Radiation Therapy And Sexual Function
Sexual dysfunction occurs in 20~80% of patients who undergo radiation therapy. Radiation therapy may cause injuries, including to nerves, if the radiation range expands to the trigone of the bladder, ectopic ureteral orifice, posterior and lateral rectal wall, and bulbo-membranous urethra. Complications that occur after radiation are classified as early and late. Early complications occur in tissues that undergo rapid mitosis, like the intestinal mucosa, and are typically reversible, whereas late complications occur due to injury of the microvessels, and are irreversible changes.
Generally, the main complications that occur after radiation therapy, such as proctitis, urethral stricture, edema of the penis and lower extremities, and erectile dysfunction, have been shown to occur at incidences of 10% or less.17 Additionally, the frequency of maintaining erectile function after radiation therapy has been reported to be approximately 50%, which is higher than that of radical prostatectomy.18 Formenti et al19 reported no increase in the frequency of sexual function abnormality after adjuvant radiation therapy following a nerve-preservation radical prostatectomy. Litwin20 reported no difference in quality of life among radical surgery, radiation therapy, and observation groups, but found that patient satisfaction with sexual function and voiding symptoms was lower in the radical surgery group than in the other two groups.
Erectile Dysfunction And The Prostate: What’s The Relationship
Written by the UPGUYS Editorial TeamPublished on March 21, 2022
Did you know that 49.4% of Canadian men between ages 40 and 88 experience ED? In the United States, 52% of men experience some form of erectile dysfunction as well. Complete ED usually increases from 5% to 15% in men between the ages of 40 and 70.
Erectile dysfunction and prostate problems are common for men, especially as they get older. While the cause of ED can be physical or psychological, one factor that is often overlooked is the role of the prostate.
We’re going to explore the relationship between ED and the prostate. We’ll also take a look at what men can do to improve their sexual health. Keep reading to find out more.
In this article, we’re going to cover the following:
- Does and How Are Erectile Dysfunction and Prostate Problems Connected?
- The Kinds of Prostate Problems That Can Cause Erectile Dysfunction
- Symptoms of Erectile Dysfunction Caused by Prostate Problems
- Can You Take Erectile Dysfunction Medications if You Are Taking Prostate Problems Medications?
- Does Prostate Disease Medication Cause Erectile Dysfunction?
- How to Treat Erectile Dysfunction Caused by Prostate Diseases?
- Improving Symptoms and Prevention
- FAQs About Erectile Dysfunction and Prostate Diseases
When To See A Doctor
Consult with your doctor if you experience any of the symptoms discussed on this page particularly if they have been going on for a while. You will need a thorough work-up to determine the underlying cause, which may or may not be prostate cancer.
Its important to understand that other diseases or disorders can share these same symptoms. Benign prostatic hyperplasia , also called enlargement of the prostate, and are quite common. Men with these benign conditions can experience symptoms more often and more severely than men with prostate cancer.
Erectile dysfunction is relatively common, especially as one ages, and can also have causes unrelated to prostate cancer, such as smoking or cardiovascular disease. Experiencing a lower amount of fluid during ejaculation can be related to something as simple as diet or dehydration.
Its important to keep track of your symptoms, determining whats normal or abnormal for your own body. If you are worried about a particular symptom, or if its interfering with a relationship, you should discuss your concerns with your primary care physician.
Prostate Cancer | Bills Story
After being diagnosed with prostate cancer, Bill Shipp, a championship swimmer, came to The Johns Hopkins Hospital seeking a second opinion. Watch his story.
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Can Masturbation Cut Prostate Cancer Risk
In this area of interest, a study that took information from 32,000 men looked at whether regular ejaculation helps to prevent prostate cancer.
The researchers published their work in the journal European Urology and reported that more frequent ejaculation might lead to a lower risk of prostate cancer.
Among men aged 2029 years old who had 21 or more ejaculations a month, there were 2.39 fewer in every 1,000 who developed prostate cancer when the researchers compared them to those ejaculating 47 times a month.
Among men who were aged 4049 years old, there were 3.89 fewer people per 1,000 who developed prostate cancer.
The reasons for these results are unclear, but one theory refers to prostate stagnation. This means that less frequent ejaculation allows prostate secretions to build up, possibly contributing to cancer.
An earlier study threw light on other potential aspects of prostate cancer, indicating that frequent sexual activity in younger life increased the risk of prostate cancer. However, the study also indicated that this activity seemed to give protection against the disease when people were older.
How Masturbating Can Help Lower Your Prostate Cancer Risk By A Third
- 6:08 ET, Aug 3 2021
MEN who ejaculate at least 21 times a month can lower their prostate cancer risk by a third, doctors have found.
A study revealed that aside from boosting your mood and giving some much needed relief, masturbating or having sex can help âprevent cancerâ.
Around one in eight men in the UK will get prostate cancer in their lifetime.
Itâs the most common cancer in men and 47,500 men are diagnosed with it each year.
Recently, Luton Town legend Mick Harford revealed he was battling prostate cancer and that he would be having radiotherapy.
Friends star James Michael Tyler also revealed he has stage four prostate cancer and is paralysed from the waist down.
Cancer will strike anyone, but doctors think men who ejaculated more are less likely to be diagnosed with prostate cancer.
Therefore ejaculating more often could actually help you look after your health.
The study was published in European Urology, with experts saying its worth taking note of the other benefits of frequent ejaculation.
The US scientists looked at data from 31,925 men who logged their monthly ejaculation.
They said: âWe found that men reporting higher compared to lower ejaculatory frequency in adulthood were less likely to be subsequently diagnosed with prostate cancer.
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Symptoms Of Erectile Dysfunction Caused By Prostate Problems
There are many symptoms of erectile dysfunction that can often be caused by prostate problems. Some of these symptoms include:
- Difficulty getting or maintaining an erection
- Inability to ejaculate or experience orgasm
- Reduced sexual desire
- Pain during sex
- Problems with urination
If you are experiencing any of these symptoms, it is crucial to see a doctor to determine the cause. Many prostate problems can get treated. This may improve your erectile function.
If your erectile dysfunction’s caused by a psychological problem, such as anxiety or depression, treatment will focus on managing those conditions.
However, if your erectile dysfunction is due to a physical problem, such as prostate cancer or enlarged prostate, treatment will address that condition.
It is important to remember that not all men who experience problems with their prostate will also experience difficulties with erectile function. And not all men who have difficulty getting or maintaining an erection have prostate problems.
However, if you are experiencing any of the symptoms of erectile dysfunction caused by prostate problems, it is important to see a doctor to determine the cause and get appropriate treatment.
If you are having difficulty getting or maintaining an erection, you should always talk to your doctor. Your doctor will be able to help you determine the underlying cause and find the best treatment for you.
Masculinity As A Moderator
Two quantitative studies examined masculinity as a moderator of the relationship between sexual function and psychosocial or QoL outcomes. Together these studies showed that when men who had poor sexual functioning endorsed more traditional masculine values they had worse social functioning, role functioning, and mental health outcomes , including depression .
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Providing Your Medical History
At first, the doctor will probably ask you about your medical history. Do you have any chronic illnesses? What illnesses and operations have you had in the past? What medications are you taking, if any? Your doctor is also likely to ask about your psychological well-being and lifestyle: Do you suffer from depression? Are you under a lot of stress? Do you drink alcohol? Smoke? Use illegal drugs? Have you felt a loss of affection for your partner? Have you recently grown interested in a new partner?
As part of this health history, be prepared to tell your doctor specific details about the symptoms that brought you to the office and when they began. Your doctor might want to know how often you had sex before the problem started and if there have been weeks or months in the past when youve had erectile dysfunction. Your doctor may conduct a written or verbal screening test.
If the cause is clear a recent operation for prostate cancer, for example the conversation may move directly to your treatment options. Otherwise, you may need to answer more questions to help the doctor narrow down the possible causes and avoid unnecessary testing.
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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Treatment Options For Erection Restoration After Prostate Cancer Therapy
There are medications and therapies that have strong clinical data to support the concept of erectile restoration. A mainstay of this therapy is daily use of medications such as Viagra and Cialis. Additionally, there are medications that act directly in the penis that can improve erectile function during the recovery period after surgery and radiation.
The important thing about sexual function after prostate cancer treatment is to not give up. Despite the best skills and efforts of your surgeon, you may have a significant reduction in your ability to achieve a full erection. There are multiple therapeutic options available to you. Feel comfortable at The Mens Clinic that you are getting state of the art care in a relaxing environment that ultimate should lead to good sexual outcomes.
Ask Your Doctor About Solutions
Patients should not be shy about discussing intimacy issues with their doctor. He or she may be able to prescribe medications to help. Certain medicationssuch as sildenafil , tadalafil or vardenafil are typically tried first. But these drugs may not help men achieve an erection if the nerves responsible are not healthy. In fact, the medications only work for a small percentage of men in the first few months after surgery, according to a 2017 study published in the International Journal of Sexual Health.
Besides oral medications for erectile dysfunction, there are other options available to men with ED after prostate cancer treatment, says Dr. Shelfo. These include penile injection therapy, which involves injecting a small amount of medication directly into the base of the penis. That has helped many men achieve erections. Another option is an intraurethral suppository of medication, an external vacuum erection device, or surgery may be performed to implant a penile prosthesis.
While regaining erectile function is not possible for all men treated for prostate cancer, it is important to remember that an erection is just one aspect of a satisfying sex life. Intimacy is another major component, one that may become more important as sexual relationships become more difficult after cancer treatment.
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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.
Causes Of Sexual Problems
While many men experience sexual issues following prostate cancer treatment, these issues are not often due to prostate cancer itself.
Most prostate cancer symptoms involve problems with expelling urine due to enlargement of the prostate gland. This enlargement begins to inhibit the urethra carrying urine out of the body. Urinary symptoms should not affect a persons sex life, however.
More active treatments for cancer, such as surgery, radiation therapy, or hormone therapy, may lead to sexual dysfunction.
Nerves that run close to the prostate gland control erections. Surgery that completely removes the prostate gland carries a risk of erectile dysfunction for this reason.
This type of surgery is usually only suitable for men with aggressive prostate cancer that is likely to grow or spread. Younger men with prostate cancer might also choose it, however.
In these surgical cases, a nerve-sparing prostatectomy aims to avoid damage to the erection-controlling nerves. Nevertheless, nerve-sparing operations are not always possible.
While reducing the risk of erectile dysfunction, this type of treatment may not deal with the cancer fully and may leave behind some cancerous tissue.
Surgery carries the greatest risk, but other treatment methods for prostate cancer can also affect sexual activity.
Treatment options with a risk of erectile dysfunction include:
Brachytherapy has a lower risk of erectile dysfunction than other types of radiation therapy.
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Treating Erectile Dysfunction With Shockwave Therapy
For over four decades, shockwave therapy has been used to treat patients with heart problems, kidney stones, fractures, and joint inflammation. Recently, researchers found that it could help men improve their sex life. Since this discovery, it has become one of the most preferred treatments for ED.
Shockwave therapy uses low-energy frequencies from acoustic waves to trigger a process known as neovascularization in the targeted parts of the body. This will help improve blood flow to the area, which is a critical factor in erectile function. Most of the physical conditions that cause ED typically form plaques that block blood flow to the penile arteries. The therapy combines its repairing and regenerative effects first to remove the plaque and then stimulate a re-growth process of new and healthy blood vessels.
Sexual Dysfunction After Prostate Surgery Is More Common Than Previously Reported Says Hutchinson Center Study
Media briefing: A media briefing will be held at 1 p.m. PST Tuesday, Jan. 18 at the Center’s Metropolitan Park East Campus, 1730 Minor Ave., between Olive and Howell streets. A Media Relations representative will greet you in the lobby and escort you to the briefing room. Free parking is available in an underground garage entrance off Minor Ave. A map of the site is available upon request.
B-roll available: A related video news release, including sound bites and b-roll of Dr. Janet Stanford and a Seattle-area prostate-cancer survivor, will be available via satellite feed twice on Tuesday, Jan. 18: first between 6 and 6:30 a.m. PST and again between 11 and 11:30 a.m. PST .
SEATTLE — Sexual dysfunction among men who undergo prostatectomy appears more prevalent than previously reported, according to a multi-center study led by an investigator from the Fred Hutchinson Cancer Research Center in Seattle.
The results will appear in the Jan. 19 issue of the Journal of the American Medical Association.
Funded by the National Cancer Institute, the Prostate Cancer Outcomes Study is the first comprehensive, population-based assessment of sexual function and urinary continence among men treated with radical prostatectomy for early stage, localized prostate cancer. It is also the first study to examine the sexual and urinary side effects of such surgery in minority populations.
Age and education also had an impact on the frequency of impotence.
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LOCALIZED PROSTATE CANCER
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