Treatments That Can Cause Sexual Problems
Some treatments are more likely than others to affect your sex life. The following treatments may cause sexual problems.
Surgery. Surgery involving the prostate, testicles, bladder, colon, and/or rectum can damage the nerves that control erections. Ask your surgeon about “nerve-sparing” surgery. Surgery can also cause “dry” ejaculation. This might bother you, or it might not.
Having a colostomy, urostomy, or testicle removal can affect your confidence and body image. Colostomies and urostomies are openings in the body for bowel movements and urine. You wear a bag with the waste in it, and this might make you avoid showing your body to a partner.
Radiation therapy. Radiation therapy to the pelvis, which is the area around the hips, can cause ED. This can happen from 6 months to 2 years after treatment. It might go away or get better in 2 to 3 years. Talk with your doctor about what to do while you have ED.
A prostate cancer treatment called “brachytherapy” involves putting small radioactive “seeds” near the tumor. Like other radiation therapy, this can cause ED. Talk with your doctor about what to do if this happens.
Radiation therapy in general can cause pain, tiredness, and loss of the ability to control your bowel movements or bladder. These problems might make you avoid sex or have less interest in it.
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.
The Basics: How An Erection Occurs
At its most basic level, an erection is a matter of hydraulics. Blood fills the penis, causing it to swell and become firm. But getting to that stage requires extraordinary orchestration of body mechanisms. Blood vessels, nerves, hormones, and, of course, the psyche must work together. Problems with any one of these elements can diminish the quality of an erection or prevent it from happening altogether.
Nerves talk to each other by releasing nitric oxide and other chemical messengers. These messengers boost the production of other important chemicals, including cyclic guanosine monophosphate, prostaglandins, and vasoactive intestinal polypeptide. These chemicals initiate the erection by relaxing the smooth muscle cells lining the tiny arteries that lead to the corpora cavernosa, a pair of flexible cylinders that run the length of the penis .
Figure 1: Anatomy of the penis
The penis is made up of three cylindrical bodies, the corpus spongiosum which contains the urethra and includes the glans of the penisand two corpora cavernosa , that extend from within the body out to the end of the penis to support erection. Blood enters the corpora cavernosa through the central arteries.
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Sexual Intercourse And Other Risk Factors Of Prostate Cancer
Sexual Intercourse and Prostate Cancer risk factors are not relevant.
So the answer to the question If having sex with a person with prostate cancer risky is in negative.
However, the study at several medical schools, shows that men with high sexual activity and frequent ejaculation are at lower risk of prostate cancer.
Study shows that men who have in average 4 to 7 ejaculation per week up to the age of 70 are 36% less at risk of prostate cancer comparing to the one who have 2 to 3 times sex per week.
Such a risk of sexual transmitted disease, whether it is through intimate contact like kissing, intercourse or oral sex are not relevant.
Hormone Therapy For Prostate Cancer
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Hormone therapy is also called androgen suppression therapy. The goal is to reduce levels of male hormones, called androgens, in the body, or to stop them from fueling prostate cancer cells.
Androgens stimulate prostate cancer cells to grow. The main androgens in the body are testosterone and dihydrotestosterone . Most androgen is made by the testicles, but the adrenal glands as well as the prostate cancer itself, can also make a fair amount. Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. But hormone therapy alone does not cure prostate cancer.
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Sex And The Prostate: Overcoming Erectile Dysfunction When You Have Prostate Disease
If you are concerned about erectile function, its important to understand what erectile dysfunction really is. Failing to have an erection one night after youve had several drinks or even for a week or more during a time of intense emotional stress is not erectile dysfunction. Nor is the inability to have another erection soon after an orgasm. Nearly every man occasionally has trouble getting an erection, and most partners understand that.
Erectile dysfunction is the inability to attain and maintain an erection sufficient for sexual intercourse at least 25% of the time. The penis doesnt get hard enough, or it gets hard but softens too soon. The problem often develops gradually. One night it may take longer or require more stimulation to get an erection. On another occasion, the erection may not be as firm as usual, or it may end before orgasm. When such difficulties occur regularly, its time to talk to your doctor.
Erectile dysfunction can have many causes, including some forms of prostate disease and medications and surgery for prostate cancer. Fortunately, in many cases, this problem can often be effectively addressed. Some men find relief by taking medications to treat erectile dysfunction. If these arent effective for you, a number of other options, including injections and vacuum devices, are available. The possibility of finding the right solution is now greater than ever.
Can Prostate Surgery Affect Penis Size Or Sensitivity
Prostate surgery is very unlikely to affect penis size. The only likely case this would occur if an individual underwent surgery for ED after prostate surgery. Implants will often cause a slight shortening of the penis.
Sensitivity, however, is an issue. In order to allow men to urinate, they have to operate on the prostate.
Its right next to the bundle of nerves that relay the sensation to the brain, causing a lot of the physical pleasure that men experience during sex.
It used to be the case that a prostatectomy would almost always damage those nerves, causing a permanent decrease or even loss of sensation. It would often be 8 months to a year before men reported any sense of sexual desire after the surgery.
However, nerve-sparing surgeries, particularly robotic prostatectomies, can avoid that nerve group far more effectively.
Its never a guarantee, but a majority of men who have undergone a nerve-sparing procedure can expect to regain the majority of the sexual desire and sensation they had before the operation.
For less-involved surgeries, men can expect to regain their sexual function a lot sooner. TURPs, ReZum, Aquablation or various other novel surgeries are all less likely to damage nerves and have faster recovery periods.
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Can You Still Have Sex After Prostate Cancer
Still want to enjoy sex after prostate cancer surgery or other such treatments that are previously known to render most men impotent?
I have very good news for you.
The power of technological improvement in the medical field has now brought solutions for prostate cancer victims who are very concerned about sex after prostate cancer.
There are now powerful therapies that help reverse erectile dysfunction that occur during surgical and other such prostate cancer treatments.
With such solutions sex after prostate cancer is now not only possible for younger men with prostate cancer but also much older men with the problem of impotence after prostate cancer treatment.
These solutions that can help your chances of enjoying sex after prostate cancer include:
Vacuum constriction devices used after the prostrate cancer treatment to restore penile sensation and the mans ability to have an orgasm
Intraurethral prostaglandin pellets which also help to improve your sexual prowess even after the prostate cancer treatments
Use of an oral medication called Sildenafil for reversing erectile dysfunction .
These and other similar solutions have been used on many men recently and there were significant improvement in their sex after prostate cancer.
So, talk to your doctor about these to see the best type of such powerful therapies to put you on to ensure you can still have a healthy sexual relationship despite your prostate cancer.
How May Erectile Dysfunction Affect My Sexual Relationships
Prostate cancer and its treatment can affect your desire for sex. Every man is different but the feelings caused by having cancer and the physical stress of treatment can affect the way you feel about your body and your relationships. Some men talk about feelings of a loss of their role within the partnership or family. This can sometimes affect a mans self esteem and confidence. For others, the physical effects of treatment may lead to tiredness and a lack of energy. Physical changes after some treatments can also affect the way you feel about your body and appearance . All of these things may result in a lack of interest in sex.
If you are feeling tired or under stress, tell your partner how your feel. Loss of interest in sex does not mean you lose interest in a loving and supportive relationship. There are ways to remain physically intimate without having sex. If you are used to a close physical relationship, it is important to remember that hugs, cuddles and kisses maintain intimacy, provide support, and do not have to lead to sex.
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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.
How Will Treatment Affect My Libido
Prostate cancer may dampen your sex drive. Knowing that you have cancer and going through treatment can both cause you to feel too anxious to have sex.
Hormone therapy used to treat prostate cancer can also affect your libido. This treatment slows prostate cancer growth by lowering testosterone levels in your body. You need testosterone to have a healthy sex drive. Hormone therapy can also affect your self-esteem and sex drive by making you gain weight or causing your breast tissue to enlarge. If your hormone levels are low, your doctor may be able to prescribe testosterone replacement therapy to bring them back up to normal. This depends on your overall cancer treatment plan.
2013 study , about 3 percent of participants reported that they had a reduced penis size after radical prostatectomy or radiation plus hormone therapy. The men said their smaller penis affected their relationships and their satisfaction with life.
For men who do experience this, the change in size is generally half an inch or less. This decrease in size may be due to tissues shrinking in the penis. These tissues may shrink because of nerve and blood vessel damage.
If youre concerned about this side effect, ask your doctor about taking a drug for an erectile dysfunction , such as Cialis or Viagra. The increased blood flow from these drugs may help prevent your penis from getting smaller. Theyll also help with acquiring and maintaining an erection.
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Cancer Treatments And Erectile Dysfunction
Following surgery, many men experience erectile dysfunction , but for many, the disruption is temporary. Nerves damaged during surgery may result in erectile dysfunction. A nerve-sparing prostatectomy may reduce the chances of nerve damage. Another factor is the surgeons skill level for performing the nerve-sparing technique, which if done correctly, may improve patients likelihood of retaining erectile function, says Dr. Shelfo.
Prostate cancer may also be treated with various types of radiation therapybrachytherapy, external beam radiation or stereotactic body radiation therapy. Each type of therapy causes somewhat different side effects. About half of all prostate cancer patients who undergo any of these types of radiation therapy are likely to develop erectile dysfunction, according to a 2016 article published in Advances in Radiation Oncology.
When you compare surgery with radiation, both may affect erections, says Dr. Shelfo. Surgery is usually more immediate, and sexual dysfunction has the potential with time to improve. With radiation, erections are usually less affected in the beginning, but over timemonths or, sometimes, yearssexual dysfunction may develop. Both treatments may affect sexual function, resulting in no ejaculate or the ability to attain erections.
Orgasm After Prostatectomy Is It Possible
You can expect to enjoy sex and orgasm after prostate surgery.
Many men are surprised to find that they even experience pleasurable orgasm without an erection. Keep in mind that your sexual pleasure does not depend on penetration.
Dr. David Samadi says restoring an enjoyable sex life after prostate cancer surgery is in part dependent on prostate cancer treatment and choice.When men and their partners know what to expect, they can accelerate recovery, experiment, and work together. Sex-related activities should be resumed as soon as you are ready but keep in mind some changes are temporary, and some might be permanent, but the bottom line is that all of the problems can be overcome.
Patients that recover from robotic prostatectomy can expect one significant change regarding orgasm, the orgasm without ejaculation. It will feel different but the pleasure part will still be there.
Note that the male orgasm has 3 main components:
Even though the first 2 parts of the orgasm are affected by the radical prostatectomy, the third one that involves brain stimulation and generates the sensation of pleasure still remains.
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What Is Advanced Prostate Cancer
When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer.
Prostate cancer is often grouped into four stages.
- Stages I & II: The tumor has not spread beyond the prostate. This is often called early stage or localized prostate cancer.
- Stage III: Cancer has spread outside the prostate, but only to nearby tissues. This is often called locally advanced prostate cancer.
- Stage IV: Cancer has spread outside the prostate to other parts such as the lymph nodes, bones, liver or lungs. This stage is often called advanced prostate cancer.
When an early stage prostate cancer is found, it may be treated or placed on surveillance . If prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer. Stage IV prostate cancer is not curable, but there are many ways to control it. Treatment can stop advanced prostate cancer from growing and causing symptoms.
There are several types of advanced prostate cancer, including:
If your Prostate Specific Antigen level has risen after the first treatment but you have no other signs of cancer, you have “biochemical recurrence.”
Castration-Resistant Prostate Cancer
Non-Metastatic Castration-Resistant Prostate Cancer
Metastatic Prostate Cancer
- Lymph nodes outside the pelvis
- Other organs
Metastatic Hormone-Sensitive Prostate Cancer
Limit Prostate Cancer To Just Another Part Of Your Evolving Sex Life
The reality is that sex changes for every man as he goes through each decade of his life. For some men, prostate cancer is part of that progression, says Dr. Samadi who works closely with men and their partners before and after prostate cancer. With dedication, eighty-five percent of his patients regain sexual potency in just 12-24 months.
Learn precisely how SMART robotic prostatectomy surgery protects sexual function and read more about your sexual recovery options after prostate cancer surgery. Dr. David Samadi has performed more than 7,000 successful robotic prostatectomy procedures as Urologic Oncologist and Chief of Robotic Surgery at Lenox Hill Hospital, in New York City.
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