms do start, they can include:

Prostate cancer and treatments for cancer might impact a man’s ability to achieve and maintain an erection and cause reduced sexual desire. Different surgeries for cancer can also disrupt the ejaculation process.

Certain medications and physical treatments, such as Viagra and related pills and creams, are available to treat erectile dysfunction. These include vacuum pumps and implants.