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Prostate Cancer, Sexuality & Intimacy:
Everything You Wanted To Know But Didn’t Know to Ask
Women Against Prostate Cancer is working to unite the voices and provide support for the millions of women
affected by prostate cancer. This fact sheet is designed to address a number of intimacy related questions
er and concerns that thousands of men and their partners face when diagnosed with prostate cancer. You
can find additional questions and answers on our website at: www.womenagainstprostatecancer.org
Rehabilitation and Recovery
anc g Q.
Are there techniques for enrichment in intimacy after prostate surgery?
There are a number of techniques to improve intimacy after prostate surgery and couples may have to try
several different options or a combination of options before they find something that works for them. Before
surgery you will want to discuss penile rehabilitation with your physician (see next question) to enhance the
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ability to get an erection. Bear in mind that impotence is a common side effect of prostate surgery and it can take
a year or more for the nerves damaged during surgery to recover. Meeting with a sex therapist may also help you
discover creative ways to be intimate including using toys, masturbation and other methods. Additionally, men
may also experience fluctuations in libido following surgery often due to psychological stress.
What is penile rehabilitation?
rosta o@w A.
Penile rehabilitation is used to treat erectile dysfunction caused by cancer therapy. It is an active
intervention to intermittently stimulate the penis during the recovery period. Penile rehabilitation should start
immediately following the catheter removal. With many physicians, the use of oral pills, vacuum erections
devices, or penile injection therapies are the first to be pursued. However, the optimal regimen is still unclear and
may vary by patient. Patients may try PDE-5 inhibitors (i.e. Viagra, Cialis, Levitra) and keep in mind that oral
medicine will not work for everyone. Only about 90% of patients will respond to medicine, even in those who
had normal sexual function prior to surgery, Q.
How long does sexual recovery take?
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This probably comes as no surprise, but the time it takes for full sexual recovery is different for everyone and
is impacted by the therapy they choose. Full recovery is achieved when the quality of erection is as good as it was
prior to surgery. However, potency following surgery is usually defined as the ability to have intercourse in more
Erectile Dysfunction (ED)
Will there be ED post-radiation treatments (Proton, IMRT, EBRT)?
Maybe, the percentage of men with ED following radiation varies by the treatment regimen and can range
omen A w Q.
What are the available treatments for ED?
The most common treatments for ED include counseling/sex therapy, oral medications, penile
injections and vacuum erection devices. You can speak with your physician about obtaining a prescription for oral
medications, penile injections or a vacuum erection device. In addition to or in place of these methods you and
your partner may choose to visit a counselor or sex therapist who is specially trained to help people work through
their sexual and intimacy problems through talk therapy. Q.
Will my partner suffer from depression due to ED?A.
It is common for patients to suffer depression from the inability to get or maintain an erection. Remember
to show your support for him during this time by lending your ear and communicating your own feelings openly
and honestly. Consulting with a sex therapist may help in this process. Vacuum Erection Devices (VEDs)
What is a VED and are erections different with VED’s?A.
A vacuum erection device or VED uses a vacuum to fill the penis with blood. Then, a rubber ring is placed at
the bottom of the penile shaft to maintain the erection. Some men may feel discomfort from squeezing sensation
Prostate Cancer, Sexuality & Intimacy: Everything You Wanted To Know But Didn’t Know to Ask
Are penile injections painful?A.
The injections usually sting a little. It is also very important to work with your doctor to determine the
correct dosage in order to avoid priaprism which is a well known side effect caused by too high a dose or
incorrect mix of medications for the injection. Priaprism is a persistent, usually painful, erection that lasts more
than four hours without physical or psychological sexual stimulation. It make take some time to determine the
correct dosage for each individual. Q.
How long will erections last?A.
Typically erections last 30 minutes to 1 hour, but may last longer. This may depend on a number of factors
including a man’s general health and whether the correct dosage was injected properly. If an erection lasts more
than 4 hours call a doctor or go to the emergency room immediately.
Orgasms, Incontinence & Toys
Can you have an orgasm without an erection?A.
Yes orgasm can be achieved without an erection.Q.
Can vibrators help men achieve better orgasms?A.
While no studies have been done on this particular topic, couples are encouraged to try different methods
such as incorporating vibrators to see if they work for you. Q.
Do penis rings help maintain an erection?A.
Yes, penis rings may help maintain and prolong an erection. Q.
Can there be urinary incontinence on arousal or orgasm?A.
Urinary incontinence is common during the early phase of recovery following surgery and over time the
incontinence should decrease or stop all together, although there is a small chance that it may not. Be sure to
speak with your doctor about the side effects of your chosen treatment method.
Stress, Anxiety & Depression
Will my loved one become depressed or anxious as a result of prostate cancer?A.
It is likely that he will, this is why partners should always be encouraged to come to the initial consultation
for prostate cancer treatment so that they have a better understanding of what the patient is experiencing. Re-
main patient and loving during this time and seek support through friends, family, faith communities or support
How can depression affect our relationship?A.
Depression has an impact on any relationship. Open and honest discussion is always recommended, and
when necessary counseling or therapy can be helpful. One of the most difficult aspects of depression is that the
signs and symptoms can creep up in many different areas including mood, appetite, sleep patterns, sex drive,
behavior, memory, concentration, and more. Q.
How can i ease stress & anxiety related to intimacy after prostate cancer diagnosis or treatment?A.
Always maintain the perspective that restoring potency following prostate cancer treatment is part of the re-
covery process. In other words, as with all treatments, recovery takes time. It has been reported that erection can
return as far out as 4 years after surgery. You can also encourage your partner to see a therapist or attend therapy
with your partner. As stated earlier, it may be helpful to find support through friends, family, faith communities
Please note: Women Against Prostate Cancer does not provide medical services. Rather, this
information is provided to encourage you to begin a knowledgeable dialogue with your physician.
Deirdre Gallagher has been a practicing trial attorney for seventeen years, representing companies in complex litigation in both Missouri and Illinois. She has tried over 30 cases to verdict in various state and federal courts. Although Ms. Gallagher’s practice encompasses the defense of class actions, mass torts, and toxic exposure
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