Sexual Intimacy After Treatment

During a recent virtual support group meeting, we had several new folks (men and their partners) show up, along with many questions on sexual intimacy following the various treatment options for prostate cancer.

Understanding your sexual relationship

Without prying into personal matters in an open forum, one of the things we suggest is that couples need to understand the status of their current sexual relationship. Is it one that is quite active, moderate, occasional, or of little importance to each of the partners in the relationship? And yes, it can be different for each partner, and perhaps it is a topic that has not been discussed in the past.

With that established, it is easier to begin looking at the pros and cons of different treatment protocols and the expectation both the patient and partner have following treatment.

Every patient is unique

Additionally, it is important to also understand that every patient is unique, and the resulting impact of any treatment is somewhat dependent on a patient’s reaction.

For example, when I underwent androgen deprivation therapy in the form of Lupron, I experienced significant levels of discomfort. Not only did the 6-month shot last for 14 months, but I also experienced sleep-disturbing night sweats, hot flashes, a 25-pound weight gain, and bouts of depression.

In sharp contrast, some in our support group hardly knew they had taken the shot. Several years later, I sailed through 40 radiation treatments with little to no impact, while others had issues. You just do not know how your body will react.

Considering prostate cancer treatment options

There are different treatment options. Yes, you can find others, but some of the most common forms used today include:

• Surgery: it includes removal of the prostate, with more of it being done today using robotic assistance
• Radiation therapy: the treatment of cancer that leaves the prostate in place while trying to kill the cancer cells with external beam radiation or seed implants
• Hormone therapy: can typically be given in shots and may impact both the quality of erections and sex drive

Different side effects

Prostate cancer treatments can impact sexual function in different ways. Surgery may impact the ability of men to have normal erections and can change other aspects of sexual function, like experiencing a dry ejaculation (no discharge of sperm), or a decrease in the sensitivity of an orgasm. Radiation can result in pelvic discomfort, rectal problems and issues related to ejaculation.

Prior to being given Lupron, my urologist casually noted that I may experience a slight decrease in libido. Wow, talk about an understatement.

Following my shot, ALL of my libido was lost for 14 months. Fortunately, we have had a great marriage for the past 55 years and have learned the power of speaking up and sharing information. And to be very candid after 3/4 of a century of living - one’s sex drive does tend to wane somewhat.

Finding support

In my opinion the key to approaching any of the treatment options for prostate cancer is to identify and find resources that can help you support your relationship. Specifically identify counselors or support groups that can help get you through the first phase where things are both different and potentially difficult.

Support groups, counselors, and sex therapists can go a long way to help you on your journey of discovery and new ways of finding intimacy.