Sexual Activity and Intimacy After Prostate Cancer

Written by: Steven Schlosser
Published 03/24/2015
Updated: 09/17/2024

• Some couples struggle to regain intimacy after prostate cancer, but cancer does not have to mean the end of sex and intimacy for you and your partner.
• Most men who undergo prostate surgery experience erectile dysfunction (ED) for at least one year following surgery.
• Men can still orgasm after prostate surgery but may face challenges regaining their previous level of sexual function.
• Research consistently shows that Viagra is the best treatment for ED after prostate surgery.
• Couples benefit from practicing open communication about sex, learning more about the relationship between cancer and sex, and taking steps to find the best treatment for their challenges in reclaiming their sex life.

Worried about how prostate cancer impacts your partner's sex life?

Thanks to modern treatments, men can still get erections and reach orgasm following cancer treatment. This article overviews common erectile challenges after prostate cancer and the best strategies for couples to regain full sexual function and intimacy.

What Can My Partner and I Expect After Prostate Cancer?

Some couples don't feel comfortable having sex after one partner has undergone treatment for prostate cancer. In some cases, erectile dysfunction (ED) is the main challenge for couples hoping to regain an active sex life. However, prostate cancer does not mean the end of a fulfilling sex life for you and your partner!

Research shows that cancer and its resulting treatments can have a negative impact on men’s overall health and sexual function. Any cancer diagnosis or treatment stress can negatively affect couples' sexual health and intimacy.

Couples overwhelmingly report declining sex, intimacy, and communication about sex during and following cancer treatment. Research also shows that couples can reclaim their sex lives and intimacy by coming together to improve communication, learning about the impact of cancer on sex and intimacy, and trying new treatment options for challenges like ED after prostate cancer.

Will I Have ED After Prostate Cancer?

Nearly all men who undergo a prostatectomy or other intensive prostate treatment will struggle with ED, at least temporarily. Most men experience ED for 18 months or longer following prostate surgery, even with treatment.

Some men develop psychologically-induced ED before or after surgery due to stress of diagnosis and anxiety surrounding performance. The less nerve damage you suffer during prostate surgery, the more likely you will see improved erectile function within your first year after surgery.

Men who undergo a nerve-sparing prostatectomy are 40 to 50 percent likely to regain their pre-surgery erectile function within one year. And approximately 60 percent of men will regain their pre-surgery function within two years.

Sexual function is a complicated process that relies on both physiological and psychological mechanisms to achieve and maintain an erection. You are more likely to experience challenges regaining your pre-surgery erectile function if you also suffer from other health conditions. Using approved treatments to improve your erectile function can help you to see better results after surgery.

Key takeaway: Sexual function is complex, and almost all men struggle with ED after prostate surgery. You will likely have better treatment outcomes if you use medication or other therapies for ED after prostate surgery.

Can I Orgasm After Prostate Surgery?

Most men are still able to climax after prostate surgery. However, you may find that your orgasms and the amount of ejaculate you produce change post-surgery. You might also experience “dry orgasms,” where you climax but do not expel any semen.

Men undergoing radical prostatectomy have removed their prostate and seminal vesicles. The prostate and seminal vesicles produce the seminal fluid expelled during orgasm. You will likely experience completely dry orgasms or a significantly reduced volume of seminal fluid following surgery.

Key takeaway: You will likely still be able to orgasm. You won't see the same "results" as before treatment. You should talk to your doctor or sex therapist about your concerns about orgasms and any performance anxiety arising from the condition.

How Can I Treat Erectile Dysfunction After Prostate Surgery?

There are various treatment options for you to consider after prostate surgery, including surgical implants and prescription medications. Many of these treatments work to treat ED and other sexual dysfunction issues or side effects caused by prostate surgery.

These treatments include:

• Injection treatments
• Lifestyle changes
• Oral medications
• Pelvic floor therapy
• Surgical implants

Oral medications, like Viagra, are the most commonly prescribed treatment for ED following prostate surgery and are the least invasive and most effective treatment. Close to 75 percent of men who undergo treatment for prostate cancer report improved erectile function after taking oral medications for ED.

Viagra continues to be the frontrunner of treatment options for men who undergo prostatectomy. If your condition is complex, you may benefit from a combination of treatments, like Viagra and a penile pump. You may wish to speak to a urologist if you feel you need more invasive or advanced therapies.

Key takeaway: Most men greatly benefit from using oral medications, like Viagra, after prostate surgery. How Can My Partner and I Work Together to Reclaim Our Sex Life and Intimacy?

Dr. Jacek Mostwin of Johns Hopkins University offers advice to couples struggling with sexual health issues after prostate cancer in a report titled Sexual Intimacy & Prostate Cancer. In this report, he mentions several factors that influence sex and intimacy for couples during and after treatment for prostate cancer, such as

• Men may feel more sensitive about discussing their sexual health issues following surgery. They may feel embarrassed, frustrated, guilty, or angry. If not addressed, these types of emotions can lead to relationship problems.
• If a man has trouble getting an erection, he may develop additional performance anxiety, which worsens ED symptoms over time.
• ED treatments are great for overcoming sexual dysfunction, but couples should also focus on strengthening their communication about sex.
• Couples may also need to work through past issues and insecurities surrounding sex to regain their intimacy and sexual function after prostate surgery.
• Counseling and sex therapy are great tools to strengthen intimacy and overcome problems with sexual dysfunction after prostate surgery.

A combination of medical treatment and sex therapy can do wonders to regain both sexual function and intimacy after prostate cancer. You and your partner may wish to attend medical appointments together so you can learn more about the impact of prostate cancer on your sex life. Becoming more familiar with the challenges and treatment options can help you feel more at ease in reclaiming your sex life.

Key takeaway: Medication alone may not solve your sexual function and intimacy problems after prostate cancer. You and your partner should practice open communication and see a counselor or sex therapist if you struggle to regain intimacy after treatment. eDrugstore Can Support You After Prostate Cancer

After speaking with your partner, visiting a medical provider is the next step in accessing treatment for erectile dysfunction after prostate surgery. We carry all FDA-approved medications for ED:

• Viagra (sildenafil)
• Cialis (tadalafil)
• Levitra (vardenafil)
• Stendra (avanafil – not yet available in a generic version)
• Staxyn (vardenafil)

If you would like to explore your treatment options, check out our medication guide and speak to one of our U.S.-licensed physicians by calling 1-800-467-5146 or visiting our erectile dysfunction page today. Virtual consultations and shipping are always free.