Cancer Men's Health

What you need to know about sex after prostate cancer

When choosing the right treatment for prostate cancer, you need to talk about it – and not just with your oncologist. Your partner should be there too.

“There are studies showing erectile dysfunction (ED) and/or low libido are potential side effects of chemotherapy, radiation and surgery for prostate cancer patients,” said Dr. Sherita King, director of prosthetic urology at the Georgia Cancer Center. “Men need to know there are treatment options for these physical problems.”

ED and low libido are intimate problems for men, but King doesn’t want them to sit and suffer in silence.

Instead, King encourages men to talk about their intimacy with their physicians and partner. To begin treatment, patients should expect to discuss how rigid their erections are and how long they last. King said honesty is very important when deciding the best treatment option.

“Like a patient going through cardiac rehab after heart surgery, I believe strongly in penile rehab for patients who have had their prostate removed via surgery or has undergone radiation treatment. They can use medications and do vacuum therapy to keep the tissues of the penis healthy while the nerves damaged during surgery regenerate,” King said.

In addition to penile rehab, patients can get treatment options to achieve “on-demand” erections for intimacy. While oral medications, such as Viagra, Levitra or Cialis, are usually the first option, they may not work for every man. The next step is having a penile Doppler ultrasound to look at how blood is flowing.

For men living with ED, their arteries may not dilate enough to bring in a sufficient amount of blood and/or their erectile tissue does not expand enough to compress veins to keep blood in place.

If it’s a problem with the arteries, there are oral medications and penile injections that can help. If the problem is a venous leak, then they may need to use a vacuum device to pull the blood in and then put a ring at the base of the penis to keep the blood from flowing out.

If none of these options work, patients can try a penile implant, which is a surgically-placed device that will allow the man to have a sustainable erection. But in the end, it’s all about the conversation between the patient, their partner, and their healthcare provider.

“If a man is going to seek treatment, I want to encourage them to bring their partner with them,” King said. “It takes two people to make physical intimacy possible. Both people need to be involved in finding the right solution to the problem.”

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About the author

Augusta University Health

Based in Augusta, Georgia, Augusta University Health is a world-class health care network, offering the most comprehensive primary, specialty and subspecialty care in the region. Augusta University Health provides skilled, compassionate care to its patients, conducts leading-edge clinical research and fosters the medical education and training of tomorrow’s health care practitioners. Augusta University Health is a not-for-profit corporation that manages the clinical operations associated with Augusta University.