You may notice other changes that affect your sexuality and how you express intimacy.
Learn more about:
Loss of libido
Reduced interest in sex (low libido) is common during cancer treatment. While anxiety and fatigue can affect libido, it can also be affected by androgen deprivation therapy (ADT), which lowers testosterone levels, and by the sexual side effects associated with radiation therapy or surgery. Sex drive usually returns when treatment ends, but sometimes changes in libido are ongoing. Learn tips for managing changes in your sex life.
Dry orgasm
After surgery, you will feel the muscular spasms and pleasure of an orgasm, but you won’t ejaculate semen when you orgasm. This is known as a dry orgasm. A dry orgasm happens because the prostate and seminal vesicles that produce semen are removed during surgery, and the tubes from the testicles (vas deferens) are sealed.
Radiation therapy may also affect how much sperm you make, but this is often temporary. While you may worry that a dry orgasm will be less pleasurable for your partner, most partners say they don’t feel the release of semen during intercourse.
Leaking urine during sex
A radical prostatectomy can weaken the sphincter muscle that controls the flow of urine. This may cause a small amount of urine to leak during intercourse and orgasm. You may find leaking urine during sex embarrassing, but there are ways to manage this. Before sex, empty your bladder (urinate). Consider having sex in the shower, or use a condom or a constriction ring (available from sex shops) at the base of the penis to prevent leakage. Speak with your doctor if you are still concerned.
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More resources
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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