Coping with sexual difficulties if you are a man

Cancer and its treatment can have different effects on your body.

These can include things such as having pain or being very tired. Or having surgery such as getting a stoma made. Or you may have side effects from treatment, for example urinary problems or bowel problems. All of these things can affect your sexual desire, your confidence or your physical sex life.

There are different things you can do to help, depending on what the problem is. For example, if you are very tired you can choose to have sex when you have more energy. If you have pain, try having sex after taking painkillers. You may also find it helpful to try different sexual positions.

If you have urinary leakage, you may find it helpful to make sure you empty your bladder before sex, or wear a condom. It is still possible to have sex even if you have a urinary catheter. If you have a stoma, choose a sexual position to keep the weight off the stoma. Emptying the bag before having sex will also help.

Pain

Pain can reduce sexual feelings and desire. If you have pain or are worried about pain, it may be helpful to:

  • have sex after taking painkillers and wait a short time for them to work
  • learn some relaxation techniques to use before having sex
  • take control of the depth and speed of penetration
  • try to ensure you and/or your partner are close to orgasm before penetration
  • try types of sexual contact that you don’t find painful, such as sexual contact without penetration
  • use pillows and cushions to help you feel more comfortable and supported
  • have sex side by side, to reduce body weight on a sore area.

We have more information about controlling cancer pain that might help.


Tiredness

You may feel tired for weeks or months after treatment. This may affect your sexual desire. If you don’t feel like having sex because of tiredness, talk to your doctor. They can check if there is anything causing your tiredness that could improve with treatment. If you feel tired but would like to have sex, you may want to try:

  • having sex in the morning, or when you have the most energy
  • experimenting with less demanding sexual positions
  • making sure you and/or your partner are close to orgasm before penetration.


Urinary problems

After some types of cancer treatment, some people can have problems with leaking urine (incontinence) or difficulty passing urine. This may be temporary, but it can sometimes be permanent. It can affect your confidence and how you feel about yourself sexually.

If urine leakage is a problem for you, talk to your doctor or specialist nurse. They may suggest pelvic floor exercises to improve control. A technique called bulbo-urethral massage may also reduce the amount of urine you leak at orgasm.

Some men use a constriction ring around the base of their penis when it is erect. The ring presses down on the urethra, stopping urine from passing through. You can keep this ring on for a maximum of 30 minutes. Keeping it on for longer periods may damage the tissues in the penis. You may need to experiment until you find the right tightness so that it prevents urine leaking, but is still comfortable for you.

Other things you may want to try include:

  • emptying your bladder before sex
  • wearing a condom
  • having sex in the shower
  • keeping a towel or tissues close by.

If you have a catheter

Sex is still possible if you have a urinary catheter (a tube in the bladder and penis that drains urine out of the body). You can fold the catheter back along the penis using surgical tape and cover it with a condom to keep it in place. You may need to use extra lubrication during sex. Always wash around the catheter after having sex.

In some situations, it may be possible to remove the catheter before sex. Your nurse, or a continence adviser, can show you how to remove your catheter.

If you do not have a catheter

Avoid drinking too much fluid for an hour or so before you have sex. Make sure you pass urine before sex so your bladder is as empty as possible. It is sometimes possible to empty your bladder by putting in a catheter – your nurse or a continence adviser can discuss this with you. You may also want to have a shower or bath before having sex, which you could do alone or with your partner.

Coping with sexual difficulties

Brian talks about the impact of prostate cancer and impotence on his sex life. He explains how his relationship with Elizabeth remained strong.

About our cancer information videos

Coping with sexual difficulties

Brian talks about the impact of prostate cancer and impotence on his sex life. He explains how his relationship with Elizabeth remained strong.

About our cancer information videos


Bowel problems

Bowel problems are sometimes a side effect of cancer treatment, especially pelvic radiotherapy. These problems include loose bowel motions (diarrhoea), and needing to open the bowels with very little or no warning (faecal incontinence). These effects may be temporary, but they can sometimes be permanent.

Problems with your bowels can have a huge impact on your life. It may make you feel less interested in sex. You may feel embarrassed and your confidence may be affected. You may feel unclean or unattractive, and you may want to avoid intimate contact.

You can discuss bowel problems with your doctor or specialist nurse, or with a dietitian. They may be able to reduce the side effects using a combination of medicines, dietary changes and exercises. They can also help you cope with the way the problems are making you feel.

There are things you can do to help you cope with bowel problems:

  • Avoid eating foods that cause you bowel problems for several hours before sex.
  • Empty your bowels just before you have sex.
  • Good personal hygiene will help boost your confidence.
  • Scented candles may help if you are concerned about smells.
  • Let your partner know that you may have to rush to the toilet.
  • Make sure you can get to the toilet quickly and easily.
  • Have tissues and towels nearby during sex.
  • You could use an anal plug. They are available online. Your doctor or specialist nurse can give you advice.


Stomas

Sometimes, surgery for bowel or bladder cancer involves having an opening made in the abdominal wall. This is called a stoma. A stoma allows waste from your body (either urine or bowel motions) to drain into a bag that covers the stoma. This is called a colostomy bag.

Having a stoma can make some sexual positions uncomfortable. It can also affect your self-confidence and the way you feel about your body. You can reassure your partner that sex will not harm the stoma. To reduce rubbing against the stoma, choose positions that keep your partner’s weight off it.

It is not recommended to use a stoma for penetrative sex. Your doctor or specialist nurse can discuss this with you further.

Make sure the bag fits well and does not leak. It is a good idea to empty the bag before sex. Some foods can cause the bag to fill quickly, so avoid eating or drinking anything that usually causes you problems. You may be able to plug the stoma or wash it out, so that a bag is not needed for a short time.

Stoma nurses can advise and help you with all of the sexual effects a stoma may cause. Information is also available from the Ileostomy and Internal Pouch Support Group or the Sexual Advice Association.


Treatment for head and neck cancer

The face, mouth and speech can play important parts in your sex life. Changes to any of these can affect how you interact sexually. They can also affect your confidence and how you feel about yourself.


Changes to speech

If there are certain things you do or do not want your partner to do sexually, let them know before having sex. You can also agree alternative ways to communicate what you want during sex.

Changes to your mouth

Surgery or radiotherapy may affect your ability to kiss or give oral sex. It may also cause problems making saliva or controlling saliva. If you have a dry mouth, deep kissing and giving oral sex may be uncomfortable.


Loss of a limb

Very occasionally, a surgeon may need to amputate an arm or leg when treating some types of cancer (such as primary bone cancer). The limb will often be replaced with an artificial arm or leg (a prosthesis).

It can be very difficult to come to terms with a major body change such as amputation. The feeling of looking different from other people can affect your self-confidence.

Whether to wear your prosthesis when having sex is a personal choice. You may find it helps with positioning and movement. Or you may find sex easier and more comfortable without it.

Some sexual positions you enjoyed before surgery may no longer be comfortable. You may need to try different positions to find what you now prefer. You can use pillows to help with positioning and balance. Your physiotherapist or occupational therapist can give you advice if needed.


Lymphoedema

Lymphoedema is swelling that develops because of a build-up of fluid in the body’s tissues. It can affect your sex life and change the way you feel about your body. The following advice might help you find sex more comfortable and enjoyable:

  • Try sexual positions that don’t put weight on the area affected.
  • Have sex at times when the swelling is low. This might be in the morning, or after you have worn a compression garment for a few hours.
  • If you have genital lymphoedema, use extra lubricant to reduce friction to the skin.

We have more information about lymphoedema.


Health and well-being

Your physical health and well-being can affect your sexual function and self-confidence. Read more about reducing stress, physical activity, stopping smoking, cutting down on alcohol and eating well in our section on maintaining a healthy lifestyle.

Back to Effects of treatment on a man's sexuality

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