What you’ll learn:
- Prostate cancer is the most common type of cancer in American men.
- 1 in 8 men will be diagnosed with prostate cancer in their lifetime.
- Prostate cancer treatments affect men’s sexual functioning.
- Erectile dysfunction is a common side effect of prostate cancer surgery.
- Men who undergo radical prostatectomy can experience orgasms without ejaculation.
- Modern treatment methods minimize the risk of sexual complications.
- Penile rehabilitation should start as soon as possible after prostate surgery.
When your doctor tells you that you have prostate cancer, your sex life may be the last thing on your mind. But you should know that while prostate cancer is easily detectable and treatment is highly effective, most men experience sexual problems after the surgery.
Rest assured, however, that many bedroom issues are temporary. Some may be long-lasting but manageable. You can have satisfying sex and orgasms after prostate surgery. Here is what you need to pay attention to.
Prostate Cancer in the United States
Prostate cancer is the most common cancer affecting men in the United States. The American Cancer Society expects over 200,000 new diagnoses in 2021. Non-Hispanic Black men have the highest incidence rate of this type of cancer.
The majority of men diagnosed with this disease are 60 and over, but younger men can get sick too. One in eight men will be diagnosed with prostate cancer in his lifetime. The good news is that this disease is highly treatable if diagnosed early.
Sex After Prostate Surgery
Treatments for prostate surgery include surgical methods, radiotherapy, and hormone therapy. All of them can have a negative impact on your sexual functioning. The most common intimate difficulties for men after prostate treatment are:
- Erectile dysfunction
- Orgasm difficulties
- Orgasms without ejaculation
- Low libido
- Performance anxiety
Erectile Dysfunction After Prostate Surgery
Most men who undergo prostate surgery will deal with ED, at least for some time. According to different studies, ED rates range from 14 to 90 percent. Whether you develop erectile dysfunction depends on a range of factors, including:
- treatment method
- surgeon’s experience
- your erectile health before the operation
Here is the bottom line: Expect to have some erectile difficulties in the first months after surgery. Within a year, your ability to have erections should improve. Talk to your doctor about a rehabilitation strategy; it should start as soon as possible after your surgery.
Orgasms After Prostate Surgery
While men who have prostate cancer treatment may not be able to ejaculate, many can still have orgasms, though men who have gone through it say their orgasms feel different. Factors that may contribute to this difference include the destruction of nerve endings, weakened pelvic floor muscles, and hormonal changes resulting from medication.
Some guys, however, find it impossible to orgasm. One study revealed that almost 40 percent of males suffered from anorgasmia (lack of orgasm) after a radical prostatectomy. Another 40 percent said their orgasms were less satisfying. Orgasmic function often improves with time, but it may take up to four years after surgery to see the full effect.
Orgasms Without Ejaculation
“Dry orgasms” are a typical result of prostate cancer treatment. During the surgery, the prostate and seminal vesicles are removed, and the body is no longer able to produce ejaculate. Some men may have some fluid before or during an orgasm, but this substance is produced in the urethral glands.
Since much of the sensation of climax comes from ejaculation, your sexual pleasure will feel different when “dry.” Note that it is possible to have satisfying sex without ejaculation. Some traditions, for example Tao, even encourage healthy men to avoid the expulsion of semen.
Changes in Anal Pleasure After Prostate Surgery
Men who enjoy anal stimulation, especially as the receiving partner, may also feel like the removal of the prostate has changed the way they feel during sex. According to one Swedish study, some gay men lost their ability to orgasm from anal penetration, while others felt the surgery did not change much in their sensations.
For men who used to be the active partner in anal contacts, erectile dysfunction could be a big obstacle. The necessity to take ED medication, such as Viagra, may take the spontaneity away from intimacy, but this can be addressed with proper partner communication.
Mood and Libido Changes
Hormonal therapy is commonly prescribed to men with prostate cancer. Unfortunately, one of its side effects is lower sex drive. Hormone pills reduce your testosterone levels, but they may also affect your general mood.
Add to that the fatigue caused by treatments and stress related to dealing with a serious illness, and it should come as no surprise your libido drops. One way around it is to talk to your doctor and try intermittent hormonal treatments to give your body a chance to revive the sexual desire.
Sometimes hormones are necessary, and you must take them for a long time. If your intimate life begins to suffer, it is time to seek psychological support, such as therapy or couple’s counseling.
Your partner plays an important role in your recovery process, but she or he may also feel exhausted. Getting some professional help might be necessary to go through these tough times.
New Methods Help Maintain Sexual Function
If you have been recently diagnosed with prostate cancer, understanding your treatment and recovery options will help you go back to satisfying sex as soon as possible. To reduce ED risk and other sexual complications, specialists often recommend opting for nerve-sparing surgery whenever possible.
Modern methods, such as robotic prostate surgery, are designed to cause as little damage to the nerves and pelvic floor as possible. Finding an experienced surgeon to perform the procedure is key. It takes great skill to remove the prostate without destroying the body’s sexual anatomy.
Radiation is another important component of cancer treatment. Here, too, modern medicine offers techniques that reduce the risk of ED. Talk to your doctor about precise radiation methods.
Pelvic Floor Exercise After Prostate Surgery
Our sexual pleasure depends not only on our nerves and hormones. Pelvic floor muscles are often omitted when discussing prostate cancer recovery.
Most of us think only women need strong and flexible pelvic floor muscles to feel pleasure in bed and avoid incontinence. This is not true. Men can also exercise these muscles to improve their sexual health.
Find a physiotherapist specializing in pelvic floor rehabilitation and get a consultation after your prostate surgery. You will be prescribed a training program that can help you get your erections back and feel more satisfaction in bed. There are also apps that can guide you through basic Kegel exercises.
ED Medication for Better Sex After Prostate Surgery
To maximize your chances of going back to satisfying sex after prostate surgery, you should start a penile rehabilitation program as soon as possible. Research shows this approach helps prevents complications and sexual difficulties in the future. Recovery may take over a year, so be patient.
ED medication, such as Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil), is the main part of the rehabilitation program for most men. According to one study, 60 percent of patients who underwent a nerve-sparing surgery saw improvement in their erections after taking Viagra.
Your doctor should get you started on ED medication about six months after surgery. Filling your prescription has never been easier. All you have to do is visit eDrugstore.com and order your medication. This reliable online pharmacy offers quick and discreet home delivery, so you can go back to a satisfying sex life as soon as possible.
Anka Grzywacz is a sexologist, reproductive health expert and Certified Sex Coach