Sexual Health Issues in Men with Cancer
Men being treated for cancer may experience changes that affect their sexual life during, and sometimes after, treatment. While you may not have the energy or interest in sexual activity that you did before treatment, being intimate with and feeling close to your spouse or partner is probably still important.
Your doctor or nurse may talk with you about how cancer treatment might affect your sexual life or you may need to be proactive and ask questions such as: What sexual changes or problems are common among men receiving this type of treatment? What methods of birth control or protection are recommended during treatment?
Whether or not you’ll have problems that affect your sexual health depends on factors such as:
- the type of cancer
- the type of treatment(s)
- the amount (dose) of treatment
- the length (duration) of treatment
- your age at time of treatment
- the amount of time that has passed since treatment
- other personal health factors
Cancer Treatments May Cause Sexual Problems in Men
Many problems that affect a man’s sexual activity during treatment are temporary and improve once treatment has ended. Other side effects may be long term or may start after treatment.
Your doctor will talk with you about side effects you may have based on your treatment(s):
- Chemotherapy may lower your testosterone levels and libido during the treatment period. You may be advised to use a condom, because semen may contain traces of chemotherapy for a period of time after treatment. Chemotherapy does not usually affect your ability to have an erection.
- External-beam radiation therapy to the pelvis (such as to the anus, bladder, penis, or prostate) and brachytherapy (also called internal radiation therapy) can affect a man’s sexual function. If blood vessels or nerves are damaged, it may be difficult to get or keep an erection; this is called erectile dysfunction. If the prostate is damaged, you may have a dry orgasm.
- Hormone therapy can lower testosterone levels and decrease a man’s sexual drive. It may be difficult to get or keep an erection. Learn more about side effects of Hormone Therapy for Prostate Cancer.
- Surgery for penile, rectal, prostate, testicular, and other pelvic cancers (such as the bladder, colon, and rectum) may affect the nerves, making it difficult to get and keep an erection. Sometimes nerve-sparing surgery can be used to prevent these problems.
- Medicines used to treat pain, some drugs used for depression, as well as medicines that affect the nerves and blood vessels may all affect your sex drive.
Ways to Manage Sexual Health Issues
People on your health care team have helped others cope during this difficult time and can offer valuable suggestions. You may also want to talk with a sexual health expert to get answers to any questions or concerns.
Most men can be sexually active during treatment, but you’ll want to confirm this with your doctor. For example, there may be times during treatment when you are at increased risk of infection or bleeding and may be advised to abstain from sexual activity. Depending on the type of treatment you are receiving, condom use may be advised.
Your health care team can help you:
- Learn about treatments: Based on symptoms you are having, your oncologist or a urologist will advise you on treatment options. For example, there are medicines and devices that may be prescribed once a sexual health problem has been diagnosed. Medicines can be given to increase blood flow to the penis. There are also surgical procedures in which a firm rod or inflatable device (penile implant) is placed in the penis, making it possible to get and keep an erection.
- Learn about condoms and/or contraceptives: Condoms may be advised to prevent your partner’s exposure to chemotherapy drugs that may remain in semen. Based on your partner’s age, contraception may be advised to prevent pregnancy. For more information, see Fertility Issues in Boys and Men.
- Manage related side effects: Talk with your doctor or nurse about problems such as pain, fatigue, hair loss, loss of interest in activities, sadness, or trouble sleeping, that may affect your sex life. Speaking up about side effects can help you get the treatment and support you need to feel better.
- Get support and counseling: During this time, it will help to share your feelings and concerns with people you are close to. You may also benefit from participating in a professionally moderated or led support group. Your nurse or social worker can recommend support groups and counselors in your area.
Learn more about organizations that provide support by visiting our database of national organizations that offer cancer-related support services and choosing from a list of services.
Talking with Your Health Care Team about Sexual Health Issues
As you think about the changes that treatment has brought into your life, make a list of questions to ask your doctor, nurse, or social worker. Consider adding these to your list:
- What sexual problems are common among men receiving this treatment?
- What sexual problems might I have during treatment?
- When might these changes occur?
- How long might these problems last? Will any of these problems be permanent?
- How can these problems be prevented, treated, or managed?
- What precautions do I need to take during treatment? For example, do I need to use a condom to protect my partner?
- Should my partners and I use contraception to avoid a pregnancy? What types of contraception (birth control) do you recommend?
- Is there a support group that you recommend?
- What specialist(s) would you suggest that that I talk with to learn more?
Listen to tips on how to manage changes in sexuality and fertility caused by cancer treatments such as radiation therapy.
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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.