Worries about the impact of prostate cancer on your sex life are common; whether you are in a relationship or single, a cancer diagnosis and treatment can impact your sexual and intimate relationships, or your choice to start a new one.
Here Amy Spurdens, Urology Clinical Nurse Specialist (CNS) at London Bridge Hospital, part of HCA Healthcare UK, talks us through some of the common worries and the support and treatment available.
Talking about sex
Talking about sex isn’t always easy, but opening up to your medical team can help us to plan the most effective treatment for you and help to plan ahead for any support you may need after treatment.
Your nurse or consultant will usually ask you about your urinary and erectile function, but if for any reason that they don’t - it’s your health and your body so don’t be afraid to bring it up
As an individual you’ll have your own feelings on sex and intimacy and how important these relationships are to you personally. For example, sex may be a very important aspect of your life or relationship, or you might not have been sexually active before treatment and therefore are not overly or immediately concerned about the impact treatment might have on your sexual function and desire. Either way, it’s important that you know you can talk to us before, during or after your prostate cancer treatment and there is lots of support and potential treatment options available to you.
Understanding and managing erection problems
When you become sexually aroused, increased blood flow to your penis creates an erection. Erectile dysfunction is a medical term used to describe problems with getting and maintaining an erection.
There are different reasons why you may experience erectile dysfunction as a result of prostate cancer. These can be associated to your treatment, or caused by a change in your desire to have sex.
Erection problems associated to treatment
Some treatments for prostate cancer can affect your ability to get and maintain an erection. Some men may find it difficult to maintain an erection for a short time after treatment, while other treatments can have longer lasting effects. Hormone therapies can also affect your sexual desire - you may hear this referred to as your libido or sex drive. This in turn can affect your ability to get and maintain an erection.
There are different treatments that can help you with erection problems, these include tablets, a vacuum pump, injections, pellets or creams, an implant or testosterone therapy. Your consultant or nurse will be able to explain each of these treatment options to you in more detail so that you can make a decision about what’s right for you.
Erection problems associated to your libido
There are many things that can affect your sexual desire - often referred to as your libido or sex drive.
A cancer diagnosis and treatment can be emotionally challenging and feeling low can affect your desire to have sex. Changes to your body may also affect your thoughts and feelings about sex and intimacy, and you may not feel as confident as before.
There is support available to help you work through these feelings, either on a 1:1 basis or through male support groups. Many men are initially reluctant to open up, but feedback from our support programme shows that sharing these concerns, either with a medical professional or through facilitated support groups, can really help in your recovery.
Certain treatments can also affect your libido. For example, hormone therapies reduce your levels of testosterone, which can impact your sex drive. If hormone therapy has been recommended as part of your treatment plan, or you are on hormone therapy and are concerned about the impact on your sex drive, speak to your consultant or nurse.
Sometimes it is possible to have ‘intermittent hormone therapy’, where if your PSA is low, you can take treatment breaks, or you may find that some erectile dysfunction treatments may still work for you. The best thing you can do is share your concerns so that we can look for a solution that works for you.
More generally, many cancer treatments can cause tiredness - medically we call this fatigue. This may make you less interested in sex, or you may feel you don’t have the energy. Fatigue can affect you both during or after treatment, but there are ways it can be managed and there is advice and support we can offer you.
Relationships
If you are in a relationship, then your cancer diagnosis and treatment may change the way you have sex. There are many ways to be intimate with your partner and changes to your sex life may mean that you find new ways to be physically close to each other.
If you are single, the thought of starting a new sexual relationship may seem daunting and you may be worried that a new partner may not understand.
The important thing to remember is that everyone is different and there is no right or wrong way to feel about sex and intimacy after cancer. Being open and honest with your partner and encouraging them to share their thoughts and feelings is often the best way to establish your individual needs and comfort levels. Some couples find that ‘couples therapy’ can facilitate a safe space to share and work through these feelings with guidance and support.
While sex may be different after cancer, many people are able to have a healthy and fulfilled sex life, or intimate relationships, after treatment. It’s just about taking the time you need in your recovery and establishing a plan for any necessary treatment and support with your medical team. It’s important to focus on what feels right for you and don’t be afraid to ask for support if you need it – you’re not alone.