by Daniela Wittmann, PhD, LMSW
Men diagnosed with prostate cancer often want to know, “How will cancer affect my sex life?” Although beating cancer is certainly the first concern, many men with prostate cancer do factor in sexual side effects as they weigh their prostate cancer treatment options. Sexuality is an important part of everyone’s identity, and the threat of losing it is a worry for many men and their partners. Naturally, couples want to learn how they can protect it.
The first thing you should do is figure out how important sex is to you. Some people think that men who undergo androgen deprivation therapy stop caring about sex when their testosterone is depleted, but this is not true for most men. It’s important to talk with your partner about what role you want sex to play in your relationship. Some couples approach prostate cancer with less priority placed on sexual activity for a variety of reasons. But if sexual activity is important to you, it is best to discuss it openly with your partner before making a prostate cancer treatment plan with your doctor.
Let your doctor know that discussing the sexual side effects of prostate cancer treatment and rehabilitation is important to you. Ask your doctor to set time aside for this conversation. There is a lot to learn, and the more you understand how prostate cancer may affect your sexual health, the more realistic your post-treatment sexual expectations will be.
The more you understand how prostate cancer may affect your sexual health, the more realistic your post-treatment sexual expectations will be.
Talking about sex can be a bit uncomfortable for most people. The thought of discussing erections, orgasms, and intercourse can make anyone clam up. These discussions can be even more challenging for gay men and their partners, as they may have to overcome implicit biases and assumptions about their sexual orientation. It can feel like coming out all over again. However, it’s important to learn about the unique healing issues for men who have anal intercourse. Regardless of your orientation, the bottom line is getting the right information about resuming sexual activity is important for all men.
You can prepare for this conversation by writing down your questions beforehand. You may even want to practice your questions so you can get more comfortable saying words like erection, orgasm, and intercourse. Here are a few things you might want to ask:
- How will each treatment affect my sexual function?
- Does the hospital offer any type of sexual rehabilitation for prostate cancer survivors?
- Can you suggest a sexual health specialist who can help with sexual health issues after treatment?
- Is there someone I can talk to about erection aids?
- Can you refer my partner and me to a certified sex therapist who can help us navigate the prostate cancer experience?
If you don’t get all your questions answered, ask your doctor for another appointment.
Many physicians who treat prostate cancer now offer penile rehabilitation to men who want to maintain their penile tissue health after treatment. Penile rehabilitation may also aid erection recovery for men who have prostate surgery, though researchers are still collecting evidence to substantiate this theory. For men with lasting erectile dysfunction, a variety of medical or mechanical aids can be prescribed. A sexual health specialist can help guide you through the process of recovering sexual intimacy after prostate cancer.
If your sexuality is important to you, don’t neglect this aspect of your recovery after prostate cancer treatment. Help is available. But, to ensure the best results, you must start early, even before your treatment begins.
Dr. Daniela Wittmann is a clinical assistant professor of urology and a certified sex therapist at the University of Michigan in Ann Arbor, MI. Her clinical work and research focus on prostate cancer survivors and their partners.
If you’re struggling with recovering your sexuality after prostate cancer, a sex therapist may be able to help. You can find one in your area through the American Association of Sexuality Educators, Counselors and Therapists (aasect.org) or the Society for Sex Therapy and Research (sstarnet.org).
This article was published in Coping® with Cancer magazine, March/April 2017.