You may have trouble getting or keeping an erection firm enough for intercourse or other sexual activity after any treatment for prostate cancer. This is called erectile dysfunction or impotence.
While erection problems become more common with age, they can also be affected by:
- health conditions such as diabetes and heart disease
- certain medicines for blood pressure or depression
- previous surgery to the bowel or abdomen
- smoking or heavy drinking
- emotional concerns.
The prostate lies close to nerves and blood vessels that help control erections. These can be damaged during treatment. If the nerves are removed during surgery, erection problems occur immediately. After radiation therapy and androgen deprivation therapy (ADT), problems may develop more slowly.
The quality of your erections usually improves over time and can continue to improve for up to three years after treatment has finished. Sometimes, erection problems may be permanent.
Before and after treatment, you can help keep your penis healthy (penile rehabilitation) in various ways. These may include:
- engaging in foreplay and other sexual intimacy with a partner or masturbating
- trying to get erections, starting a month after surgery
- taking prescribed medicines to maintain blood flow in the penis
- stopping smoking and limiting the amount of alcohol you drink
- doing pelvic floor exercises
- injecting prescribed medicine into the penis.
Learn more ways to improve erections. Even without a full erection, you can still reach orgasm by stimulating the penis. Learn about other changes to sexuality and tips for managing changes to your sex life.
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A/Prof Ian Vela, Urologic Oncologist, Princess Alexandra Hospital, Queensland University of Technology, and Urocology, QLD; A/Prof Arun Azad, Medical Oncologist, Urological Cancers, Peter MacCallum Cancer Centre, VIC; A/Prof Nicholas Brook, Consultant Urological Surgeon, Royal Adelaide Hospital and A/Prof Surgery, The University of Adelaide, SA; Peter Greaves, Consumer; Graham Henry, Consumer; Clin Prof Nat Lenzo, Nuclear Physician and Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics, and Notre Dame University Australia, WA; Henry McGregor, Men’s Health Physiotherapist, Adelaide Men’s Health Physio, SA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, NSW; Dr Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; A/Prof David Smith, Senior Research Fellow, Daffodil Centre, Cancer Council NSW; Allison Turner, Prostate Cancer Specialist Nurse (PCFA), Canberra Region Cancer Centre, Canberra Hospital, ACT; Maria Veale, 13 11 20 Consultant, Cancer Council QLD; Michael Walkden, Consumer; Prof Scott Williams, Radiation Oncology Lead, Urology Tumour Stream, Peter MacCallum Cancer Centre, and Professor of Oncology, Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC.
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