Effects of prostate cancer treatment
Treatment for prostate cancer can cause a variety of side effects which can affect your mind, your body and your relationships. All of this can impact your sex life, some more than others. Your side effects may be different to the ones listed here and the type of treatment you have will also affect your side effects, and the impact on your sex life.
You may not feel like sex at all while you are having your treatment, or for some time after you are diagnosed. Many people feel very low after they have been told they have cancer and don’t feel interested in sex. But some people react to their diagnosis by feeling they should be packing as much into life as possible. If you feel like this, and treatment has caused erection problems, this may be hard to bear.
Whatever happens at first, remember that things will change. To see how your sex life will be affected, you will need to wait until at least the end of your treatment. And it is best to wait until you are feeling more back to normal.
Some of the side effects listed here are temporary – for example, tiredness and diarrhoea due to radiotherapy will wear off some weeks after your treatment has finished.
The Prostate Cancer UK website has information for gay and bisexual men about side effects of treatment.
You cannot pass the cancer to a partner
Cancer is not contagious. You will not pass cancer on to your partner during sex.
Side effects
Diarrhoea
Some men get diarrhoea during radiotherapy and for some time afterwards. This can be unpleasant and tiring and may put you off wanting to have sex. However, it will gradually go back to normal after a few weeks.
Tiredness
You may feel too tired to want sex for some time after prostate cancer treatment. There is information about coping with tiredness in the section about coping with prostate cancer.
Leakage of urine
If you have leakage of urine (incontinence) or a catheter into your bladder, you may feel embarrassed and that may put you off sex. You can get help with urine leakage from your specialist nurse.
Less interest in sex
Prostate cancer and its treatment can affect your libido (your desire for sex.) Hormone therapy for prostate cancer reduces your sex drive so you may have less interest in sex. This is because of the drop in testosterone – the hormone responsible for giving you a sex drive.
Consider asking your doctor or nurse about **intermittent hormone therapy**. This involves stopping treatment when your PSA level is low and steady, and starting it again if your PSA level starts to rise. Your desire for sex may improve after hormone therapy is stopped, but this can take several months.
You might want to try treatments for erection problems, even if your sex drive is low. Some of the treatments for erection problems may still work for you.
Hot flushes and sweats
Hot flushes and sweats can be a side effect of hormone therapy or removal of the testicles (orchidectomy). They may be at their worst when you have just started your hormone treatment, or have just had your testicles removed. The flushes and sweats may get better with time. They may become less frequent or stop altogether. Or you may not be troubled by them at all.
Everyone reacts to cancer treatment in different ways, both emotionally and physically. If you are having problems with sweats and flushes talk to your doctor or specialist nurse. They can prescribe medicines to help.
Difficulty getting an erection (impotence)
Difficulty in getting an erection can be caused by radiotherapy to the prostate; prostate surgery; having both testicles removed and most types of hormone therapy. There is information about erection difficulties on the Prostate Cancer UK page.
Erection problems can be permanent or temporary. And they can be affected by your mood and feelings. If you are having problems, they may sometimes be caused by anxiety and not the effects of treatment. You may find it difficult to talk about this both with your doctor and with your partner.
Remember that your doctor and specialist nurse will have treated many other men with the same problem so there is no need to feel embarrassed. If they cannot find treatments to help you, they can refer you to specialist sexual therapy advisors.
If you are worried about talking to your partner, it may be because you are afraid that they might reject you, or be angry with you in some way. But your partner may be wanting to talk things over.
Infertility and prostate cancer treatment
Treatment for prostate cancer will mean that you cannot father children in the future. This is called **infertility**. This can be very hard to accept, especially if you were hoping to have children. You and your partner need to discuss this with your doctor before you start treatment, particularly hormone treatment or radiotherapy. Some men may want to collect and store sperm before they start treatment.
