How being diagnosed with prostate cancer can affect your sex life and what can help with intimacy...

Did you know that, every day, 129 men in the UK are told that they have prostate cancer? That’s more than 47,000 each year and one in eight men are diagnosed with prostate cancer at some point during their lives. It’s the most common cancer for men, so most of us will know someone who has had prostate cancer, or is currently having treatment for it.

Every single cancer diagnosis, whatever the type of cancer, brings with it a host of questions, about the likely outcome, what treatment to expect, and possible side effects, for example. One of the main worries for men diagnosed with prostate cancer is, understandably, how will treatment affect their sex lives - and their fertility. 

So, what are the facts about prostate cancer treatment and sex, and what can you do if you are having problems, such as lack of libido or difficulty getting an erection? 

We hope this round up of frequently asked questions, together with answers and recommended sources of reliable information and support, will help reassure you, whatever your age or sexuality and whatever treatment you are facing.

Prostate cancer treatment - why it can affect your sex life

The prostate is a small walnut-shaped gland in men, which wraps around the urethra; it produces semen that nourishes and transports sperm. Treatment for prostate cancer can include surgery, chemotherapy, radiotherapy and hormone therapy, all of which can affect your sex life and fertility, in one way or another.

What about my libido – will I still want to have sex?

Many people find that the shock of a cancer diagnosis and the emotions that come with it leave them feeling worried and anxious and treatment can be exhausting - and sex ends to tae a back seat.

If you have been given hormone therapy, this will lower your testosterone levels, which means that you may find you have a much lower sex drive than usual. You may also find yourself putting on weight, which could make you feel anxious about your appearance and affect your confidence.

Do speak to your GP if you are struggling with either or both of these side affects; your GP may be able to prescribe something to raise your hormone levels and can advise you on a healthy eating plan that will help you to lose weight.

(And see below for a list of foods that are said to be good for a healthy sex drive.)

Will prostate cancer treatment affect my penis?

Certain types of treatment, including surgery and radiotherapy, may cause nerve and tissue damage to the penis. Most men don’t notice any difference in size but some do - about three per cent say that their penis is slightly smaller (half an inch or less in most cases). 

If you are worried about any change in the size of your penis, your GP may be able prescribe a drug such as Viagra, which is usually used to treat erectile dysfunction (see below) and which boosts blood flow to the penis. (Don’t be tempted to buy this type of drug online. Viagra and similar drugs are not suitable for anyone with heart problems or who takes alpha-blockers, for example; that’s why a consultation with your GP is essential.)

Will I be able to get an erection after prostate cancer treatment?

Getting and sustaining an erection depends on extra blood being able to flow to your penis but, if the nerves that control this have been damaged in any way during surgery or radiation, you may find it difficult to get an erection. This is called erectile dysfunction or ED for short. As you can imagine, it’s a very delicate area for surgery; your surgeon will do their best to avoid causing any damage, or as little as possible, but you may find that you are experiencing ED, even if the nerves have only had very little damage. Although this may be temporary, you could experience ED for weeks or months or even years. If the damage is severe, you may suffer permanent ED.

Radiotherapy can have a similar effect on nerves and blood vessels and one man in every two who has radiotherapy, as part of their treatment plan will suffer from ED afterwards.  For some, things gradually improve but that won’t be the case for everyone.

There are drugs like Viagra and Cialis that help to relax the muscles in the penis, enabling you to get an erection, so ask your GP if one of these drugs would be suitable for you. But, as we mentioned above, do not be tempted to buy them online, as they can present a risk to people with certain heart conditions or who are taking particular types of medication. The good news is that, if you do find one of these drugs helpful, you may only need a few treatments before you are able to achieve an erection in the usual way again.

Other treatments for ED include a urethral suppository called MUSE, a vacuum pump and ring, penile injections, and penile implants. All work by encouraging more blood to flow into the penis.

If you want to know more about any of treatments above, do read this excellent factsheet from Prostate Cancer UK. It covers each type of treatment in detail and you can download it free or order a print copy. It also includes a question sheet that you can print, fill in, and take with you to any appointments with your specialist nurse or GP. 

Will I be able to have an orgasm after prostate cancer treatment?

Your prostate gland helps to produce the semen that supports your sperm so, if it is removed during surgery, you won’t produce any semen. The good news is that you will still be able to have an orgasm – known as a dry orgasm – although it may feel a little different to the orgasms you had before surgery.

You’ll also be able to have an orgasm after radiotherapy, although you won’t produce as much semen as you did before.

What happens if I want children – will I be fertile after prostate cancer treatment?

To be fertile, you need to be able to produce semen so, if you think you will want to be able to father a child after treatment, you can bank your sperm with a sperm bank before you start treatment. Speak to your GP or specialist nurse about this as soon as possible after you are diagnosed. The bank will freeze and store your sperm until you decide to use it.

Read more about sperm banking here.

What else might affect my sex life?

Although we’re focusing on prostate cancer treatment, other factors can affect your sex life and fertility too, including:

  • ageing
  • alcohol
  • cardiovascular disease
  • diabetes
  • lack of exercise and a sedentary lifestyle
  • lack of sleep
  • obesity
  • relationship problems
  • smoking

Ageing affects all of us, so there’s not much you can do about that! However, you can do a lifestyle check to see if there’s anything you can do to boost your overall health and fitness levels, such as regular exercise, drinking in moderation, not smoking, and keeping to a sensible, healthy diet.

Simple changes like these can also reduce your risk of developing other chronic illnesses, especially as you move into older age. If you want to make changes but are finding it difficult, do see your GP, as they can help with advice and information. You’ll feel better, and look better, and you’ll be improving your ability to have an erection.

All of these are important for self-esteem and confidence too, especially when you have been through the physical and emotional ups and downs of prostate cancer treatment.

If you are making some changes to you diet, do try to include one or more of the following: almonds, avocados, coffee, dark chocolate, eggs, peaches, red berry fruits like raspberries and strawberries, saffron, steak, walnuts, and water melon, all of which contain nutritional elements that promote a healthy sex drive. Nature’s aphrodisiacs!

These Live Better With expert guides could help too:

The Live Better With Guide to Cancer and Eating Well

The Live Better With Guide to Cancer and Exercise

The Live Better With Guide to Cancer and Having Difficulty Sleeping

How do I talk to my partner about what’s happening?

Whether you’re in a long-term relationship or you’ve only recently got together, it’s really important to talk to your partner – and listen to them - at every stage from first concerns, through diagnosis and treatment.  They will have concerns too and it’s important that you share your worries and questions with each other.

Encourage your partner to come with you to GP and hospital appointments, so that they have a better understanding of what your treatment will involve and so that they can ask questions too.

If you are finding it difficult to talk to each other about what is happening, it could be worth seeing a relationship therapist or sex therapist, who can help you both work through these problems. Your GP may be able to recommend someone, or check with Relate, the relationship charity, which has branches around the country. You may be embarrassed about discussing your sex life with a stranger but therapists like these are trained to listen without judging and are used to hearing about all sorts of sexual difficulties. The more open you and your partner can be, the more effective the help and advice the therapist can give you.

Getting in the mood – less anxiety, more confidence

Many things can have a negative impact on our sex lives – prostate cancer treatment is just one of them. So, we always encourage people to think in terms of intimacy rather than sex, and penetrative sex in particular – and to focus on what you can still do together and enjoy, rather than what you can’t do.

Make sure that you set aside time to be private and intimate – touch is a very much under-rated sense and gentle mutual massage is a great way to enjoy being together and giving each other pleasure.

To begin with, try a back and shoulder massage, with an oil like this one, to soothe tension, and to help you both relax and feel less anxious. Set aside some time like this as often as you can; it will help you through the difficult days after treatment, boost your confidence and self-esteem, and ease the transition to more active and penetrative sex when the time is right.

And don’t forget your favourite music playlist to help create that special mood…

Ask the experts

  • Prostate Cancer UK offers advice, information and support on all aspects of prostate cancer and its treatment. It also has a team of specialist nurses who can answer your questions by phone or email.
  • The Sexual Advice Association helps and supports people (and their partners) with all forms of sexual problems. Factsheets for men cover topics such as erectile dysfunction and testosterone deficiency.

Do read:

  • The Live Better With Guide to Cancer and Sex
  • The Live Better With Guide to Radiotherapy
  • Cancer and Sex: 6 questions you’re too embarrassed to ask

    Browse the Live Better With Cancer range of products for help with having sex here.


    And visit the Live Better With Cancer Community Forum for information, advice, and tips and to share your own questions and suggestions on prostate cancer treatment and sex.