Prostate cancer and your sex life
ONE OUT of seven men will be diagnosed with prostate cancer in his lifetime, making it the most common cancer in men. Treatments like surgery, radiation, and hormone therapy remove or destroy the cancer. However, all of these treatments can have sexual side effects. This can include trouble getting an erection, having an orgasm, and fathering children.
Prostate cancer may dampen your sex drive. Knowing that you have cancer and going through treatment can both cause you to feel too anxious to have sex.
Hormone therapy used to treat prostate cancer can also affect one’s libido. This treatment slows prostate cancer growth by lowering testosterone levels in your body. You need testosterone to have a healthy sex drive. It can also affect your self-esteem and sex drive by making you gain weight or causing your breast tissue to enlarge. If your hormone levels are low, your doctor may be able to prescribe testosterone replacement therapy to bring them back up to normal. This depends on your overall cancer treatment plan.
Some men notice that their penis is slightly smaller after prostate cancer treatment. In a 2013 study, about three per cent of participants reported that they had a reduced penis size after radical prostatectomy or radiation plus hormone therapy. The men said their smaller penis affected their relationships and their satisfaction with life.
For men who do experience this, the change in size is generally half an inch or less. This decrease in size may be due to tissues shrinking in the penis. These tissues may shrink because of nerve and blood vessel damage.
When you are sexually excited, nerves cause tissues in your penis to relax, allowing blood to flow into the organ. The nerves that control erection are very delicate. Surgery or radiation for prostate cancer may damage them enough to cause erectile dysfunction. When you have erectile dysfunction, you cannot get or keep an erection.
Radical prostatectomy is a surgery to remove the prostate gland. When your surgeon removes the gland, they may damage the nerves and blood vessels that run along it. If they are damaged enough, you won’t be able to get an erection following the procedure.
Today, doctors can do nerve-sparing surgery, which helps prevent permanent erectile dysfunction. Your surgeon can still touch those nerves and blood vessels, causing erectile dysfunction as a temporary side effect. Many men have trouble getting an erection for a few weeks, months, or even years after their procedure.
Radiation therapy also damage blood vessels and the nerves that control erection. Up to half of men who have radiation for prostate cancer experience erectile dysfunction afterwards. In some men, this symptom will improve with time. Sometimes radiation side effects do not appear until a few months after the treatment. If erectile dysfunction starts late, it may not be as likely to go away.
Surgery for prostate cancer can affect both your orgasms and your ability to have children. The prostate gland normally adds a fluid called semen to sperm to nourish and protect it. You will no longer make semen after surgery, which means your orgasms will be dry. Radiation therapy can also reduce the amount of fluid you ejaculate. Without semen, you won’t be able to father children. If you are concerned about fertility, you can bank your sperm before your surgery.
After surgery, orgasms will also feel different. You won’t have that normal build-up of sensation before you have an orgasm. You will still be able to feel pleasure, though.
The Jamaica Cancer Society will be hosting a Prostate Cancer Public Forum on Sunday, September 19, beginning at 1 p.m. This is free of cost to the public and the meeting link will be posted on their website. The society is also hosting their Annual Prostate Cancer Medical Symposium on September 26 at 9 a.m.
The month of September is also observed as Paediatric Awareness Month, and the Jamaica Cancer Society will be hosting a Paediatric Mini Symposium on Thursday, September 30, 2021 from 1 p.m. to 4 p.m.
WHAT YOU CAN DO:
Sexual side effects from prostate cancer treatment are often temporary, especially if your doctor used nerve-sparing surgery. While your body recovers, you can try a few things to maintain your sex life:
• Let your doctor know about any sexual problems you are having right away. Although it can be hard to talk about sex, being open and honest will help you get the treatment you need.
• See a therapist. Couples therapy can help you and your partner understand and deal with sexual issues.
• Take care of yourself by exercising, eating a well-balanced diet, reducing stress, and getting enough sleep. Looking and feeling your best will give your self-esteem and mood a boost.