How might hormone therapy (ADT) for prostate cancer affect my sex life?

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*Currently best for people who’ve had prostate cancer surgery and their partners.

After (also know as androgen deprivation therapy or ADT), you should expect some changes in your sex life. These changes can affect your body, mind, and relationships because sexuality is not only physical, it includes your thoughts and feelings too.

Common sexual changes after
hormone therapy for prostate cancer

Take a look at the Body, Mind and Relationships diagram below for a deeper understanding.

Diagram: Mind Body Relationship

Coping with cancer and sexual challenges with a partner, or your feelings about starting a new one.


Treatment can damage the nerves and blood supply needed for erections.


Cancer and sexual challenges following treatment can make you feel down and anxious, changing your feelings about sex.

Click on the list below to see
the most common changes
following hormone therapy.

Problems with orgasm

After treatment, reaching orgasm takes longer, but it's still possible for most men. You might find:

  • your orgasm feels different now than before treatment

  • you produce less semen during and after treatment

  • you can still orgasm, but it may feel less intense

Even without an erection, it is still possible to reach orgasm and enjoy sex

“For months I thought my sex life was over and I would never orgasm again. I was playing around in the shower and low and behold, ACTION! It was an incredible feeling."

Iain, 48 years

Penis and testicles getting smaller

Sometimes the penis can shorten because of the lower levels of male hormones caused by hormone therapy. And if you go a long time without having any erections, this can cause some scarring of the tissues in your penis, which can cause shortening. On top of that, because the testicles aren't producing testosterone, they might get smaller.

These changes may have been unexpected for you, but know that there are ways to reduce shrinkage and help get full erections.

For example, there's an erectile aid called a ‘vacuum pump’ or 'penis pump' which may help to reduce shrinkage. This may stretch the tissue and help maintain your penis size.

“My partner kept reassuring me that it doesn’t matter but it did to me. I did try the pump. My penis felt cold and strange but it did help."

Gary, 69 years

Penis not getting as hard (erectile dysfunction)

Because of the way hormone therapy affects your body, many men experience difficulties with their erections and sex drive.

How soon after treatment does this start?
Within six weeks of treatment, many men experience problems with their erection. If your hormone therapy is short-term, you may see recovery of erections about six months after stopping treatment. For long-term hormone therapy, difficulty in getting a hard erection may be permanent.

How can I maintain a satisfying sex life?
Even though you'll need to adjust to changes to your body, you can still have a satisfactory sex life. If you're comfortable, you can:

How can I maintain a satisfying sex life list

  • try medication and erectile aids to help get a firmer erection

  • keep your penis active during hormone therapy to help with erections after treatment

  • adapt your role and expand your routine in the bedroom to cope with these changes

Starting to think about other ways to get pleasure will help you on this journey.

"The gradual change to my erections was strange, I feel less like wanting sex now but I know I will be finished this hormonal treatment soon and I use the pump to give my penis some exercise. It might be a waste of time but I feel I’m doing something."

- Gary, 69 year

Body changes

Changes like weight gain, breast swelling and hot flushes are common side-effects of hormone therapy.

There are things that can help:

  • wear loose cotton clothing and reduce alcohol – this may help with hot flushes

  • being patient with yourself if you do gain weight, as it may take a while to lose the extra weight

  • staying physically active

"With all the changes to your body, breast growth seems like a small thing to worry about, but it is so uncomfortable. It helped when I had some daily exercise."

Trevor, 68 years

Feeling fatigued, even after rest

Hormone therapy is likely to cause this tiredness. Fatigue can come on quite suddenly and can affect your energy levels, motivation and emotions.

There are things you can do to help:

  • plan your sexual activities ahead, in a part of the day when you have more energy

  • research shows that regular exercise, even if you feel tired, can help with fatigue

  • remember that this tiredness is normal and will ease after treatment stops

"My energy levels go up and down, but I try and take things slowly, and take advantage of the times I feel like I have more energy. We now have cuddles in the bed in the morning.”

Patrick, 72 years

Coping with sexual changes

Many individuals say that after having prostate cancer and treatment, they initially struggled with sexual changes. And after working through these changes, although their sex life is different, they now feel satisfied with their ‘new’ sex life.

If you’re experiencing changes to your body, remember that you’re not alone. Talk to your partner about how you feel and other ways you can stay close and connected. Your care team can give you advice and help find a treatment plan that works for you. Your doctor can also refer you to a sexual health counsellor or sex therapist who can provide some helpful guidance.

What's next?

Now that you've read up on How might hormone therapy (ADT) for prostate cancer affect my sex life?, here are some related articles to explore as you continue to build your knowledge and understanding of this topic.
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