Dealing with anger, grief and emotions during sex after prostate cancer

Older man walking alone by the water's edge

Experiencing grief, especially when your sex life changes after prostate cancer and you can no longer make love exactly the way you were used to, is completely normal. You and your partner or spouse can feel upset. It’s all part of the recovery process.
While grief can’t (and shouldn’t) be avoided, there are ways to navigate it together.

Grief is a normal part of recovery from prostate cancer

The first step in coping with your grief? Acknowledging the sexual changes you’ve experienced and your feelings about them. Grief looks different for everyone, but you may feel:

  • Shock. No one is ever truly ready for the sexual changes that prostate cancer brings.

  • Sadness. Some men feel as though they’ve lost a part of themselves, something to be mourned.

  • Anger. It’s normal to feel upset when you’ve gone through prostate cancer and you've lost your usual sexual function.

  • Frustration. Recovery takes time and is uncertain. That can be incredibly frustrating for some men.

  • Hopelessness. You may feel defeated, afraid that there’s nothing you can do.

  • Fear. Some men worry they’ll never get their sex life back after prostate cancer.

Grief can show up in unexpected ways. Find yourself getting irritated by small things that never used to bother you? You may not realize that grief is behind this feeling.

Some common signs of grieving after prostate cancer may be:

  • Mood swings

  • Crying spells

  • A shorter fuse than you normally have

  • Socially isolating yourself (keeping away from friends and family).

  • Anxiety.

  • Low motivation.

Grief can affect your sense of manhood

Some men feel less manly and confident when they can’t get an erection. If you’re feeling this, you’re not alone. Hear from someone who’s been there:

"I’ve been working on myself in other ways to compensate for the fact that I don’t have that same feeling of manhood...it’s like there’s something lost, there’s something gone, there’s something missing."

Man treated for prostate cancer

Partners feel grief after prostate cancer, too

Partners can also feel grief, but may experience it differently from the person with prostate cancer.

    Partners may:

  • Worry about how sexual changes after prostate cancer might affect them and their own pleasure during sex.

  • Worry their partner isn’t attracted to them anymore if he can’t get an erection.

  • Feel unsure about how to help their partner with sexual recovery.

  • Not understand that their partner is grieving the loss of their body image due to the lack of erections.

Your feelings on this are valid. And it’s OK to acknowledge that things have changed. Hear from someone who's been there:

"I didn’t think it would matter to me...but it matters... I was quite sad that our sex life had changed... It was like a mourning..."

Partner

How does grief impact your relationship after prostate cancer?

You and your partner may feel grief as a couple because suddenly, your whole sex life feels different. You may have low or no sex drive after prostate cancer treatment and feel that this putting a strain on your relationship.

You may not be able to have sex in the same ways you always have. You may be worried about whether you can still give each other pleasure.

If there were relationship or sexual problems before prostate cancer, coping with sexual changes after treatment can be even more challenging.

The day-to-day squabbles about dishes in the sink or whose turn it is to take out the trash may feel bigger than usual, because you’re not connecting as a couple in the same ways you did before.

Both of you might also grieve on different timetables. One of you may process your grief more quickly or slowly than the other.

All of this is normal. Even if you’re not always on the same page, you can still support each other through the grieving process if you understand that you're both going through it.

How do you work through grief together?

Be kind to yourself and each other.

Recognize that you have both experienced a real trauma. Being diagnosed and treated for prostate cancer is traumatizing. So is watching each other go through the experience.

Work together as a team and lean on each other. Remember that sexual side effects of prostate cancer treatment are the challenge you’re battling, not one another. Don’t let the trauma find its way between you.

Keep talking.

Many couples don’t talk about their sexual relationship or being intimate but have a perfectly good sex life. This changes after prostate cancer treatment because the usual, spontaneous sexual activity is not available. Learning what works sexually is new again.

Now, more than ever, it’s important to talk with your partner about sex and how you’ll manage the changes after prostate cancer. Communicating openly about sexual changes and about the feelings that come along with it can ease the grieving process and bring you closer.

Couples sometimes avoid talking about their feelings because they’re overwhelmed or trying not to burden or embarrass one another. This can actually hurt their relationship and lead to a number of problems like:

  • Avoiding sex altogether.

  • Feeling lonely and distant from each other.

  • Losing your emotional connection with one another.

  • Low confidence and motivation.

  • Anxiety.

  • Depression and feeling low.

Get support

Maybe you’re already comfortable talking about your emotions around sex after prostate cancer. Maybe you’re not sure where to start. Either way, getting support while you’re grieving can help you feel less alone.

Don’t be afraid to reach out to a trusted doctor, counselor, nurse, social worker or a psychologist who knows how to help with sexual problems after prostate cancer. If the person you contact can’t help, ask if they can refer you to someone who can.

You might also feel comfortable talking about this in a prostate cancer support group, or with a close friend. Just knowing that other people have been there can be reassuring.

Give it time

Patience is key when it comes to working through grief and sexual recovery after prostate cancer. You may feel more in control when you understand what to expect. Accept that it’s a process and it will take time.

With time, your feelings of grief may get less intense because:

  • You’ll figure out how your body works and reacts after your prostate cancer treatment.

  • You’ll learn what to do to get the most pleasure during sex.

  • You and your partner will have a better sense of how you work together and a greater ability to talk about it.

  • You'll learn how to use sexual aids if you need them.

  • You’ll feel more competent as a lover and partner.

Is it normal to feel grief during sex after prostate cancer?

Yes, this is absolutely normal.

Some people are surprised to be hit by a wave of grief in their more intimate moments. Crying during sex happens, and there’s no need to feel embarrassed.

Some reasons you or your partner (or both of you) may feel grief during sex include:

  • You may be distracted by thoughts about what sex was like before your prostate cancer diagnosis.

  • You may feel sad about the changes now.

  • You might worry about whether your partner is enjoying sex with you as much as they did before.

  • You may feel disappointed or frustrated if one of you doesn’t experience as much pleasure as before.

These thoughts and feelings are a normal part of grief and will get better with time and as you adjust. The important thing is to follow the suggestions shared above. Talk to each other, be patient with each other, and if it feels like more than the two of you can handle, get support.

When you’re making love and feel grief, stop, talk, reassure each other. Then resume sexual activity or make love later. Over time, it will no longer be stops and starts. You’ll know what to do.

If you find that you’re having trouble working through your feelings of grief as an individual or as a couple, ask your healthcare provider to refer you to a sexual health specialist who can help.