Male Sexual Dysfunction: Suggestions

Loss of desire for sex after cancer

• Discuss whether this is a possible side effect of your medicine with your health care team.

• If you think your testosterone may be low, see a urologist or an endocrinologist for a blood test. However, if you had prostate cancer, you cannot take testosterone safely. You can discuss other options with your health care team.

• If there isn't a physical cause, see a mental health professional to find out if it's related to feelings of depression, anxiety or low self-esteem.

Erection problems (erectile dysfunction or ED)

• See a urologist or family doctor who specializes in men's sexual problems. You may find a clinic that focuses on erectile dysfunction.

• If you think your problem is caused by anxiety or stress and not physical damage from cancer treatment, you might want to talk to a mental health professional.

Orgasm problems (hard to reach an orgasm, orgasm feels weak, no semen comes out at the time of orgasm)

• Discuss whether this is a possible side effect of your medicine with your health care team.

• Dry orgasms are mainly a problem if you want to get a partner pregnant. There are fertility options for men who have dry orgasms. You should discuss these with a member of your health care team.

• Try not to pressure yourself to have an orgasm. This may make it hard for you to relax. Give yourself time.

Pain in the penis or testicles during sex

• If you have pain in the penis when you get an erection, it may be a sign of inflammation or scarring, especially if you notice that your penis curves when it is erect. In this situation, you can visit a urologist.

• A sharp pain in the penis or testicles during climax can result from scar tissue after surgery or radiation therapy, chronic tension in muscles on the floor of the pelvis, or occasionally, an infection in the prostate. If no infection is involved, this type of pain can be difficult to treat. See a urologist or a doctor who specializes in pain.

Treatment Options for Erectile Dysfunction

Pros

Cons

Pills (PDE-5 Inhibitors)

• Easy to use

• Natural

• Only minor side-effects

• Safe for most men unless they have severe heart disease or use nitrates

• Expensive

• Do not work well for men who have severe ED

• One-time purchase

• Covered by insurance

• Few side effects

• Using the pump interrupts intercourse

• Band on penis may be uncomfortable

• Requires practice to use correctly

• Erection may not be firm enough for satisfying intercourse

• Very effective for most men

• Can be used before starting sex

• Expensive

• Need to refrigerate medicine and take syringes

• Must learn self-injection

• May cause pain for some men

• Same medicine as injections but put inside urinary opening as a small pill that melts.

• Expensive

• Only works for a few men

• Very effective for most men

• Becomes part of man's body

• Inflatable types are not visible

• Erection looks and feels natural

• Covered by insurance

• Involves surgery and pain during recovery

• Can only be repaired surgically

• Erections are slightly shorter than before

• Destroys natural erection reflex

• Not a reversible treatment

• Inexpensive

• Easy to get

• Do not always work

• May interfere with a man's other medicines

• May have unknown dangers