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Recovering Sexual Intimacy after Prostate Cancer

by Daniela Wittmann, LMSW

Prostate Cancer Image

Maintaining intimacy after prostate cancer treatment can be challenging, yet ulti­mately rewarding. Regardless of the type of treatment, most men experience some degree of erectile dysfunction. Many men worry about not being able to meet their partners’ sexual needs. Their part­ners may be distressed by the sexual changes, too, and couples are often at a loss about how to recover their sexual relationships.

Successful sexual recovery requires attention to the body, to emotions, and to the couple’s interactions. The first step is to make sure that both partners’ bodies are as sexually viable as possible. Penile rehabilitation is often recom­mended to men after prostate cancer treatment. Its goal is to maintain the health of penile tissues and maximize the possibility of erection recovery. Your urologist can help you develop a reha­bilitation regimen.

Many female partners of prostate cancer survivors are post-menopausal and experience vaginal dryness, which makes intercourse uncomfortable. They can consult their gynecologists about aids to promote the maintenance of vag­inal moisture and the elasticity of vaginal walls. Regular stimulation of sexually sensitive tissues, including masturbation, helps maintain sexual responsiveness. It brings blood flow into genital tissues. Blood flow underlies not only tissue health but also sexual pleasure.

Author of Article photo

Daniela Wittmann

While exploring options for aids to erections, such as vacuum pumps, penile injections, and penile supposito­ries, couples can begin to reconnect sexually without penetration. Talking about wanting to be sexual again is im­portant. A man’s partner often does not want to pressure him for fear that he will feel inadequate. Men with prostate can­cer may fear that their partners will be disappointed in a sexual interaction with­out penetration. But sexual changes after prostate cancer treatment should be discussed.

For prostate cancer survivors and their partners, the loss of erection can be emotionally significant. Loss of ejac­ulate is also something that both partners may have strong feelings about. Re­assuring each other that affection and alternative sexual touch is a good way to begin the journey to sexual recovery can be freeing and may lead to bonding over a shared goal of renewed physical intimacy.

Sexual activity can begin with sensual touch, such as cuddling or body massage, and lead to more focused sexual stim­ulation with hands, lips, and tongue. Couples can decide which technique to use to stimulate to orgasm. Most couples have used techniques other than penetra­tion in the past. This is the time to dust them off and use them again. For some couples, techniques such as manual stim­ulation or oral sex can be a sweet reminder of the way they started as sexual part­ners. A vibrator can be an extra tool for stimulating blood flow. It can be used equally on both partners’ sexually sen­sitive regions of the body. Penetrative sex can be resumed once erectile treat­ment is successfully underway.

There are websites that provide in­formation on sexual health products in an effort to encourage healthy sexuality after cancer or other chronic illnesses. They usually promote vacuum devices, vasoconstriction rings to help maintain erections, vaginal moisturizers, lubri­cants, and vibrators. Couples can browse these sites as a part of planning for sen­sual and sexual bonding.

When couples work on sexual recov­ery, along with the feelings of closeness, feelings of grief about the changes in their sexual relationship can bubble up. These feelings are normal and should not be suppressed. Rather, couples can share them and support each other. Be­ing able to share such difficult feelings builds emotional intimacy.

It is important to realize that sexual recovery will take time and effort. Grad­ually, prostate cancer survivors and their partners learn how their bodies work together in these new circum­stances and can even take pride in having mastered their new sexuality. Patience, toler­ating grief, accepting frustration, maintaining hope, and embracing humor are the ingredients necessary for a successful recovery of sexual intimacy.

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Daniela Wittmann is a certified sex thera­pist in the University of Michigan Health System’s departments of Urology and Social Work in Ann Arbor, MI. She has worked with couples for over 30 years.

Many couples find it helpful to work on sexual recovery with a sex therapist. Find one in your area through the American Association of Sexuality Educators, Counselors, and Therapists website, It is always good for a couple to interview a therapist or two to make sure they are a good fit. Finding a good sex therapist is no different from finding a good doctor.

This article was published in Coping® with Cancer magazine, May/June 2012.