Sex With Prostate Cancer: How to Get Your Sex Life Back on Track

In 2021, over 248,000 new cases of prostate cancer were reported, indicating that 1 in 8 men may be diagnosed with the condition during their lifetime.

However, a common challenge arises. Many men experience some degree of erectile dysfunction within the first few months of prostate carcinoma treatment. 

Fortunately, one year after cancer treatment, a significant improvement is observed in almost all patients with intact nerves. These rates, however, depend on the level of nerve damage in the penis and whether they previously had erectile dysfunction. 

If you are worried about your sex life with prostate cancer, then you are in the right place. Here you can see exactly what to expect with carcinoma treatment and the ways to mitigate erectile dysfunction. 

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What to Expect When Having Sex With Prostate Cancer

Around 30% to 40% of cancer patients may experience erectile dysfunction following radiation therapy. Even after cancer treatment, men can still maintain the feeling in their penis. So, they can have an orgasm. But it will feel different.  

The prostate is closely located to nerves, muscles, and blood vessels. They all have an important role to play in getting and keeping the penis erect. 

Radiation therapy and surgery, like transurethral resection that treats prostate cancer, can damage these vital components. As a result, individuals affected may encounter challenges with erectile function after treatment. 

In fact, from 2% to 56% of cancer patients have ejaculatory disturbances after radiation therapy. That includes decreased amounts or no amounts of semen, painful ejaculation, and blood when ejaculating.  

Prostate surgery can lead to urinary incontinence, penile problems, and erectile dysfunction. With such complications from radiation and surgery, it is normal for prostate cancer treatment patients to have poor sexual desire. 

How Do Ejaculation and Orgasms Change? 

According to Prostate Cancer UK, the male body goes through a series of changes after prostate cancer treatment. Men can still feel sensations on their penis. But, these sensations are somewhat different than before.

For example, radical prostatectomy may result in penile shortening. Radical prostatectomy is a surgery that takes out the prostate gland and the nearby tissue to treat cancer. After a radical prostatectomy, many patients report having a change in penis size. They can also develop incontinence or trouble keeping the penis erect.

Also, after a prostatectomy, men can’t ejaculate during an orgasm. That’s because the surgery removes the seminal vesicles and prostate – both of which are critical for making some of the semen fluid. What a prostate cancer patient does experience is a “dry orgasm.” 

They can still feel that sensation. But aren’t able to ejaculate. The penis might release a tiny amount of fluid after cancer has been managed. However, this fluid is most likely coming from the glands lining the urethra. 

Men who produce less semen after receiving treatment for their prostate cancer have either received:

  • Radiotherapy


Cancer management isn’t easy. This is why it can lead to serious sexual dysfunction. After going through any surgery associated with the penis, sexual problems almost always happen. 

Some individuals have urine leakage during orgasms, other experience painful sensations. Then, there is the possibility of premature ejaculation. Post-treatment, like is the case with prostate cancer therapy, blood in the semen could occur. It is normal for it to happen. But you should still contact a specialist when it does. 

Also, some men who had hormone therapy for their prostate stated having less powerful orgasms. The hormone therapy might have had an impact on their penile function. This sexual dysfunction can emerge after treating prostate cancer. Plus, after brachytherapy or radiotherapy, the treatment could affect sperm count. 

Although the results are often temporary, people may not be able to have children. That’s why many men, before getting cancer surgery or treatment for the prostate, are looking to store their sperm. Instead of dealing with the aftermath. So, before you book brachytherapy, prostatectomy, or any treatment, be sure to have everything ready beforehand. 

With permanent seed brachytherapy, the prostate gland can swell. The prostate gland enlargement makes urination painful and difficult.

Whatever cancer management strategy you take, sex after prostate cancer can change. These changes from prostate cancer treatment are uncomfortable and debilitating. But, there are ways for people to manage their sex life and enjoy any sexual activity. 

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Tips to Ramp up Your Sex Life With Prostate Cancer the Right Way

To improve sexual function, doctors recommend you visit trained counselors. As a prostate cancer survivor, counselors and psychologists can provide you with practical strategies for sexual recovery.

Depending on the type of penile rehabilitation necessary, some men opt for a more targeted approach to fix the sexual dysfunction. After cancer treatment, a patient can get a penile implant. When the prostate cancer cells have been successfully managed, penis implants can help. 

Another option to try is typical ED treatment. Oral medication like Viagra or Levitra might prove useful for a patient. An intraurethral suppository is also used. It is a group of medicine known as vasodilators, which can expand blood vessels. Topical creams like Vitaros (alprostadil) that a patient applies directly to the penis can help with sexual function. Many men prefer this method as a short-term strategy. 

Others are choosing a more intensive treatment to restore sexual function. Penile injection therapy is another option, particularly for patients in need of severe erectile dysfunction management. Those who had localized prostate cancer or had a prostatectomy might select an option such as this. Those who went through prostate cancer management can choose any approach that fits them best. 

Irrespective of the chosen treatment, the goal is to enhance blood flow and facilitate an erect penis. Blood flow improvement is critical after having a robotic prostatectomy. The main problem with robotic prostate surgery or any surgery for the prostate can result in poor blood flow. This is what causes erectile dysfunction.


As you can see, sex after prostate cancer changes. The prostate has gone through a great ordeal, so it’s normal to experience erectile dysfunction. 

External beam radiation and surgery for treating the prostate are major contributors to sexual dysfunction. Now that you know what happens in the body post prostate cancer management, you will have an easier time dealing with erectile dysfunction. 

For more details about cancer or the state of your prostate after treatment, be sure to consult with a cancer specialist. 

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  1. Madan R, Dracham CB, Khosla D, Goyal S, Yadav AK. Erectile dysfunction and cancer: current perspective. Radiat Oncol J. 2020.
  2. Hyun JS. Prostate cancer and sexual function. World J Mens Health. 2012.

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