Reclaiming Sex & Intimacy After Prostate Cancer

Everyday I see patients who are struggling with the issues of sexual dysfunction and/or incontinence after prostate cancer. Every time I speak to a group of men, many of them come up afterwards to tell me how important this information is to them and their partners.

In terms of sexual dysfunction, several issues occur after prostate cancer treatment. First, men typically do not ejaculate fluid after prostate removal (surgery) and/or radiation.  The prostate plays a vital role in contributing some of the volume to ejaculate as well as mixing everything together before it is expelled and that is why a man will typically not ejaculate after prostate removal or radiation.

Second, the penis may atrophy (shrink) up into the body after prostate removal or radiation. This is related to unchallenged sympathetic tone (nerve influence which becomes out of balance after surgery or radiation). This may resolve within a few months, but the lack of regular night time and morning erections can lead to further atrophic (muscle shrinkage) changes causing a more lasting effect.

Third, the nerves for erections lay on the back of prostate and so they are traumatized by either surgery or radiation leaving many men with an inability to get and keep an erection sufficient for penetrative sex. Sometimes this situation resolves as nerves may recover from the trauma and sometimes it does not. If the surgeon is concerned about getting all the cancer during surgery, he may need to remove the nerves leading to permanent erectile dysfunction. Even when nerves are sparred, they often take an average of 1-2 years to recover from the trauma.

The good news is that there are several different treatments for erectile dysfunction. Each treatment has pros and cons and what is right for one man, may not be right for another.

If you are interested in learning more about the topic, you may want to go to the website for my book “Reclaiming Sex & Intimacy after Prostate Cancer Treatment”.  The book was written out of a request from so many men for the information. It is available at

I hope this information has been helpful!



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