Treatment Of Prostate Cancer And Sexual Function
Prostate cancer treatments include surgery, hormone therapy, radiotherapy, and chemotherapy. Each treatment method is selected primarily according to the disease stage of the patient. In prostate cancer treatment, as testosterone is involved in the prostate and its mechanism of action, erectile dysfunction often occurs as a critical complication regardless of the selection of a surgical treatment or hormonal therapy.
What Are Pelvic Floor Exercises And Can Improve Erection Quality
As we age, we lose muscle tone throughout your body. That includes the muscles that men need to maintain erections. However, there are physical exercises men can do to reduce erectile dysfunction. The best ones are known as pelvic floor exercises or kegels.
Those muscles are the core of how your body maintains blood flow to the penis and therefore keeps erections strong.
They put pressure on the veins in your penis, preventing blood from flowing back into the rest of your body. If they arent strong enough then even if you can get an erection, you wont be able to keep it.
The process starts with identifying the muscles you need to activate. Thats best achieved by lying down with knees bent and feet flat on the floor. Thats when you breathe out and squeeze your pelvic floor muscles for 3 seconds.
Its important that you identify the right group, at the base of your buttocks, on either side of your perineum. It can be easy to mistake other muscles, such as the legs or stomach for the pelvic floor.
Once you are confident you have the right muscle group, then doing the exercises in a seated or standing position three times a day can firm and strengthen the muscles, with a likely improvement within four to six weeks.
Some men find that after the initial strengthening that options like Pilates become appealing as not only are there many exercises which improve the pelvic floor, but they can improve overall posture and strength.
Sex After Prostatectomy: How To Have A Healthy Sex Life After Surgery
Medically reviewed by Kristin Hall, FNP
Prostate health issues such as benign prostatic hyperplasia and prostate cancer affect hundreds of thousands of men in the United States every year.
If youve been diagnosed with a serious prostate issue, your healthcare provider may suggest a prostatectomy a surgical procedure in which your part or all of your prostate gland is surgically removed from your body.
Prostate removal surgery is usually highly effective at treating cancer and prostate enlargement , but it can potentially lead to complications.
These include some sexual performance issues, such as erectile dysfunction and difficulty ejaculating normally.
Although these effects can change your sexual experience, many men are still able to enjoy a fulfilling, satisfying sex life after prostate surgery by making certain lifestyle changes and using medication.
Below, weve talked about what to expect if youre scheduled to undergo a prostatectomy and want to maintain an active sex life after surgery.
Weve also explained how you can have a healthy sex life after a partial or complete prostate removal, whether through exercises to improve sexual functioning, medications, devices or a combination of different approaches.
Read Also: How To Get Tested For Prostate Cancer
What Is Prostate Cancer
Prostate cancer develops in the prostatea small gland that makes seminal fluid. It is the second most common type of cancer in men. Prostate cancer usually grows over time and in the beginning stays within the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
Prostate cancer that is caught early has a better chance of successful treatment.
If You Identify As Lgbt+
If you identify as gay, bisexual, transgender or LGBT+, you may worry about being treated insensitively by your healthcare team. Many sexual difficulties caused by prostate cancer are similar whatever your sexuality, but you may have some specific questions. Having your sexual or gender identity acknowledged may help you feel better supported. It also means your healthcare team can give you the right information and advice. Prostate Cancer UK has specific information for gay and bisexual men.
Pelvic radiotherapy and brachytherapy can affect the back passage . This can cause different side effects. If you receive anal sex, it is best to wait until these side effects have improved. It is important not to injure the tissues of the rectum. Radiotherapy may cause long-term changes to the rectum that may make receiving anal sex difficult. You can talk to your doctor or nurse for more advice.
If you feel unable to talk to your healthcare team about your sexuality, the LGBT Foundation has a helpline that can give you confidential advice and support call 03453 30 30 30.
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How May Erectile Dysfunction Affect My Sex Life
Most men find that their sex life is different after prostate cancer treatment. Some men question their manliness when they cannot have an erection or find that they are not interested in sex. This can happen even if you are not currently in an intimate relationship. You may find this upsetting. Even if one of the medications or erection aids is helpful, having sex using these things may take some getting used to. It may not feel entirely natural. You can talk with your doctor or healthcare team about these feelings. Counseling may also help.
If you have an intimate partner, it is important for you to talk to your partner about how you are feeling. There is an old saying that a problem shared is a problem halved. Not everyone wants a sexual relationship. Dont try to guess or assume what your partner wants. Have an open and honest discussion with your partner.
This may seem unnecessary in long-term relationships as people tend to assume they know all there is to know about their partner but this is not always the case. With time, you and your partner may be able to find satisfying ways to have a sex life even though you have erectile dysfunction. Your partner will also have concerns about your sex life as well as concerns about your health. Talking about your feelings is very important during this time.
Sexual Intercourse And Other Risk Factors Of Prostate Cancer
Sexual Intercourse and Prostate Cancer risk factors are not relevant.
So the answer to the question If having sex with a person with prostate cancer risky is in negative.
However, the study at several medical schools, shows that men with high sexual activity and frequent ejaculation are at lower risk of prostate cancer.
Study shows that men who have in average 4 to 7 ejaculation per week up to the age of 70 are 36% less at risk of prostate cancer comparing to the one who have 2 to 3 times sex per week.
Such a risk of sexual transmitted disease, whether it is through intimate contact like kissing, intercourse or oral sex are not relevant.
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Other Cancer Treatment Effects On Ejaculation
Some cancer treatments reduce the amount of semen thats produced. After radiation to the prostate, some men ejaculate less semen. Toward the end of radiation treatments, men often feel a sharp pain as they ejaculate. The pain is caused by irritation in the urethra . It should go away over time after treatment ends.
In most cases, men who have hormone therapy for prostate cancer also make less semen than before.
Chemotherapy and other drugs used to treat cancer very rarely affects ejaculation. But there are some drugs that may cause retrograde ejaculation by damaging the nerves that control emission.
Sex Therapists And Other Types Of Counselors
Sex therapy is psychotherapy or counseling that’s focused on solving a sexual problem.
Sex therapists may practice in a clinic or alone. Look for a sex therapist who is a mental health professional with special training in treating sexual problems.
Psychotherapy can help you feel better about the changes in your body, help you and your partner communicate more clearly, and give you skills to better cope with the cancer and cancer treatment. Couples counseling may be helpful, too.
Finding a well-qualified mental health professional is important. These are some of the different types of mental health professionals out there:
The cost of counseling varies with the professionals training and experience, and health insurance companies reimburse at different rates. You may want to check with your insurance company to find out if it will pay for counseling or therapy.
Professional societies can often give you information about their members in your area who have special training in sex therapy. These are good places to start:
- American Association of Sex Educators, Counselors, and Therapists
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Things That Can Happen When You Live Without A Prostate
Beyond the oft-reported effects of urinary incontinence and impotence following surgery, there are a number of less widely known possible side effects of prostate removal.
Fun fact number one: Half of all men who die in this country this year will be killed by heart disease, stroke, or cancer. Fun fact number two: Half of all doctors seem to have different ideas about how to prevent the biggest killers of men. We spoke to the best of them, and we’ve simplified, clarified, and prioritized their advice on minimizing the risks of dying before your time. For more tips, . Reporting by Sarah Z. Wexler.
As more men deemed to be at genetic risk of prostate cancer opt to have the organ removed preemptively, lesser-known side-effects of the procedure are coming to the fore. In addition to the oft-reported effects of urinary incontinence and impotence following surgery, here are some symptoms more rarely accounted for:
Shrunken penises. As many men are prescribed antiandrogen treatments to block testosterone effects on advanced prostate-cancer tissue, Dr. Celestia Higano of the University of Washington reports that up to 68 percent of men experience penile shortening after radical prostatectomy surgery.
“Dry orgasm”or, rather, orgasm without ejaculation, which occurs after surgery when retrograde ejaculation sends semen back into the bladder instead of out the penis.
This article originally appeared in Esquire‘s November issue.
What Determines Erection Recovery After Surgery
The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states , lifestyle factors , and the use of medications such as antihypertensive agents that have antierectile effects.
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What You Can Do Now
Sexual side effects from prostate cancer treatment are often temporary, especially if your doctor used nerve-sparing surgery. While your body recovers, you can try a few things to maintain your sex life:
- Let your doctor know about any sexual problems youre having right away. Although it can be hard to talk about sex, being open and honest will help you get the treatment you need.
- See a therapist. Couples therapy can help you and your partner understand and deal with sexual issues.
- Take care of yourself by exercising, eating a well-balanced diet, reducing stress, and getting enough sleep. Looking and feeling your best will give your self-esteem and mood a boost.
Your Emotions And Sex
Your prostate cancer and its treatment wonât just affect your body. Theyâll also have a serious impact on your emotions. Stress and anxiety can trigger your body to make adrenaline, which gets in the way of having sex. The more you worry, the worse the struggle. If youâre in a relationship, your partner will be going through many of the same feelings.
One of the most important things you can do is to talk to your partner. Have an honest conversation about your fears and expectations when it comes to sex. Don’t assume they know how you feel. Being open with each other will help you both feel supported and help you work together to make any adjustments that you may need to stay intimate.
Talking with a mental health professional — either one-on-one or with your partner — can be a powerful way to help manage your emotions. A therapist can also prescribe medications that may ease stress and anxiety. A professional sex therapist can help you and your partner find ways to improve your sex life. It may also be helpful to join a support group where you can talk with others who share your experience.
Prostate Cancer Foundation: “Erectile Dysfunction.”
UCLA Urology: “Prostate Cancer: Dealing with Erectile Dysfunction.”
Albaugh, J. Reclaiming Sex & Intimacy After Prostate Cancer: A Guide for Men and Their Partners. Anthony J. Jannetti, Inc., 2012.
Harvard Prostate Knowledge: “Achieving orgasm after radical prostatectomy.”
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Changes In Penis Size
Some men notice that their penis is shorter after surgery . Some men notice other changes such as a curve in their penis or a narrower area. We don’t know for certain why these changes happen, but it could be because of low oxygen levels in the penis, caused by not having erections. Other treatments such as hormone therapy with radiotherapy may also cause changes to the size of your penis.
Encouraging blood flow to the penis after surgery may help prevent this. In particular, using a vacuum pump, either on its own or with PDE5 inhibitor tablets could help maintain your penis size and improve erections.
Keeping your penis active after surgery
Although you may not be ready or recovered enough for sex, you can still start treatment for erection problems in the weeks immediately after surgery. It could be taking a low-dose PDE5 tablet once a day or using a vacuum pump, or sometimes both together. The treatment along with masturbation encourages blood flow to the penis. This can help keep your penis healthy. You may hear this called penile rehabilitation. Think of it in the same way as having physiotherapy if you had injured your arm or leg. Starting treatment soon after surgery may help improve your chance of getting and keeping an erection. But it may not work for every man.
Sex Life And Prostate Cancer
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We have included information about managing side effects in our information on individual treatments. As your side effects improve, you may feel more interested in having sex.
If cancer and its treatments affect your sex life, it can feel like a serious loss. You do not need to be in a relationship to feel this. But there are different ways to manage sexual difficulties.
Cancer and its treatments can also affect how you feel and think about your body. You may feel less sexually attractive. If you are having issues with your body image, ask your doctor or nurse for advice.
Certain lifestyle changes may help improve body image concerns, such as being more physically active, eating healthily and managing your weight. Ask your doctor or nurse for advice.
Prostate cancer treatments can have a direct effect on your sex life.
Different cancer treatments may:
- cause difficulties getting or keeping an erection
- affect your ability to have an orgasm or to ejaculate
- the penis and testicles to get smaller if you are taking hormonal therapy for a long time.
If you are having sexual difficulties, there are different treatments and types of support to help you.
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Does Sexual Activity Improve Prostate Health
Regular ejaculation enhances the immune systems response to the presence of cancer cells.
According to a report published in JAMA, men who reported having more than 20 ejaculations per month were 33% less likely to develop prostate cancer.
These measured ejaculations included sexual intercourse, nocturnal emissions, and masturbation. Researchers evaluated nearly 30,000 patients, of whom 1,449 developed prostate cancer.
Assuming the men answered the survey questions honestly, the results indicated that active sex life is not associated with higher cancer risk in most men.
An Australian study of 2,338 men also came to a similar conclusion. This study found that men who averaged 4.6 to seven ejaculations a week were 36% less likely to be diagnosed with prostate cancer before the age of 70 compared to men who ejaculated less than 2.3 times a week on average.
The study found no connection between prostate cancer and the number of sex partners.
What Concerns Could Arise
Some men experience a loss of desire for sex, an inability to achieve or maintain an erection, inability to reach orgasm or have a change in orgasm , experience pain during sex, or just do not find sex pleasurable. Sexuality is an important factor in their quality of life for many men. Know that these concerns are common and your healthcare team can provide guidance. Write down your questions and concerns so you don’t forget to ask about them. If your provider cannot help, ask them to recommend someone who can.
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Avoiding Risks During Cancer Treatment
Talk with your doctor about how to protect yourself and your partner from any risks from your cancer treatment. For example, such protections may include using a condom to protect your partner from being exposed to chemotherapy. These drugs stay in your semen for 48 to 72 hours. Also, use a condom if you had brachytherapy. The condom protects your partner if a radiation seed comes out.
You are less likely to make a partner pregnant when you are receiving chemotherapy. But it is still possible. Protect your partner and any future children by avoiding pregnancy until at least 2 months after finishing chemotherapy.
Chemotherapy, radiation therapy, and some types of surgery can take away your ability to make a woman pregnant. The medical name for this is infertility. Be sure to let your oncologist know before cancer treatment starts if you are concerned about infertility. You might want to freeze some of your sperm or try another fertility-preserving option. Learn more about fertility and cancer.