Sexual and Fertility Problems (Men)
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?
- 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)
Radiation Therapy Audio Transcript
What Men Can Do About Changes in Sexuality and Fertility
What men can do about changes in sexuality and fertility caused by radiation therapy.
Wondering how getting radiation therapy might impact your sex life? All men can listen to this track to learn about possible changes in sexuality. For men getting radiation therapy to the pelvic area, such as the testes or prostate, Dr. Ross will also talk about changes in fertility. Let's listen in now.
I'd like to open up with some general information about sexuality that may be helpful to all men getting radiation therapy.
One of the most common questions I get from men is "Can I have sex during radiation therapy?" The good news is most men can continue to have sex during their treatment. However, it's best to check with your doctor to make sure it's okay for you.
Others ask, "Is it normal to have a low sex drive during radiation therapy?" And the answer is also yes. So, while you may be physically able to have sex, you may just not feel like it. Guys, be easy on yourselves. You may be very tired, worried, or in pain from the treatment.
There are many steps you can take to stay close with your partner, other than having intercourse. You can figure out together what kind of touching feels good, such as holding, hugging, and cuddling. You can also stay close without being physical. Many couples bond by listening to music together or taking walks and holding hands.
Now for questions from men who are getting radiation therapy to the pelvis.
They often ask me what changes they might have after radiation therapy. Of course, this varies from person to person and depends on the type of cancer being treated. Here's what we know:
Many men don't have problems having sex after radiation therapy. For other men, radiation therapy can make it more difficult to get or keep an erection. These changes can happen slowly, after completing radiation therapy. Talk with your doctor or nurse to learn what you should expect.
I also receive questions from men getting radiation to the pelvis about whether or not they can have children in the future. I tell them that it's important to talk with their doctor. There are things you can do now to plan for children later. Your doctor can talk with you about sperm banking or refer you to a fertility specialist.
We've covered a lot of information, so let's go over the main points:
First, while it depends on the type of cancer you have, it is likely that you can continue having sex during treatment. However, some men find that they have low sex drive during this time.
For men getting radiation to the pelvis, some may find it difficult to get or keep an erection. These changes can happen slowly after completing radiation therapy.
Some men receiving radiation therapy to the pelvis are still able to make a woman pregnant—but some are not. So if you are getting radiation to the pelvis and would like to have children later on, talk with your doctor before you start treatment. Your doctor can help you learn about what you can do now or refer you to a fertility specialist. Some men place their sperm in a sperm bank to use later.
Lastly, the best advice I can give you is to learn about all your treatment options. Ask about any side effects. And keep talking with your partner and your doctor as issues or questions come up.