Other changes to sexuality
You may notice other changes to your sexual functioning, which can 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 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 you sex life.
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. It happens because the prostate and seminal vesicles that produce semen are removed during surgery and the vas deferens is sealed.
You may also produce less semen after radiation therapy. 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 prostatectomy can damage 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 urine leakage. 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.
Dr Amy Hayden, Radiation Oncologist, Westmead and Blacktown Hospitals, and Chair, Faculty of Radiation Genito-Urinary Group (FROGG), The Royal Australian and New Zealand College of Radiologists, NSW; Prof Shomik Sengupta, Professor of Surgery and Deputy Head, Eastern Health Clinical School, Monash University, and Visiting Urologist and Uro-Oncology Lead, Urology Department, Eastern Health, VIC; A/Prof Arun Azad, Medical Oncologist, Urological and Prostate Cancers, Peter MacCallum Cancer Centre, VIC; Ken Bezant, Consumer; Dr Marcus Dreosti, Radiation Oncologist, GenesisCare, and Clinical Strategy Lead, Oncology Australia, SA; A/Prof Nat Lenzo, Nuclear Physician, Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics and The University of Western Australia, WA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, and HeadwayHealth Clinical and Consulting Psychology Services, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia; Graham Rees, Consumer; Kerry Santoro, Prostate Cancer Specialist Nurse, Southern Adelaide Local Health Network, SA; A/Prof David Smith, Senior Research Fellow, Cancer Research Division, Cancer Council NSW; Matthew Starr, Consumer. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. This booklet is funded through the generosity of the people of Australia.
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