What Is Prostate Cancer
Prostate cancer develops in the prostatea small gland that makes seminal fluid. It is the second most common type of cancer in men. Prostate cancer usually grows over time and in the beginning stays within the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
Prostate cancer that is caught early has a better chance of successful treatment.
Tips For Great Sex After Prostate Cancer
Its very likely that whichever prostate cancer treatment you choose prostatectomy surgery, hormone therapy, brachytherapy, external beam radiation, or HIFU will impact your sex life. Exactly how depends on which method you choose and your dedication to getting back in bed.
Once patients are assured that they will have sex after prostate removal surgery, they can shift their focus to enjoying sex as soon as possible, encourages Dr. David Samadi, creator of the SMART robotic prostate removal surgery.
While his innovative surgical technique and experience give men a tremendous leg up in sexual recovery after prostate cancer, men have to play an active role as well.
After Prostate Removal The Sperm Has To Go Somewhere But Where
Men who are facing prostate removal due to cancer will surely wonder where their sperm will go after removal of the prostate gland. Its fair to wonder about this.
First of all, sperm is produced in the testicles.
The testicles continue to make sperm, but because the vas deferens is clipped and cut, and because there is no prostate or seminal vesicles, there is no ejaculate, explains Michael Herman, MD, director of urologic oncology at South Nassau Communities Hospital in Oceanside, NY.
People can continue to have orgasms, though, because the nerves that have to do with climax are unaffected, and are actually not related to whether or not someone ejaculates.
The sperm gets broken down and reabsorbed by the body. This is the same process as if someone were abstinent or had a vasectomy.
In short, prostate removal will not affect sperm production or quantity. It only affects what happens to the sperm once its produced.
Unfortunately, removal of the prostate may be more of an issue to a woman than to the man, if she believes she cant enjoy intimate relations without ejaculations.
Men who have partners like this should focus on all that can be done to treat their prostate cancer and prevent a recurrence.
Women who feel deprived without the ejaculate need a harsh lesson in priorities.
Prostate cancer affects one out of six men as a lifetime risk, and the number it kills every year in the U.S. averages in the high 20,000s.
How May Erectile Dysfunction Affect My Sex Life
Most men find that their sex life is different after prostate cancer treatment. Some men question their manliness when they cannot have an erection or find that they are not interested in sex. This can happen even if you are not currently in an intimate relationship. You may find this upsetting. Even if one of the medications or erection aids is helpful, having sex using these things may take some getting used to. It may not feel entirely natural. You can talk with your doctor or healthcare team about these feelings. Counseling may also help.
If you have an intimate partner, it is important for you to talk to your partner about how you are feeling. There is an old saying that a problem shared is a problem halved. Not everyone wants a sexual relationship. Dont try to guess or assume what your partner wants. Have an open and honest discussion with your partner.
This may seem unnecessary in long-term relationships as people tend to assume they know all there is to know about their partner but this is not always the case. With time, you and your partner may be able to find satisfying ways to have a sex life even though you have erectile dysfunction. Your partner will also have concerns about your sex life as well as concerns about your health. Talking about your feelings is very important during this time.
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.
Read Also: What Happens To The Prostate Later In Life
Your Emotions And Sex
Your prostate cancer and its treatment wonât just affect your body. Theyâll also have a serious impact on your emotions. Stress and anxiety can trigger your body to make adrenaline, which gets in the way of having sex. The more you worry, the worse the struggle. If youâre in a relationship, your partner will be going through many of the same feelings.
One of the most important things you can do is to talk to your partner. Have an honest conversation about your fears and expectations when it comes to sex. Dont assume they know how you feel. Being open with each other will help you both feel supported and help you work together to make any adjustments that you may need to stay intimate.
Talking with a mental health professional either one-on-one or with your partner can be a powerful way to help manage your emotions. A therapist can also prescribe medications that may ease stress and anxiety. A professional sex therapist can help you and your partner find ways to improve your sex life. It may also be helpful to join a support group where you can talk with others who share your experience.
Prostate Cancer Foundation: Erectile Dysfunction.
UCLA Urology: Prostate Cancer: Dealing with Erectile Dysfunction.
Albaugh, J. Reclaiming Sex & Intimacy After Prostate Cancer: A Guide for Men and Their Partners. Anthony J. Jannetti, Inc., 2012.
Harvard Prostate Knowledge: Achieving orgasm after radical prostatectomy.
How Does Prostate Surgery Affect You Sexually
If you are diagnosed with prostate cancer and opt for a prostatectomy, particularly a radical prostatectomy, the surgeons will have removed your prostate.
While the prostate isnt directly responsible for your libido or sexual sensation, in some men who have had a prostatectomy, there can be damage to nerves or blood vessels.
The prostate is next to a dense group of nerves and the seminal vesicles .
There is a heightened chance of an infection such as spermatocystitis which can cause you pain or in some cases impotence.
For men who have had an open prostatectomy, they will find that they can no longer ejaculate. This is known as a dry orgasm and can still be pleasurable.
Even with less invasive surgeries, the most common complaint or side effect tends to be sexual in nature.
However, according to systematic reviews and meta-analysis of the scientific data, these cases of sexual dysfunction are often associated with psychological factors that might be present before surgery or as a result of stress related to the surgical procedure.
Radiation therapy can impact the pelvic floor muscles and nerves that control erections and provide pleasure.
According to a 2016 study, around half of Prostate Cancer patients who have any form of radiation therapy go on to develop erectile dysfunction.
For a large section of men who opt for radiation-based therapies, the first stage is usually hormone therapy.
Read Also: Male G Spot Side Effects
Can A Man Have A Normal Sex Life After Prostate Surgery
The question is loaded what is a normal sex life anyway? Most men will experience a slowing down or drop off in their sexual activity as they get older.
That said, it is still a source of pleasure and intimacy amongst older couples, and for those for whom it is an important part of their relationship, they are keen to understand what sex after surgery will look and feel like.
The majority of men with a diagnose of localized prostate cancer will undergo a conservative approach known as active surveillance, but some of them will require surgery at some point.
The surgeons will excise the growth, or in some cases remove the entire prostate. There are also less invasive surgeries, such as the TURPs and other non-surgical therapies such as radiation therapy.
With careful intervention, most men will be able to resume a healthy sex life after the initial recovery period.
If you have had a radical prostatectomy without a nerve-sparing technique, theres a high chance you will experience a significant reduction in your sexual sensation and libido
Even then, the likelihood is that pleasure will be diminished, and men will only experience dry orgasms, as they will no longer ejaculate merely experiencing the mental side of orgasm. This is not common, and when it happens, it is temporary.
Management Of Erectile Dysfunction
Oral medications relax the muscles in the penis, allowing blood to rapidly flow in. On average, the drugs take about an hour to begin working, and the erection-helping effects can last from 8 to 36 hours.
About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs. However, they are not for everyone, including men who take medications for angina or other heart problems and men who take alpha-blockers.
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Prostate Surgery And Erectile Dysfunction
The short answer is yes prostate surgery is very likely to cause erectile dysfunction.
A prostatectomy, even though modern surgeries are nerve-sparing is likely to cause months of issues to a mans sex life.
Less invasive procedures that avoid the bundle of nerves and seminal vesicles next to the prostate will still likely cause ED, even if its a shorter-term issue.
Other surgeries are less likely to cause lasting damage, but the fact is that sexual dysfunction is a complicated issue. Men have to grapple with the mental side of it as well.
A cancer diagnosis can weigh heavily on a mans mind, which can impact both his sex drive as well as his ability to maintain an erection.
Theres also the fact that as we age, men experience a natural reduction in sex drive and are likely to be less able to get and maintain an erection.
The likelihood is that any surgery would just exacerbate the underlying issue.
Around 1 out of every 4 men over the age of sixty will experience some form of erectile dysfunction. Thats also the most likely group to undergo surgery, which is why the two are often linked, but not necessarily the sole cause.
If you have some pre-existing medical condition that impacts your floor muscles, sexual function or urine/ urinary function than you might find that the side effects of the surgery are more severe.
You should talk with your Urologist about any pre-existing medical conditions and how they might affect the treatment.
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.
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Questions To Ask Your Doctor Or Nurse
- How could my prostate cancer treatment affect my sex life?
- How soon after treatment can I masturbate or have sex?
- Which treatments for erection problems would be best for me? Can I get them on the NHS?
- Is there anything I can do to prepare myself before I start my prostate cancer treatment?
- What happens if the treatment doesnt work? Are there others I could try?
- What other support is available to me?
- Can my partner also get support?
Why Does It Take So Long To Recover Erections After The Very Best Surgery
A number of explanations have been proposed for this phenomenon of delayed recovery, including mechanically induced nerve stretching that may occur during prostate retraction, thermal damage to nerve tissue caused by electrocoagulative cautery during surgical dissection, injury to nerve tissue amid attempts to control surgical bleeding, and local inflammatory effects associated with surgical trauma.
Recommended Reading: Does Enlarged Prostate Affect Ejaculation
Sex When Youre Single
Being sexually active and feeling attractive can be just as important if you are a single man. All the treatments described here are available to you if youre single whether you want to be able to masturbate, have sex, or want to start a new relationship.
If you are starting a new relationship, sexual problems and other side effects like urinary or bowel problems could be a worry. Some men worry that having problems with erections will affect their chances of having a new relationship. Fear of rejection is natural, and everyone has their own worries, whether or not theyve had cancer. If youre single, you may want time to come to terms with any changes prostate cancer has caused before you start having sex or dating.
Try talking over your worries with someone you feel comfortable with, such as a friend. Counselling or sex therapy may also help if you would prefer to talk to someone you dont know.
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Other Cancer Treatment Effects On Ejaculation
Some cancer treatments reduce the amount of semen thats produced. After radiation to the prostate, some men ejaculate less semen. Toward the end of radiation treatments, men often feel a sharp pain as they ejaculate. The pain is caused by irritation in the urethra . It should go away over time after treatment ends.
In most cases, men who have hormone therapy for prostate cancer also make less semen than before.
Chemotherapy and other drugs used to treat cancer very rarely affects ejaculation. But there are some drugs that may cause retrograde ejaculation by damaging the nerves that control emission.
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Sex When You’re Single
Being sexually active and feeling attractive can be just as important if you are a single man. All the treatments described here are available to you if you’re single – whether you want to be able to masturbate, have sex, or want to start a new relationship.
If you are starting a new relationship, sexual problems and other side effects like urinary or bowel problems could be a worry. Some men worry that having problems with erections will affect their chances of having a new relationship. Fear of rejection is natural, and everyone has their own worries, whether or not they’ve had cancer. If you’re single, you may want time to come to terms with any changes prostate cancer has caused before you start having sex or dating.
Try talking over your worries with someone you feel comfortable with, such as a friend. Counselling or sex therapy may also help if you would prefer to talk to someone you don’t know.
What You Never Lose: The Good News About Sexual Function
While regaining erectile functiom is not possible for all men, it is important to remember that erection is just one part of a satisfying sex life. The other parts remain intact despite prostate cancer surgery. Sexual feelings, sexual fulfillment, climax and the sensation of orgasm are still available without erection.
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Surgery Effect On Ejaculation
Surgery can affect ejaculation in different ways. For example, if surgery removes the prostate and seminal vesicles, a man can no longer make semen. Surgery might also damage the nerves that come from the spine and control emission . Note that these are not the same nerve bundles that pass next to the prostate and control erections . The surgeries that cause ejaculation problems are discussed in more detail here.
Erection Concerns After Prostate Biopsy
When his doctor mentioned the prostate biopsy, Stans heart sank. What did this mean? Did he have cancer? And if so, how would his life change?
Quietly, he listened his doctor explain. Stan had high levels of prostate-specific antigen and the doctor had found an unusual lump on his prostate during his digital rectal examination. These two factors made a biopsy necessary. Stan might have cancer and catching it early was important.
Some men do develop ED for a time after a prostate biopsy. But not all do. Learn more hereâ¦
Stans expression was stoic, but inside, his body was in turmoil. He was anxious about his prognosis, of course. Also, the idea of having a needle in his private parts made him nervous. He knew the biopsy was necessary. He knew it could save his life. But he had other questions, too.
For example, what would happen to his erections? Would the biopsy procedure affect his sex life?
Lots of men share Stans concerns. The anxiety of a biopsy is enough to cope with, but wondering about your erections afterward is also difficult.
Some men do develop erectile dysfunction for a time after a prostate biopsy. But not all do. Lets look at this topic more closely.
What happens during a prostate biopsy?
Typically, a prostate biopsy is done in one of three ways:
Will I have problems with erections afterward?
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