Sexual and Fertility Problems (Men)

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Many cancer treatments can cause changes to a man’s fertility and sexuality. It’s important to talk with your doctor to learn what to expect before starting treatment.

Credit: National Cancer Institute

Many cancer treatments and some types of cancer can cause sexual and fertility-related side effects. Whether you have these problems depends on the type of treatment(s) you receive, your age at time of treatment, and how long it has been since you had treatment.

It is important to learn how the treatment recommended for you may affect your fertility before you start treatment. Many men also find it helpful to talk with their doctor or nurse about sexual problems they may have during treatment. Learning about these issues will help you make decisions that are best for you.

Treatments That May Cause Sexual and Fertility Problems

  • Radiation therapy to the pelvic area (such as to the anus, bladder, penis, or prostate) may make it difficult to get or keep an erection. It may also cause infertility, which may be temporary or permanent. Some men notice that changes in sexual function occur slowly over the period of about a year. Smoking, heart disease, high blood pressure, and diabetes can make some problems worse.
  • Hormone therapy may cause mood changes, decreased sexual desire, erectile dysfunction, and trouble reaching orgasm.
  • Some types of chemotherapy may cause low testosterone levels and lower your sexual desire. Chemotherapy may also cause infertility, which may be temporary or permanent.
  • Surgery for penile, rectal, prostate, testicular, and other pelvic cancers may affect sexual function and fertility.
  • Other side effects of cancer and its treatment, such as fatigue and anxiety, can also lower your interest in sexual activity.

Learn What to Expect

Before starting treatment talk with your health care team to learn what to expect based on the type of treatment you will be receiving. Get answers to questions about:

  • Sexual activity. Ask your doctor or nurse if it is okay for you to be sexually active during your treatment period. Most men can, but you will want to confirm this with your doctor or nurse.
  • Infertility. Ask if your treatment could affect your fertility or make you infertile. If you would like to have children after treatment, talk with your doctor or nurse before you start treatment. Learn ahead of time about your options, such as sperm banking. Procedures such as testicular sperm extraction, testicular tissue freezing and testicular tissue cryopreservation (for young boys) are available. Talk with your doctor or a fertility specialist to learn more about these procedures and other that may be available through a clinical trial.
  • Birth control. It is important to prevent pregnancy during treatment and for some time after treatment. Ask your doctor or nurse about different methods of birth control to choose one that may be best for you and your partner.
  • Condom use. If you receive chemotherapy you will most likely be advised to use a condom during intercourse, even if your partner is on birth control or cannot have children. This is because your semen may have traces of the chemotherapy drugs.

Talking With Your Health Care Team

Prepare for your visit by making a list of questions to ask. Consider adding these questions to your list:

Sexual and Sexuality-Related Questions

  • What problems or changes might I have during or after treatment?
  • How long might these problems last? Will any of these problems be permanent?
  • How can these problems be treated or managed?
  • Could you give me the name of a specialist who I can talk with to learn more?
  • What precautions do I need to take during treatment? For example, do I need to use a condom?
  • Is there a support group for men that you would recommend for me?

Fertility-Related Questions

  • Will the treatment I receive make me infertile (unable to have children in the future)?
  • What are all of my options now if I would like to have children in the future?
  • Could you give me the name of a fertility specialist who I can talk with to learn more?
  • After treatment, how long should I use some method of birth control?


Listen to tips on how to manage changes in sexuality and fertility caused by cancer treatments such as radiation therapy.
(Type: MP3 | Time: 3:19 | Size: 3.1MB)