Managing sexual changes – men only

As well as general sexual issues experienced by both men and women after cancer, men may encounter problems with erections and ejaculation.


Erection problems

When a man has trouble getting or keeping an erection firm enough for intercourse, it is called erectile dysfunction (or impotence). For many men, erection problems are a result of anxiety about the cancer, but sometimes cancer treatment damages the nerves.

Erectile dysfunction can sometimes improve. There are also many products to treat the problem, including penile injections, penile implants and PDE5 inhibitor drugs (e.g. Cialis® or Viagra®), which you can obtain through a doctor. There are also herbal preparations, nasal sprays and lozenges that contain testosterone, but check with your treatment team before using any of these.

Tips for managing erection problems

  • Try sex with a half-erect penis. Men do not need a full erection to have an orgasm. This may work best with the partner on top guiding the penis inside.
  • Help satisfy your partner and yourself without using penetration. Experiment with all-over touching, oral sex, masturbation or sex aids.
  • Ask your doctor about taking tablets or having injections to help with erections.
  • Use a vacuum pump device, which draws blood into the penis to make it firm.
  • Consider having an implant surgically inserted into the penis. A pump is placed in the scrotum and squeezed when an erection is needed.
  • If your cancer specialists say it is safe to use with your type of cancer, you could consider testosterone replacement therapy. This may help if you have low testosterone levels.
Read more about erection problems

Ejaculation and orgasm changes

Men who have had their prostate removed produce little or no semen. This means that they may have a dry orgasm, which can be quite a different sensation – some men say it does not feel as strong or long-lasting as an orgasm with semen, while others say it is more intense. They may also experience retrograde ejaculation, where the semen goes backwards towards the bladder, rather than forwards out of the penis. This is not dangerous or harmful.

In some cases after prostate surgery, men leak urine during orgasm. Premature ejaculation can also be a problem for men who are feeling anxious about their sex life.

Tips for adapting to orgasm changes

  • Talk to your partner about the issue. Even if you feel you ejaculate too quickly, your partner may be satisfied, especially after lots of foreplay. If you have no semen, explain why and that it doesn’t affect your enjoyment of sex.
  • Ejaculate often, perhaps by masturbating, to help control ejaculation and increase the amount of semen ejaculated.
  • To minimise urine leakage, empty your bladder before sex. Try wearing a condom to catch any leakage. Pelvic floor exercises can help improve bladder control.
  • To improve ejaculation control, explore medicines or numbing gels or talk to a sexual therapist about the stop-start technique.
  • Concentrate on enjoyment of sexual activity. Worrying about controlling your ejaculation may lead to erection problems or loss of interest in sex.
Read more about ejaculation and orgasm changes

This information was last reviewed in May 2016
View who reviewed this content
View our editorial policy

Support services

Coping with cancer?
Speak to a health professional or to someone who has been there, or find a support group or forum

Rekindle – relationships after cancer
Personalised online resource addressing sexual concerns for all adults, whether in a relationship or single

Cancer information

Your coping toolbox
Strategies for managing difficult situations during and after cancer treatment

View our publications
Guides and fact sheets for people with cancer, their families and friends

SHARE
TOP BACK TO TOP