Home  Prostate cancer Questions and answers Sexual function
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The inability to achieve or maintain an erection long enough to reach orgasm can be divided into the inability to achieve an erection (impotence) and the lack of desire to have sex (loss of libido).
Radiotherapy and surgical removal of the prostate may cause erectile failure. After surgery or radiotherapy, initial difficulties in erection may slowly recover, possibly within a period as long as a year. Erectile failure following surgery or radiotherapy can be treated with treatments as sildenafil, although it is not always effective.
Surgical removal of the testes (orchidectomy) reduces the level of the male hormone, testosterone and this will result in sexual impotence, which is permanent.
LHRHa’s, which provide a medical castration by reducing the levels of testosterone, can also cause impotence. The failure of erection caused by LHRHa’s usually recovers if treatment is stopped, since testosterone levels return. However, drug treatment often has to be taken indefinitely.
Non – steroidal anti-androgens do not reduce the levels of testosterone, but prevent (block) it from working. As a result they are less likely to interfere with sexual activity. There is evidence that these treatments (i.e. bicalutamide) help patients retain some sexual activity during long-term treatment.
Loss of libido means that you become less interested in sex and sexual activities, which can occur as part of the normal ageing process.
Surgical (orchidectomy) or medical castration (LHRHa’s) act against prostate cancer by preventing the production of testosterone. Testosterone stimulates the brain into sexual interest. Therefore, if there is a loss of this hormone, patients experience a lack of sexual desire (libido), which can then lead to impotence. Both libido and potency should return to normal if treatment is stopped. However, orchidectomy for prostate cancer will often cause permanent loss of libido.
Non – steroidal anti-androgens do not reduce the levels of testosterone, but prevent (block) it from working. As a result they are less likely to reduce interest in sex. There is evidence that compared to castration, these treatments (i.e. bicalutamide) help patients to retain their interest in sex.
Radical prostatectomy can result in loss of ejaculation. Other sexual problems after prostatectomy can include loss or reduction in orgasm and involuntary loss of urine at orgasm. There are practical ways of reducing these unwanted effects.
If you have received radiotherapy treatment for prostate cancer, it is possible that you may experience a sharp pain as you ejaculate. This is caused by the irritant effects of the radiation on the urethra (the tube which carries the urine from the bladder to the opening of the penis). Once your course of radiotherapy has ended these effects should become less troublesome. |
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