Prostate cancer is a malignant disease that develops in a gland present in men’s reproductive system known as the prostate. The gland is sized and shaped like a walnut and its main function is to produce a fluid that is expelled with sperm during ejaculation. The prostate is located below the bladder, near the rectum and around the urethra, while cancer occurs when the prostate cells start to grow out of control. Due to the location of the prostate, cancer affects both the urinary and reproductive system.

Symptoms of the disease include urinary problems like a slow or weak urinary stream or the need to urinate more often, especially at night, blood in the urine, erectile dysfunction, pain in the hips, back (spine), chest (ribs), or other areas from cancer spread to bones, and weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord. Given the importance and impact of prostate cancer in sexuality, it is important for patients to understand what may occur and how to address it.

How Prostate Cancer Impacts Patients’ Sex Lives

Prostate cancer impacts patients’ sex live at three different levels — body, mind and relationships. At the physical level, patients are at risk of erectile dysfunction, loss of libido and infertility. Difficulties in getting an erection (erectile dysfunction) may be caused by the tumors or by a treatment with radiation therapy, prostate surgery, and most types of hormone therapy. Similarly, being less interested in sex (loss of libido) may occur. Patients are more likely to experience it after a surgery to remove the testicles (orchidectomy) or an hormone treatment.

In addition, men who are treated for prostate cancer are at risk of losing the capacity to father a child in the future (infertility). Hormone treatment and radiation therapy decrease the possibilities, while a TURP surgery makes men unable of producing semen, which does not mean that they won’t have orgasms. If semen is not produced, men are more likely to have retrograde ejaculation, which means that when they orgasm, the sperm goes backwards into the bladder instead out through the penis. However, these are hypothesis that may or not occur and each case is different.

The impact of prostate cancer and prostate cancer’s treatment in patients’ sex lives is not limited to physical limitations. Finding out about cancer, the symptoms of the disease and treatments’ side effects may also cause anxiety or depression and alter patients’ feeling about sex. Relationships may also be affected by the physical and emotional burden of the disease. Common worries from prostate cancer include transmitting cancer through sex, which cannot occur since cancer is not contagious. Having sex will also not affect the cancer or the success of the treatment, or have effects on the probability of cancer reoccurrence. If possible, erections and sex are safe.

Management of Sex Problems Related to Prostate Cancer

“The effects on your sex life can be difficult to live with. The way that the side effects affect you will depend on your own individual situation. It will also depend on your partner (if you have one) and how your sexual relationship has been in the past. It will help to talk things over with your partner and discuss the changes in your lives,” explain the organization Cancer Research UK. It may be difficult, but there are ways to manage the sex problems associated with prostate cancer and its treatments.

In the case of erectile dysfunction, medicines such as sildenafil citrate (Viagra), vardenafil (Levitra) or tardenafil as well as gels (MUSE), injections (Caverject) or vacuum devices may help. Loss of libido is usually treated with testosterone injections or patches, but in the case of prostate cancer it is not possible since testosterone could encourage the cancer to grow or come back. Therefore, patients should discuss an alteration in the treatment to address the problem. Regarding infertility, patients may prevent it by collecting and storing sperm before the treatment. In the case of retrograde ejaculation, sperm may be taken directly from the testicles even after the surgery, and be used to fertilize the patient’s partner.

The psychological and emotional burden of prostate cancer is as important as the physical one in patient’s sex life. Both patients and their partners or loved ones are encouraged to share their experience and feeling. Seeking a psychologist can help deal with these problems. In addition, there are support groups in which patients can share and hear the problems and experiences of other going through the same disease. One example of this is the patient and caregiver support network powered by the Prostate Cancer Foundation (PCF) and My Bridge 4 Life, which include financial resources, help to find a doctor or treatment center, help find a support group and prostate cancer blogs.

Note: Prostate Cancer News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.