If You’re A Gay Or Bisexual Man
To be the active partner during anal sex you normally need a strong erection, so erection problems can be a particular issue. You could try using a constriction ring around your penis together with another treatment like PDE5 inhibitor tablets, to help keep your erection hard enough for anal sex.
If you are receiving anal sex, a lot of the pleasure comes from the penis rubbing against the prostate. Some men who receive anal sex find that their experience of sex changes if they have their prostate removed .
If you receive anal sex, then bowel problems or sensitivity in the anus may be an issue after radiotherapy. Its best to wait until your symptoms have settled before trying anal play or sex. If youve had permanent seed brachytherapy there is a risk in the first few months that your partner might be exposed to some radiation during sex. Talk to your doctor or nurse for further advice.
With all sexual changes you may be able to find ways to work through this.
Watch Martin’s story below for one gay man’s experience.
Watch other men’s personal stories about sex after prostate cancer.
Your Thoughts And Feelings
Changes to your body and your sex life can have a big impact on you. You may feel worried, unsatisfied, angry and some men say they feel like they’ve lost a part of themselves. There are ways to tackle these issues and find solutions that work for you.
If you are stressed or down about changes to your sex life, finding some support may improve how you feel. There are lots of different ways to get support.
You are not alone. A lot of men, with and without prostate cancer have sexual problems. Talking to other men who have had similar experiences can help.
- Our sexual support service is a chance for you, or your partner, to talk to one of our Specialist Nurses with an interest in helping with sexual problems.
- Our one-to-one support service is a chance to speak to someone who’s been there. They can share their experiences and listen to yours.
- Our online community is a place to deal with prostate cancer together. You can talk about whatever’s on your mind. Anyone can ask a question or share an experience.
- Our Specialist Nurses can answer questions and explain your treatment options. You can also email or chat online with our nurses.
- Get in touch with your local prostate cancer support group.
Counsellors are trained to listen and can help you find your own ways to deal with things. Many hospitals have counsellors or psychologists who specialise in helping people with cancer – ask your doctor or nurse if this is available.
Pathophysiology Of Erectile Dysfunction And Prostate Biopsy
The risk of developing temporary erectile dysfunction is largely dependent on the number and volume of tissue samples obtained during the procedure. Needless to say that the risk is greater if more biopsies are taken.
There are three primary types of prostate biopsies a typical standard one utilizes only 1 needle to take no more than 10 samples. The risk of complications like erectile dysfunction is higher if more than 10 tissues samples are obtained or if any type of nerve block is used for pain reduction.
According to a new study, investigators evaluated the risk of erectile dysfunction in men who undergo prostate biopsy. 25% of men in the study sample who underwent standard saturation biopsy admitted that they had erectile dysfunction before the biopsy but the percentage went up to 50% just a week after the procedure. The group in which men had nerve block, erectile dysfunction rate raised to 39% from 11% after the biopsy. However, by12th week post-procedure, the transient erectile dysfunction resolved in the study sample suggesting no nerve damage or dysfunction takes places during the procedure.
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Dealing With Erectile Dysfunction: For You And Your Partner
The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.
What Will I Learn By Reading This
When you have treatment for your prostate cancer, you may have erectile dysfunction also known as impotence. Erectile dysfunction is a very common side effect . Side effects from prostate cancer treatment are different from one man to the next. They may also be different from one treatment to the next. Some men have no erectile dysfunction. The good news is that there are ways to deal with erectile dysfunction. In this booklet you will learn:
- What erectile dysfunction is
- Why prostate cancer treatment can cause erectile dysfunction
- What can be done about erectile dysfunction
- How erectile dysfunction may affect your sex life
- What your partner can expect
It is important for you to learn how to deal with erectile dysfunction so that you can continue to have a satisfying intimate relationship.
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Treatment For Erectile Dysfunction When You Have Prostate Issues
If you have prostate conditions such as BPH or prostate cancer and erectile dysfunction, there may be treatments that you can use to help regain some or all of your erectile function.â
Oral medications like Sildenafil or Tadalafil are often used as first-line treatment for erectile dysfunction. These medications work by helping to improve and enhance blood flow to the penile tissues when you are aroused. However, these medications may not be appropriate for you if you have cardiovascular problems or take certain medications like nitrates.
If oral medications do not work for you or you are not a good candidate for them, injection medications to bring blood flow to the penile area like Alprostadil or compounded âTrimixâ or âBimixâ injections may be able to help you. These medications are injected into the side of the penis before sexual activity. Injection medications are the most effective treatment for men who have ED due to prostate surgery.
An insertable urethral suppository containing Alprostadil called Muse may also help with ED in some men. If oral or injectable medications are not a good fit for you, vacuum or surgical options including a penile pump, a penile band, surgical implants, or vascular surgery may be able to help you maintain or achieve an erection.
If you have a prostate condition along with erectile dysfunction, there are many potential treatment options, and your doctor can help you find the best ones for you.
What Causes Benign Prostatic Hyperplasia
Its a little hard to say for sure what causes BPH.
What we do know for a fact is that men go through two main stages of prostate growth in their lives first at puberty, where the prostate doubles in size, and then growth begins around the age of 25 and continues during most of a mans life.
BPH is known to surface in this second stage, and mostly affects men above the age of forty. Autopsy data has found evidence of the condition in about 90 percent of men above the age of eighty.
The growth of the prostate in this second stage may be linked to androgens in the body. Men produce testosterone throughout their lives. They also produce estrogen the female hormone but only in small amounts.
When testosterone levels drop as they inevitably do with age a higher proportion of estrogen may remain.
This increase in the ratio of Estrogen or its receptors to testosterone may directly and indirectly affect the growth of prostate cells.
Another possible cause is DHT or dihydrotestosterone. This male hormone is a bit of a villain. It is a major cause of alopecia in men, but is however useful for the development and maintenance of the prostate.
Unfortunately, this role can be dangerous for the adult prostate, as DHT can cause excessive growth.
BPH may also result when there is an imbalance between the production and death of prostate cells. When the imbalance is in favor of cell proliferation, it can lead to BPH.
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Chemotherapy Targeted Therapy And Immunotherapy Effects On Erections
Other types of treatment for other types of cancer sometimes affect sexual desire and erections because certain drugs slow down testosterone output. Whether chemotherapy, targeted therapy, or immunotherapy drugs cause problems with erections depends on the type of cancer being treated and the type of drug or drugs being given. Some of the medicines used to prevent nausea during chemo can also upset a mans hormone balance. But hormone levels should return to normal after treatment ends.
Can A Man Develop Erectile Dysfunction After A Prostate Biopsy
Erectile dysfunction can occur after prostate biopsy, but the reasons for this are unclear. Some men do recover their function in a few months, however.
When a man has a prostate biopsy, small samples of prostate tissue are removed and checked for cancer cells. To collect the samples, a urologist uses a small needle.
Generally, there are three ways to approach the prostate for a biopsy:
- through the rectum ,
- through the urethra , and
- through the perineum . The transrectal approach is the most common one.
Several studies have found that men develop ED after prostate biopsy.
Men who are concerned about their erections after biopsy should talk to their urologist, who can let them know what to expect.
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Can Prostate Biopsy Cause Erectile Dysfunction
If are recommended by your doctor to undergo prostate biopsy procedure for the detection of cancer, you must have a lot of questions and reservations. One of the most common question that people usually have is, can prostate biopsy cause erectile dysfunction or alter the quality of sex life at all?
The answer is yes erectile dysfunction may occur after prostate biopsy in some susceptible individuals but it is usually transient and self-limiting.
Accorded to a study published in the Journal of Urology, men who undergo prostate biopsy are at risk of temporary erectile dysfunction due to anxiety or pain however, in most men, symptoms improve within a couple of weeks.
Does Enlarged Prostate Cause Ed
Of the many symptoms caused by BPH, one of the most common complaints men have when visiting a urologist is Erectile Dysfunction or ED. This is defined as the inability of a man to attain or maintain an erection sufficient for vaginal penetration and satisfactory sexual performance.
BPH does not directly cause ED, but many men with BPH seek medical attention to relieve ED.
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Bph Medications And Sexual Side Effects
Some drugs used to treat BPH can cause difficulty in maintaining an erection. Men who take alpha-blockers such as doxazosin and terazosin may experience decreased ejaculation. This is because alpha-blockers relax the bladder and prostate muscle cells.
Alpha reductase inhibitors can also cause ED. Additionally, reduced sex drive is a possible side effect of the alpha reductase inhibitors dutasteride and finasteride.
Approximately 3 percent of men taking dutasteride reported experiencing a decreased libido in the first six months. About 6.4 percent of those taking finasteride experienced this within the first year. Roughly 4.5 percent of men taking dutasteride-tamsulosin reported decreased libido in the first six months.
Men who take these medications may also experience lower sperm count, decreased sperm volume, and lower sperm movement. Adverse events typically decrease with continued use.
Medications that treat erectile dysfunction may help improve BPH. The ED drugs below have all been shown to reduce BPH symptoms:
However, they arent currently approved to treat BPH.
These medications inhibit a protein that breaks down a chemical called cyclic guanosine monophosphate , which increases blood flow to the penis. By inhibiting the protein that breaks down cGMP, blood flow to the penis can be increased.
One comparing tadalafil and a placebo showed that men who took 5 milligrams of tadalafil daily had significant improvement in both BPH and ED symptoms.
Erectile Dysfunction Following Radical Prostatectomy
Assuming the management of erectile dysfunction requires expert diagnosis and treatment.
Diagnosis includes sexual function history, general medical history, psychosocial history, medication history, physical examination, and appropriate laboratory testing.
Treatment follows diagnosis, and we provide a range of treatment options through the Clinic. Minimally invasive treatment options range from oral medications to medications administered directly to the penis to a mechanical vacuum device applied to the penis. Invasive treatments include implants or vascular surgery. We are particularly expert in the surgical treatment of patients with erectile dysfunction. The range of conditions we manage include penile prosthesis complications, penile vascular abnormalities, penile curvature, and abnormally prolonged erection consequences.
Psychological treatment is an important adjunct to managing erectile dysfunction. If our diagnosis suggests a psychological association with your erectile dysfunction, we may recommend that you pursue counseling with a qualified psychologist available through the Clinic.For instance, there may be relationship problems that negatively affect sexual functioning with your partner. Referrals can be made to the Johns Hopkins’ noted Sexual Behaviors Consultation Unit.
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Changes In Penis Size
Some men notice that their penis is shorter after surgery . Some men notice other changes such as a curve in their penis or a narrower area. We don’t know for certain why these changes happen, but it could be because of low oxygen levels in the penis, caused by not having erections. Other treatments such as hormone therapy with radiotherapy may also cause changes to the size of your penis.
Encouraging blood flow to the penis after surgery may help prevent this. In particular, using a vacuum pump, either on its own or with PDE5 inhibitor tablets could help maintain your penis size and improve erections.
Keeping your penis active after surgery
Although you may not be ready or recovered enough for sex, you can still start treatment for erection problems in the weeks immediately after surgery. It could be taking a low-dose PDE5 tablet once a day or using a vacuum pump, or sometimes both together. The treatment along with masturbation encourages blood flow to the penis. This can help keep your penis healthy. You may hear this called penile rehabilitation. Think of it in the same way as having physiotherapy if you had injured your arm or leg. Starting treatment soon after surgery may help improve your chance of getting and keeping an erection. But it may not work for every man.
Current Treatments For Ed
Various treatment options are available and you should discuss them with your doctor. A primary care doctor can give a preliminary diagnosis of ED based on a patient history and a physical examination, but may refer a patient to a specialist, such as a urologist. Current treatments for ED include:
- Oral medication
- Penile implants
- Counseling and sex therapy
These methods have varying degrees of effectiveness and tolerability, and are used to treat ED caused by physical or psychological conditions.
If you are seeking products to help with your ED, click below to visit to the Urology Health Store.
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Treatment Options For Symptomatic Bph
Symptoms related to BPH, particularly LUTS, can be managed by waiting for spontaneous improvement of symptoms, by medical therapies, or by various surgical procedures. The choice of treatment depends on the severity and annoyance of the patients symptoms, his expectations of treatment, and his acceptance of the risks of treatment.
One of the factors most frequently considered by patients contemplating a particular therapy for BPH is the effect of that therapy on sexuality. An inability to ejaculate or a significant decrease in ejaculate volume is significantly associated with deterioration in QOL. The selective 1-blockers cause few sexual side effects as a result, they are associated with a higher QOL. Physicians should inquire about sexual function as part of each patients pretreatment evaluation and, where appropriate, manage BPH and ED simultaneously.
How Effective Is Injection Therapy With Each Type Of Treatment
If oral erectile dysfunction drugs fail, injections into the penis can be an effective form of treatment for men who have undergone surgery or who have received radiation therapy for prostate cancer.
Overall, up to 80% of men will regain erections with the use of injection treatments. Side effects include occasional pain due to one of the drugs used for injection therapy, and the development of scar tissue.
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Is Another Treatment Option Better For Preservation Of Erectile Function
The growing interest in pelvic radiation, including brachytherapy, as an alternative to surgery can be attributed in part to the supposition that surgery carries a higher risk of erectile dysfunction. Clearly, surgery is associated with an immediate, precipitous loss of erectile function that does not occur when radiation therapy is performed, although with surgery recovery is possible in many with appropriately extended follow-up. Radiation therapy, by contrast, often results in a steady decline in erectile function to a hardly trivial degree over time.
Getting Treatment And Support
Speak to your GP or doctor or nurse at the hospital.
Your GP, hospital doctor or nurse can prescribe treatment for erection problems for free on the NHS, whether it’s for sex or masturbation. There may be a limit on how much treatment they can prescribe, but there is no age limit.
Talking about sex
It can be difficult talking about sex, but talking to your doctor, nurse or other health professional will mean you can get treatment and support. It can also help you feel more positive and more in control.
You can ask about sexual problems at any stage – before, during or after your prostate cancer treatment. Talking about it before your treatment will mean you know what to expect and can help you to prepare to start treatments for sexual problems soon afterwards.
Your team should ask you about your erections and sex life during your treatment for prostate cancer. But if they don’t then you may need to bring it up yourself.
Not everyone is used to talking about sex. You might need to bring it up more than once, or with a different person in your team. You can also ask to be referred to an expert in sexual problems or an ED clinic – they will be used to talking about sexual problems.
Our sexual support service
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