Prostate Cancer Survivors Battling Sexual Dysfunction in the COVID-19 Era

Last updated: December 2021

I work as a pelvic floor physical therapist. I got into this line of work because I had inexplicable pelvic pain of my own. It took several years of self-discovery and lots of research to learn that the pelvic floor responds very readily to stress and anxiety of the body and mind.

The pelvic floor muscles control our bodily functions of urination, defecation and sexual activity. These small saddle muscles of the human body can become shortened and tight in a person living under protracted stress. Almost like a fearful dog, the tailbone of a human tucks under the body, much like a dog whose tail won’t wag when the canine senses danger.

A life-altering event

In treating men with prostate cancer, I have observed a war-torn feeling that accompanies this diagnosis. Some men who come to the office where I work suffer from post-traumatic stress disorder; that is to say that those with prostate cancer have been through a battle which is solitary and stark and real.

Post-traumatic stress disorder is now well-recognized as a condition associated with living through a life-altering event, and this can trigger flashbacks and moderate to severe anxiety for those who have it. Prostate cancer would certainly fall into the category of a life-altering event.

More sexual dysfunction

Now, let’s add a global pandemic on top of an already near-boiling cauldron of worry about one’s prostate cancer treatment and aftermath. While I was completely aware of how my pelvic floor responded to stress in my outside environment, I was startled to see what happened to my prostate cancer patients in the wake of COVID-19.

Some patients reported a recurrence of urinary leakage which had been previously mastered following surgery or radiation years ago. I heard stories of unrelenting constipation and rectal spasms. But the most salient commonality of the men who had already beaten prostate cancer years ago and were now living through COVID-19 was sexual dysfunction.

Another dose of anxiety

Let’s face it: I think men with prostate cancer have already fought their own personal war with the disease. They are veterans now. They are owed a military pension and some well-deserved rest. Yet when COVID-19 tore through the globe in no more than three months (the winter of 2020), these survivors of cancer were handed another dose of anxiety. This was PTSD multiplied exponentially. It just wasn’t fair.

The symptoms of increased urinary leakage, constipation and erectile dysfunction all correlate with increased tension in the pelvic floor muscles. And living through traumatic events induces fear, which can lead to postural and bodily changes as clearly seen in the dog whose tail is tucked underneath him. In a study in 2015, sexual dysfunction was common among veterans of war who had been diagnosed with post-traumatic stress disorder.1

What you can do

Now that it is clear that cancer and pandemics can lead to shortening of the pelvic floor muscles and result in the worsening of the basic bodily functions of elimination and sex, what can you do with that information? First, you can acknowledge that the changes in your body during heightened stress are quite real. Unusual urinary patterns or decreased sex drive are not imagined.

Secondly, engaging in activities to calm the nervous system during a time of war is not only helpful, it can be essential to restore the body to some degree of relaxation, if only for a few minutes daily. Such activities might include walking, deep breathing, spending time with loved ones and pets, or embracing any hobby that you totally dig.

Finally, drinking more water can assist the body in producing a more consistent urinary stream, reduce leakage and help prevent constipation. Remember that the guys in the foxholes during World War II didn’t have access to lots of fresh and clean water; but you do!

Keep moving forward

Living through prostate cancer is not easy. Living with prostate cancer AND through COVID-19 is that much harder.

But if there is anything I have learned from the guys with prostate cancer, it is that they aren’t ones for easy. They inspire me every day – their faces are lined from battle fatigue, but they just keep fighting. I would venture to say that prostate cancer survivors are some of the best platoon mates to have during a global pandemic, because they have experience in how to see clearly during the fog of war.

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