Changes in ejaculation

After some cancer treatments, you may still be able to orgasm, but how you ejaculate may change.

Retrograde ejaculation – After transurethral resection of the prostate (TURP) surgery, semen may go backwards into the bladder, rather than forwards out of the penis. This is called retrograde ejaculation. It is not harmful, but it does mean that you will be infertile and unable to get someone pregnant naturally.

Dry orgasm – Some surgery, including prostate removal surgery, stops the body from making semen. This means that when you orgasm, nothing comes out (called anejaculation). This may feel quite different. Some people say this type of orgasm doesn’t feel as strong or last as long as an orgasm with semen, while others say it’s more intense.

Leaking urine – After some types of cancer treatment, including for testicular or prostate cancer, you may leak a small amount of urine (pee) during ejaculation. This is not harmful.

Premature ejaculation – Some people with cancer may experience early ejaculation, before or just after penetration.

Ejaculation changes after radiation therapy – After some cancer treatments, including radiation therapy to the pelvic area, you may ejaculate less semen, and the semen may look slightly discoloured.

If the urethra is inflamed, ejaculation may be painful for some weeks. Radiation may also reduce sperm production, which may be temporary or permanent. If you might want to have a child in the future, talk to your doctor or nurse about saving sperm or other fertility options.

Learn more about radiation therapy.

Tips for adapting to ejaculation changes

• Talk to your partner about the changes. Let them know that it doesn’t affect your enjoyment of sex and that you can still have an orgasm.
• Include lots of foreplay to build arousal and increase your satisfaction.
• Try to urinate (pee) before sex to reduce any chance of leaking urine.
• If you or your partner are worried about urine leaks, you can use a constriction ring (available from sex shops) at the base of the penis during sex. It puts pressure on the urethra, which stops urine from passing through.
• Use a condom to catch any urine leaks, or if your partner doesn’t like the changes to the semen you ejaculate.
• Do pelvic floor exercises to improve your bladder control.
• If you are worried about premature ejaculation, try changing to a position that reduces stimulation.
• Ask your doctor or a sex therapist about medicines or numbing gels.
• Use the stop–start technique if you are ejaculating too soon.
• Focus on enjoying sexual activity. Worrying about controlling ejaculation may lead to erection problems or loss of interest in sex. Counselling may help if your anxiety becomes a concern.

For men who have sex with men, changes to ejaculation may feel more significant. See LGBTQI+ people and cancer.

Sex was the last thing on my mind when I found out I had cancer. I couldn’t imagine ever having desire again. But after the treatment was over, it came back.

PAT

→ READ MORE: Difficulty reaching orgasm

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