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Can prostate cancer surgery affect you sexually?
Prostate cancer surgery alone should not change your ability to be aroused or experience physical desire. Since surgery does not impact your levels of testosterone (the hormone responsible for your sex drive), you’re all good on that front.
The nerves in your penis that help you feel pleasure are not harmed by prostate cancer surgery. So how it feels to touch yourself or be touched on and near your penis will not change, and can still spark feelings of desire.
However, some men experience difficulty getting a firm enough erection after prostate surgery—and that can cause stress, anxiety, anger and even shame. These feelings can lower your sex drive and desire to have sex with a partner and make it difficult to get in the mood.
Trouble getting an erection can lead to loss of sex drive after prostate cancer
Left unaddressed, trouble getting hard in the sack can cause your sex drive to go south. How does this play out for couples in real life? Here’s what some people describe:
Men with erection problems try to have penetrative sex, without success
The failure to get an erection causes frustration, embarrassment, even anger.
Partners feel helpless and struggle to know how they can be supportive
Patients and partners think erection problems are linked to lower sexual desire
Couples become upset and confused; try to understand “failed” attempt at penetrative sex.
Less-than-enjoyable experience lowers couple’s desire to try to have sex again
So, what can you do if your sex drive is fading after prostate cancer surgery? Lots, actually.
Talk to your partner about your sex drive and what’s affecting it.
Communicate openly with each other about prostate cancer and sex.
It may feel awkward to talk openly with your partner, especially after a less-than-satisfying sexual experience. But doing so is essential. It will keep you connected and focused on solutions, rather than on what went "wrong".
Keep your perspective—erection troubles don't mean the end of your sex drive
Remind yourselves—and each other—that being unable to have a firm erection is a direct side effect of the surgery. It is not the result of a sudden lack of attraction. Nor does it signal a permanent loss of sex drive.
Discuss the tools available to give your sex life a boost
Talk about how comfortable you feel about different erection aids. Are you willing to try a vacuum erection device (aka penis pump)? What about erection pills or injections?
If you’re both involved in learning about the options and how to use them, you’ll be more likely to find something that works for you.
Explore alternatives—there’s more than one way to have great sex after prostate cancer
There are lots of pleasurable activities besides just penetrative sex. And, no, men don’t need to have an erection to reach orgasm.
Kissing, cuddling, massage, using your mouth or hands (or both)...all of it can lead to an enjoyable and spontaneous intimate and sexual experience, with or without an erection.
Talk to your doctor
Find the right option
Your doctor can help you choose the erection aid (or aids) that you’re most comfortable with and aligns with your goals and values. They’ll explain how to use it, what to look out for, and what you can expect.
Get extra support
Your doctor can also refer you to a counselor or certified sex therapist. Coping with even temporary changes to your sex drive can be really tough, and there are people who can help you work through the emotional part of it.
Many men will have a return of erections firm enough for penetrative sex. Sometimes it can take up to 3 years. Some men will benefit from the help of erection pills, devices or some type of aid longer-term.
Remember that each time you have a successful sexual encounter (with or without an erection), you’re keeping your connection strong as a couple and stoking your desire for sex.
Above all, try to stay patient with your body, and with each other.