How can prostate cancer affect your sexual life and sexuality?
While this toolkit uses male pronouns, we acknowledge that people assigned male at birth who identify as members of the transgender and LGBTQIA+ community are also impacted by prostate cancer.
Sex is often thought of as a physical activity, whereas sexuality is more about feelings of sexual desire, how you see yourself and feel about yourself in a sexual way. When people speak of intimacy, they are referring to the giving and receiving of love and affection, comfort and safety, understanding and warmth. They are different but are often intertwined.
Being diagnosed and treated for prostate cancer can affect how you feel, your sexual function, sexuality and the intimacy in your current or future relationships.
The physical side effects of treatment can be challenging for you in many ways. Side effects from treatments (e.g. erectile dysfunction, reduced penis length and dry orgasm) may affect how you feel about yourself, your sense of masculinity and your sex drive. Follow the link to Sexual Function to learn the possible effects of treatment.
You might not be feeling your best emotionally as you try to cope with your cancer diagnosis and how it impacts your life, or you may be dealing with fatigue or low mood as a result of treatment. This may affect your wellbeing, feelings of self-worth, and your relationships. Find out how to manage your mental wellbeing by following the link to: Psychological Wellbeing.
How do you manage changes in sexual function when you are sexually active?
If you are in a relationship, both you and your partner need to discuss what’s important to each of you. A good place to start is to think and talk about what your normal sex life is and how your treatment may affect it.
After or during prostate cancer treatment, it’s likely you’ll need to renegotiate your sex life. That means you may find penetrative sex less important and focus more on different ways to give and receive sexual pleasure or build intimacy with your partner. Many people find this type of sex even more fulfilling and enjoyable than the sex they had before.
Some people say cancer makes them feel closer to their partners because it gives them a different way of looking at things. But it can also put strain on a relationship because it can change some of the roles and responsibilities. It really does depend on what your relationship was like before the diagnosis and how you both cope with the changes that follow.
The importance of communication
Talk openly to your partner and involve them in treatment decisions so you both build realistic expectations. Couples who can talk honestly about sex report better sexual experiences after treatment.
You may want to resume your sex life on a solo basis if you don’t have a regular sexual partner. This is to be expected as the normal expression of your sexual feelings. If you are starting a new relationship after prostate cancer treatment, communication is key. You can tell them how your cancer has affected you physically and emotionally. Take it slowly. It can be difficult to discuss these changes with someone new. Take your time and tell them when you feel ready. You don’t have to tell them everything at once. Also, what you want to tell a casual sexual partner and what you want to tell a potential life partner may be two very different things. It is entirely up to you as to how much to tell.
It’s a good idea to focus on your relationship and build intimacy first, rather than just thinking about the sexual act.
Some ways you can build intimacy with your partner include:
- Spending time together
- Focusing on the relationship rather than just having sex
- Going on a date
- Buying each other gifts
- Doing activities together
- Take things slowly – you don’t have to have sex right away
- Starting with cuddling or massaging each other the first few times
- Being patient and understanding that it might take time for you and your partner to regain intimacy
You can also give and receive sexual pleasure from:
- different erogenous zones (such as the breasts, ears or thighs)
- oral sex
- sexual aids (such as a vibrator)
- erotic images and stories
- sexual fantasies
- mutual masturbation
How do you manage changes in sexual function when you are an LGBTIQA+ person?
Sex and sexuality are important in LGBTIQA+ people’s lives. Sexual issues caused by treatment can also affect your relationships and mental and emotional health, when you are an LGBTIQA+ person.
The prostate itself, and surrounding area, is an erogenous zone. Surgery to remove the prostate can change your experience of anal sex.
The good news is that research has found people who are LGBTIQA+ are able to successfully engage in sex and intimacy after cancer, and specialised support is available if you need it. Open discussion with sexual partners is important.
You might also like to seek support from a sexual therapist. For counselling and referral, reach out to QLife, a service tailored to members of the LGBTIQA+ community. Visit qlife.org.au or call 1800 184 527. You can also reach out to a PCFA nurse on 1800 22 00 99.
How do you get support for sexual issues?
Discussing your sex life with your healthcare team might seem difficult, but it’s important for you to understand how prostate cancer and its treatments can affect your sexual activities and sexuality. It’s also important as treatment for side effects, such as erectile dysfunction get better results if you start it as soon as possible.
You may also need to discuss with your healthcare team when it’s safe for you to start having sex again after treatment.
Prostate cancer support groups may also be helpful and are located all around Australia. Your GP can help you and those close to you manage your physical and emotional health needs throughout the cancer experience, including help with sexual issues.
You can also talk to a:
- Cancer care coordinator
- PCFA nurse
- Social worker
- Sexual health physician
- Sex counsellor
- Specialist psychosexual service
Learn about the different medical specialists by following the link to: The Role of Medical Specialists.
Make sure you also look after yourself. A healthy diet and lifestyle is important for sexual function and recovery after treatment.
You can find out more about diet, lifestyle factors and how to support your mental wellbeing by following the links below:
Prostate cancer and fertility
All treatments for prostate cancer can affect your fertility. Follow the link to Sexual Function to find out how your sexual function and fertility may be affected by treatment.
A loss of fertility means you will not be able to father a child naturally. If fertility is important to you, ask your healthcare team to refer you to a service that provides fertility-preserving options, such as sperm banking before you start treatment. That way, fathering a child using your stored sperm may be possible in the future. You can also ask your doctor, a member of your healthcare team or a fertility counsellor about changes to your fertility and discuss ways of managing these changes.
You can also reach out to a PCFA nurse on 1800 22 00 99 if you have any concerns, worries or questions about sex and fertility.
Learn how side effects from treatments can affect your sexual function and fertility by following the link to side effects. If you are struggling to cope with the changes to your sexual function, contact your doctor or a member of your healthcare team.
- Sex, sexuality and intimacy are all different but are often intertwined
- Prostate cancer treatments can affect your sex life, how you feel about yourself sexually and your ability to be intimate
- You may need to renegotiate your sex life when in a relationship or decide on whether and what you tell new or casual partners
- Communication is always important when you are sexually active and/or in a relationship
- It’s a good idea to focus on building intimacy and fostering your relationship, rather than the sexual act
- There are many ways you can build intimacy and give or receive sexual pleasure
- Specialised support are options available to LGBTIQA+ people
- There are a number of health professionals available for support and advice
- For sexual health it’s also important to look after your physical and mental heath and wellbeing
- All treatments for prostate cancer can affect your fertility – seek advice on fertility preserving options before treatment if fathering a child is important to you