Male Sexual Health After Cancer
One area of life that might change after cancer and treatment is the ability to have or enjoy sex. This is sometimes referred to as male sexual dysfunction. Whether the cause is physical or emotional, there are often ways to treat and manage concerns about sexual functioning after cancer.
You’ll need to discuss treatment options with your health care team. Some men feel uncomfortable discussing sexual concerns with others. However, your health care team can answer questions, refer you to a specialist and help you find solutions.
When to Start Thinking About Sex After Cancer
Some survivors may decide to wait for a while after treatment before having sex. Others may be ready right away. There is growing evidence that staying sexually active, especially having erections regularly after cancer treatment, may help men avoid worse problems as time passes. There are ways to prepare physically and emotionally for having sex again.
Here are some signs that it is time to talk to your health care provider about sexual functioning after cancer treatment:
- Inability to get or keep a firm erection (erectile dysfunction or ED).
- Loss of desire for sex.
- Difficulty reaching climax.
- Having a dry orgasm or a climax without any semen.
- Having urine leak out at climax instead of semen.
- Orgasms (climaxes) that don't feel as good as they did before cancer.
- Pain in the penis or testicles during sex.
All of your physical and emotional concerns are important. Prepare talk with your health care provider. Write down questions and concerns about your sexual health before your medical appointments. If needed,ask for a referral to another health care professional who specializes in this area.
Effects of Cancer on Sexual Functioning
Certain types of cancer, such as those that affect organs in the pelvis, may put survivors at risk for problems. These include prostate cancer and cancers of the bladder,colon,or rectum. Men treated for prostate cancer have higher rates of dysfunction--up to 75 to 85 percent.
Sexual functioning challenges can become more common in men as they get older. For example, about half of men without a cancer history will experience erection problems by age 70. This means that older male survivors may experience sexual functioning problems later in life that are not related to cancer or the treatment they received.
Other factors can also affect sexual functioning. For example, men are more likely to develop erectile dysfunction if they are overweight, smoke, or drink heavily. In addition, other health problems like heart disease,high blood pressure,kidney disease or diabetes may also affect a man's erections.
The emotional effects of cancer may contribute to survivors feeling anxious, depressed or self-conscious. This can also create stress for a partner. In some cases, the result may be challenges with sexual functioning. Working with a licensed mental health professional to deal with these types of emotions is often very helpful.
The following table lists some of the possible causes of sexual dysfunction and issues that can be discussed with your health care team:
Cancer Treatments |
Physical Effects |
Symptoms |
|
Low testosterone levels |
|
|
Damage to nerves near prostate |
|
|
Damage to blood flow to the penis |
|
|
Damage to nerves controlling outflow of semen during orgasm |
|
|
Removal of prostate and seminal vesicles |
|
|
Radiation near the prostate and seminal vesicles |
|
|
|
|
Finding Help for Male Sexual Health
It’s best to talk to your health care provider about sexual functioning even before cancer treatment begins. After treatment, you can work with your health care provider after pelvic surgery or radiation therapy to try medical treatments that promote erections in order to optimize the chance of maintaining or recovering good sexual function. Counseling, medical treatments and surgery are all options to treat cancer-related sexual problems in men.
Sexual Functioning Concerns |
How to Find Help |
Loss of desire for sex after cancer |
|
Erection problems (erectile dysfunction or ED) |
|
Concerns about orgasm |
|
Pain in the penis or testicles during sex |
|
Treatment Options for Erectile Dysfunction
Below are treatment options for erectile dysfunction along with some the pros and cons. Talk with your health care team about the best options for you. You can research information at WebMD Erectile Dysfunction Health Center.
Treatments For Erectile Dysfunction |
Pros |
Cons |
Pills (PDE-5 Inhibitors) |
|
|
Vacuum devices |
|
|
Penile injections |
|
|
Penile suppositories |
|
|
Penile prostheses |
|
|
Herbs and vitamins |
|
|
Your health care team can help you learn more about how to treat concerns and improve your ability to enjoy sex again. There are many ways to enhance and share pleasure and closeness with your partner. Even survivors who no longer have sex are able to find ways to continue to enjoy affection and closeness with their partners.
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Works Cited
American Cancer Society. Sexuality and Cancer:“For the Man with Cancer and His Partner.” Atlanta:American Cancer Society,2001(99-rev. 07/01-50M-no.4658-HCP). Downloadable version: http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/SexualSideEffectsinMen/SexualityfortheMan/index
Mulhall,John P. “Saving Your Sex Life:A Guide for Men with Prostate Cancer.” Bethesda,MD:Ci-I-ACT Inc.,2010.
Schover,Leslie R.,Rachel T. Fouladi,Carla L. Warneke,Leah Neese,Eric A. Klein,Craig Zippe,and Patrick A. Kupelian. “Defining sexual outcomes after treatment for localized prostate cancer.” Cancer95(1992):1773-85.
Schover,Leslie,&. Thomas,Anthony J. Overcoming Male Infertility:A Guide for Men and Their Partners. New York:John Wiley & Sons,2000.