Male Sexual Dysfunction: Detailed Information

Cancer and its treatment can affect many different aspects of your life. One area of your life that might have changed is your ability to have or enjoy sex like you did before cancer. These changes are sometimes referred to as sexual dysfunction caused by cancer or its treatment.

Cancer doesn’t always cause sexual dysfunction in survivors. Survivors respond to sexual dysfunction in different ways. If you are frustrated and want to find ways to manage the sexual dysfunction that you experience, this document has information that may help you.

There are many different causes of sexual dysfunction after cancer. Whether the cause is physical or emotional, there may be ways to treat and manage your sexual dysfunction. You can discuss treatment options with your health care team.

You may find it difficult to discuss sexual dysfunction with your health care team. It can feel uncomfortable or embarrassing. But your health care team can answer your questions. You can talk to them about how sexual dysfunction is affecting your life after cancer.

What are some signs of male sexual dysfunction?

Some signs of sexual dysfunction men may experience after cancer include:

• Inability to get or keep a firm erection (erectile dysfunction or ED)
• Loss of desire for sex
• Difficulty reaching climax
• Having a dry orgasm – a climax without any semen
• Orgasms (climaxes) that don’t feel as good as they did before cancer
• Pain in the penis or testicles during sex

The symptoms listed above aren’t always medical emergencies. You may wonder if you should bring them up to a member of your health care team. But all your concerns are important. If you are experiencing pain or if sexual dysfunction makes your life less enjoyable, you should discuss your concerns with a member of your health care team. You may feel more comfortable if you write down your questions beforehand and bring them in and read them. Your health care team can talk to you and answer your questions about of all your health problems, including sexual dysfunction.

When does male sexual dysfunction appear?

Sexual dysfunction for survivors usually happens after cancer treatment. With radiation therapy to the pelvis, sexual dysfunction may begin gradually after treatment is over and may get worse over several years. Because a man’s risk for sexual dysfunction increases as he gets older, you may not notice sexual dysfunction until years after your treatment ends.

What causes male sexual dysfunction after cancer?

There are many different causes for sexual dysfunction in cancer survivors. Some are physical causes and some are caused by changes in how you feel about yourself, your body or other aspects of your life.

There are certain types of cancer, like those that affect your sexual organs, that put you at risk for sexual dysfunction after cancer. Men treated for prostate cancer have much higher rates of sexual dysfunction, up to 75% or 85%. Sexual dysfunction is most common in men whose tumors were in the pelvic area, including prostate cancer, and cancers of the bladder, colon, or rectum.

Different types of sexual dysfunction in male survivors can result from:

• A drop in a man’s testosterone levels (the hormone made in the testicles) during hormone therapy for prostate cancer
• Damage to areas of the brain by cancer or its treatments
• Radiation to the pelvic area (prostate, bladder, colon, groin or penis)
• Surgery removing pelvic organs such as the prostate, seminal vesicles, areas of the colon or the penis
• High doses of chemotherapy may damage sexual desire or erections
• Side effects of medicines to treat pain, nausea, depression or anxiety

Generally, sexual dysfunction becomes more common in men as they get older. Half of men without a cancer history will experience erection problems by age 70. This means that older male survivors may experience sexual dysfunction later in life that isn’t related to their cancer or their treatment. Men are also more likely to develop erectile dysfunction if they are overweight, smoke, or drink heavily, or if they have health problems like heart disease, high blood pressure, or diabetes.

Cancer may also affect a man emotionally and cause him to feel depressed, anxious, self-conscious, or have conflict with his partner. Sometimes, when a man struggles with these emotions, he may experience some sexual dysfunction. Sexual dysfunction linked to a man’s emotions can be treated with individual or couple counseling.

The table below lists more information about some of the causes of sexual dysfunction. This table doesn’t provide all of the information about the many possible causes for sexual dysfunction in cancer survivors, but it does provide you with information that you may want to discuss further with your health care team.

Are there successful treatments for male sexual dysfunction?

There are many different treatment options that may help you with your sexual dysfunction. But if you think that sexual dysfunction is interfering with your ability to enjoy life after cancer, talk to your health care team about what you are experiencing. Ask for a longer appointment with your doctor so you will have time to bring up sensitive questions. Sexual dysfunction may not go away on its own. Your health care team can help you learn more about the treatment options available and how to improve your ability to have and enjoy sex again.

Sometimes treatments do not work and your sexual dysfunction may continue to affect you. This can be very frustrating and upsetting for both survivors and their partners. Intercourse is only one way of sharing pleasure and closeness with your partner. Some survivors who can’t have sex find they still enjoy cuddling and caressing their partner. You might want to try other ways of sharing pleasure and feeling closeness with your partner.

You have a right to sexual health, and you can work with your health care team to treat sexual dysfunction. You do not have to be sexually active in order to stay healthy.

What can be done to manage male sexual dysfunction?

The most important factor in choosing a cancer treatment is its ability to control cancer. However, your sexual health is also important. If you are worried about sexual dysfunction after your treatment, talk to your health care team about different therapies to help you.

For more information on managing male sexual dysfunction, see Suggestions.

This document was produced in collaboration with:
Leslie R. Schover, Ph.D.
Professor of Behavioral Science, UT M. D. Anderson Cancer Center

Male Sexual Dysfunction: Suggestions

Below is a list of some of the treatment options for erectile dysfunction and pros and cons for using them.

When you talk to you a member of your health care team about your erectile dysfunction, they may offer different treatment options.