Sex After Cancer
There is nothing, absolutely nothing, redeeming about cancer. And in many cases, treating it wreaks even more havoc on your body, mind…and sex life. But alas, broken crayons can still color, and much of what cancer does to unravel sex can be repaired.
A Sex Trio
In order to understand how cancer can affect a man’s sex life — and what’s possible after cancer — it’s first necessary to understand the essential elements of male sexual health: sex drive, erections and ejaculation. Let’s break it down.
Libido. Sex drive falls like a brick with severe stress of any kind, whether it be emotional or physical. And cancer is a hell of a body stressor. It’s no surprise then that cancer and its treatment (surgery, chemotherapy and radiation therapy) are more than enough to squelch sexual desire. The solution: acupuncture, yoga, massage or exercise: Get your mind and body to relax and unwind. Try to maintain a healthy weight and sleep patterns if possible. Prioritize simplicity. Replace testosterone if it is low. And continue to hope — one of the best 4-letter words out there.
Erections. The penis is known to have a mind of its own and it too feels the stress of cancer on the body. Exhausting cancer treatments like chemotherapy and radiation are also kill-switches for erections. Surgery and radiation for prostate cancer are particularly injurious as these treatments can damage the nerves that govern erections. In general, surgical-related erectile dysfunction (ED) is worse early on and improves with time, whereas radiation-related ED is better early on and worsens over time. First line treatments for ED are the little blue pills (PDE5 inhibitors) and their popular brothers known to all of us. After that, we go “local” with penile suppositories, injections, vacuum erection devices and surgical implants if needed. The bottom line is we can reawaken that erection that cancer put to sleep.
Ejaculation. Disordered ejaculation consists of dry, rapid, delayed, or total absence of ejaculation. As ejaculation is a true reflex, like a sneeze, it is very susceptible to nerve injury from radiation, or from abdominal, pelvic or spinal surgery. Typically, damage to thread-like pelvic nerves causes either retrograde (backward) ejaculation due to poor bladder neck closure or true absence of ejaculation. Both of these are difficult to treat but may respond to adrenaline-like drugs in a minority of cases. I’ve also been working on developing a procedure to “puff up” the bladder neck to help it close more tightly during ejaculation and restore forward (normal) ejaculation. Delayed ejaculation from decreased penile sensation can be due to surgical nerve damage or chemotherapy and is difficult to correct. Ejaculation after prostate cancer surgery is uniformly dry due to removal or blockage of all organs that contribute to normal semen volume. Early or premature ejaculation with cancer is typically stress-related or ED-related and correctable with stress reduction or improved erections.
The field of men’s sexual health is all about helping out when it comes to cancer related sexual dysfunction. Give us a shout. We’d love to help you get your sex life back on the right track.