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This may happen gradually. You’re more likely to have these problems if you’ve also had surgery in the pelvic area or chemotherapy| treatment. Hormonal therapy for prostate cancer| can also cause some side effects that may affect your sex life. Sexual difficulties can also be caused by other medical conditions and are more common as men get older.
There are things that can be done to help, so it’s important to talk to your doctor or nurse if you’re having problems.
Pelvic radiotherapy can damage the nerves in the pelvic area and the blood vessels that supply blood to the penis. This can cause problems in getting or keeping an erection (impotence). The likelihood of erection problems depends on the type of cancer you’ve had, the dose of radiotherapy you were given and any other treatments you’ve had. Your cancer specialist will discuss this with you.
Some treatments can help you get and maintain an erection. These include:
There’s some evidence that starting tablets, such as Viagra, sooner rather than later is more likely to improve your ability to get and maintain an erection.
Your doctor or nurse should be able to advise you on the different methods above and can refer you to a specialist if necessary.
There’s more information about these treatments in our section on sexuality and cancer|, and leaflets are available from The Sexual Advice Association|.
After pelvic radiotherapy, the amount of semen you produce is reduced. This means that, when you ejaculate, you may notice that only a small amount of fluid comes out. Some men don’t produce any semen at all, and this is known as a dry ejaculation. Although you will still be able to orgasm (climax), some men find the sensation feels different from before.
It may take longer to reach orgasm and you may find the sensation is less intense. This may be due to changes in the blood flow to, and nerves in, the pelvic and genital area following pelvic radiotherapy. But it may also be caused by a change in how you feel about yourself sexually.
Some men may not have erection difficulties but may find that their interest in sex is reduced after treatment.
There are different reasons for this:
You may find it helpful to get emotional support| or talk to a counsellor or sex therapist|. As the late effects ease, you may start to feel better about yourself sexually.
If blood tests show you have low testosterone levels, your specialist may prescribe replacement therapy for you. Your specialist can tell you if testosterone replacement therapy is likely to be helpful for you.
It can be difficult to talk about your sex life and any problems you’re having, but doctors and specialist nurses are used to dealing with intimate problems. They can often give you advice and support if things aren’t going well. Your hospital doctor or GP can refer you to an erectile dysfunction (ED) service at your hospital, or to a counsellor or sex therapist.
A sex therapist can help you adjust to physical changes and explore different ways of getting sexual satisfaction. If emotional problems are affecting your sex life, ask your doctor to refer you to a counsellor or doctor who specialises in emotional support.
If you have a partner, talk to them| about the effect that treatment is having on your sex life. It’s good to look at ways of overcoming any problems as a couple. You can talk to sex therapists or counsellors in detail about the effects these changes are having on you and your partner. You can contact a sex therapist through your doctor or specialist nurse.
There are many organisations that may be a source of help for you. For example, the College of Sexual and Relationship Therapists| provides a list of qualified practitioners and The Sexual Advice Association| offers a confidential helpline.
Our section on sexuality and cancer| has more detailed information on dealing with the physical and emotional effects that cancer and its treatment may have on your sex life.
Content last reviewed: 1 June 2012
Next planned review: 2014
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
Watch our video of Denton explaining how he coped with the fatigue he felt as a result of cancer treatment.
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© Macmillan Cancer Support 2013
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