Sex and prostate cancer: communicating with your partner or spouse

Man and woman facing each other with their palms touching

Talking about your sex life during and after prostate cancer can be uncomfortable for partners. But open communication between you and your partner is a key part of recovery following treatment. It can help to ease any fears and worries about your relationship.
Let’s look at why communication matters and how you can get the conversation about sex and how you’re feeling started with your partner.

Why it’s so hard for some guys (and couples) to open up after prostate cancer

Some men don’t like to talk about their vulnerable feelings because they think they should be “strong and silent”. Some couples avoid talking about their feelings because they’re overwhelmed or trying not to burden one another. You may feel like you’re letting your partner down. Your partner may be unsure how to help, how to talk about sex after your prostate cancer diagnosis, and may feel guilty about their own desire to be sexual.

However, expressing these feelings can help with the process of grieving after prostate cancer or re-adjusting to life. If you’re struggling, worried or grieving but don’t talk about it, you may end up feeling worse.

    Not communicating can lead to:

  • Starting to feel distant from each other.

  • Losing emotional closeness.

  • Decrease in confidence.

  • Depression.

Why you should talk with your partner about sex and prostate cancer now

Most couples who talk openly about sexual challenges, changes and worries have a stronger connection — and a better sex life after prostate cancer. Opening up about sex during and after prostate cancer treatment makes it something you can approach as a team.

Research has shown that sharing worries takes away the feeling of being in it alone. For example, you may be worried your partner will be disappointed if you don’t get an erection before or during sex. Meanwhile, your partner may be worrying that it means you’re not as attracted to them. Often, neither is true. You can dispel a lot of needless worry and strengthen your connection simply by opening up with each other.

Plus, the more you talk the easier it gets. If you’re struggling to get started, consider some cancer counseling. A good place to start can be talking about how you’re feeling about the way your body has changed with prostate cancer treatment. Opening up can help you recover your sexual intimacy together.

4 things to cover when talking about sex and prostate cancer

Before we get into when and how to start, there are 4 things to make sure your conversation includes:

  • Acknowledge that sexuality has changed for both of you.

  • Express your grief about losing sexuality as you know it, alone and to each other or to others who support you.

  • Remember good feelings about your sexual relationship, and use them as a way to have confidence about the future.

  • Communicate about new sexual needs and roles.

Getting ready for a good conversation

Here are some tips to smooth the path ahead:

  • Choose a good time and quiet place. Set a time and place when you have time to talk uninterrupted. Turn off the TV, the phone, and computer. It’s worth your attention.

  • Be relaxed. Take a deep breath. You and your partner know each other and have shared a lot. You can even take some deep breaths together.

  • Listen without interrupting. When sensitive subjects are discussed, listening and repeating back what you heard is very helpful.

  • Ask questions and be curious about how they’re doing.

  • Compliment each other. Don’t hold back here. Let each other know what you’ve enjoyed about each other emotionally and sexually. For example, you might share how you like the way your partner smiles or reacts to you. How they held, or stroked you.

  • Try not to ‘fix’ each other’s feelings. Allow the other person to express how they feel.

How and when you decide to engage in sexual intimacy is up to you and your partner, but remember — good communication is essential whether you’re communicating with words or your body language.

Use conversation starters to open up

Talking about your thoughts and feelings may not be easy — but it’s important. Don’t know how to start? We’ve got some pointers that can kick off the conversation. Consider these:

"I know I don't always explain how I'm feeling, so I wanted to take a moment now."

"I know cancer is affecting us differently, so l wanted to know how you felt."

"Some of what I’m going through may be obvious, but there's a lot of stuff I don't talk about."

Openness and communication are very important as you’re working on staying sexually active. Bottling up your feelings, you will start to come to terms with the changes and this feeling will reduce over time. Telling someone about how you are feeling will help. This could be a partner, a close friend or by getting some cancer counseling. Bottom line: The more you talk, the easier it will be to have these conversations. You can also get more support if others know how you feel.

Try a communication activity

If you’re looking for a simple place to start, here’s an activity that can help you and your partner communicate how you’re feeling and discuss sex during and after prostate cancer treatment. You can do this on your own or together, as many times as you like. Try putting a reminder on your calendar to do it regularly — this way, you can make sure it happens.

How to begin: Grab some paper or something to jot down your responses. Look at each prompt below, and take time to answer each question. Share and discuss your responses with each other.

Think about and write down one question to ask your partner about how prostate cancer has affected them.

Think about and write down one activity (that you already do) that makes you feel physically close.

Think about and write down one activity you would like to do (in the future) to stay physically close.

Talking with your partner about erection troubles

Of course, sex is about more than erections. But for some men, this can be the most sensitive topic of all. Losing erections can feel like losing a part of yourself. Being able to talk about how you feel can help you heal.

As a partner — it helps to listen closely, but let them come to terms with it on their own. Each of you has needs and wishes and worries. Being able to share and be heard is a great way to support each other.