Prostate cancer treatment can be life-saving. But the aftermath of treatment side effects can have a devastating impact on the quality of life for a man and his partner. The common side effects of erectile dysfunction (ED) and incontinence can be temporary or ongoing. Regardless of the duration, they pose a challenge to maintaining a satisfying sex life that may be part of a couple’s intimate relationship. Without acknowledgement and resolution, these issues can develop into a wedge that can fracture a couple’s physical and emotional bond at a point when it needs to be strong and sustainable.
The value of Us TOO is in addressing the unmet or underserved needs of the prostate cancer community. Based on recent survey results from Us TOO support group leaders across the country, we recognize the need to address the impact that prostate cancer has on sexual health and intimacy. In addition to updated content on the Us TOO website, we are pleased to introduce Between the Sheets as a new, regular feature of the Us TOO Hot SHEET newsletter.
This column will provide the platform for experts in the field to help men and women by providing answers to questions about sexual health and intimacy challenges that can result from prostate cancer treatment.
- November 2021 – Does prostate surgery decrease sex drive and testosterone levels?
- October 2021 – Can L-arginine help with my erectile dysfunction?
- September 2021 – It seems like I start out with a good erection and then I lose it during sex, and now I worry about losing my erection during sex. What can I do?
- August 2021 – My wife keeps telling me that it doesn’t matter that I can’t get an erection, but I don’t think she’s telling me the truth! We used to have a great sex life but since I had radiation, all that has ended. Is it possible that she’s seeing someone else on the side?
- July 2021 – What kind of lubricant can I use with the vacuum device and what if my wife likes other kinds of lubricants during sex?
- June 2021 – It’s been 5 years since my prostate surgery, and nothing has helped me to get erections. Not the pills or the pump or even the injection and I don’t want to have an implant and, anyway, I can’t afford it. I am so sad about this and also mad that I was not told that this could happen. But I can’t turn back the clock and here I am. How do I get over this?
- May 2021 – I don’t notice much difference between generic sildenafil and Viagra. Is there a difference? Why can’t I take more than 100mg?
- April 2021 – My urologist has recommended that I use an injection in my penis to get erections because nothing else has worked. I am really not keen to do this – please help!
- March 2021 – Do you have any advice to improve communication with my wife? Sometimes it feels like we are just on completely different pages when we are trying to talk to each other, especially if we disagree.
- February 2021 – My wife has decided that due to COVID, we can no longer kiss or do anything sexual. I know I’m on borrowed time because I had radiation therapy and they told me that my erections would get weaker over the 2 years after treatment. It’s been 17 months since the radiation and that means that I have only 7 months left. Is she right?
- January 2021 – Can you offer some pointers for success with using the vacuum device for sex?
- December 2020 – I can’t get the answers I need for my questions or problems but I am really frustrated at the length of time it is taking for things to return to normal for me. I had radiation (36 treatments) that ended about 9 months ago, as well as hormone therapy with my last injection 3 months ago. I am still having hot flashes and I have not seen any return of erections, never mind sexual interest. I’m 74 years old and I feel like my life is over. I thought that once my treatment was done I would see improvements in all areas but, so far, things are as bad as they ever were. Am I alone in this? What do other men experience?
- November 2020 – I was wondering if you could go over the changes that occur after nerve sparing prostate cancer surgery?
- October 2020 – This question is more about my wife than me. I had surgery to remove my prostate for high-grade cancer nine months ago. My PSA didn’t go down to zero and I had positive margins, so they recommended I have radiation and hormone therapy too. Due to the length of treatment we had to change our plans for the winter. We had to stay home in the Northeast and it has been a brutal winter, especially after being in Florida at this time for the past five years. The real problem is that my wife is driving me nuts! She’s angry and sad, crying a lot or telling me that I’m not listening to her and I just want her to stop! I’m not really sure what she’s so upset about – I’m the one with prostate cancer, I’m the one who can’t get it up – doesn’t she think it’s upsetting to me too? But what can I do about it? What’s done is done and here we are. How can I make her stop?
- September 2020 – I feel very fortunate to be free from cancer after my surgery. I hate to admit it, but the erectile dysfunction really messes with my mind. I didn’t think it would bother me as much as it does, but I don’t feel like the man I was anymore. Do you have any advice for me?
- August 2020 – I am starting something called SBRT (I’m not 100% sure what that is!) later this month and I’m afraid to have sex with my girlfriend (we recently got together after I was widowed a year ago) in case I pass on the radiation to her. I have had difficulty finding any information about this.
- July 2020 – It has been about 13 months since my robotic nerve-sparing radical prostatectomy surgery. I wondered why my erections seem stronger when I am working on the penile rehabilitation on my own and sometimes during a bowel movement then when I am trying to have sex with my wife?
- June 2020 – I got a prescription from my family doctor for Viagra but it doesn’t work at all. I had my prostate removed about six months ago and I sailed through the surgery. I’m 60 years old and I was assured that everything would work as normal after the surgery. Is it me or am I missing something here?
- May 2020 – I have been feeling it is difficult to connect with others due to the coronavirus (in addition to the difficulty in continuing to deal with prostate cancer). Do you have any guidance?
- April 2020 – I have chosen to go on active surveillance because I have low risk prostate cancer (diagnosed 6 months ago) and I do not want to deal with the prospect of sexual changes after surgery or radiation. I am recently divorced and sex is important to me, especially now that I am single (and looking!). I have noticed in the past few months that my erections are not as rigid as they once were. Could this have something to do with being on active surveillance? I am 61 years old and have never had this problem before.
- March 2020 – The cost of Viagra and Cialis has gotten so expensive. My friend said he is using generic Viagra and it is working well and much cheaper. Is that true?
- February 2020 – I’m confused about the role of penile rehabilitation in getting erections back after surgery. I’m 67 years old and having robotic surgery in 3 weeks. I have been reading on the internet about something called penile rehabilitation and I’m not sure what to do about this. My urologist told me not to bother but a couple of my friends who have had the surgery (not by my urologist) said that their urologist told them that they must start this before the surgery. They also said that they were told different ways of doing this – pills, pumps, injections – and I don’t know what to do!
- January 2020 – My wife and I are trying to enjoy sex without any erections and she also has some issues that make vaginal penetration uncomfortable, can you explain about “outercourse”?
- December 2019 – My husband of 32 years has been a great partner and father to our four kids. He has always been a good provider and I love him very much. We married a little late (I was 30 and he was 35) and while we have had our financial challenges over the years, we managed to get through them all. We are now comfortable in retirement and I thought these were going to be the golden years everyone talks about.
- November 2019 – I had brachytherapy 18½ years ago but about two years ago started having some ED symptoms. My urologist gave me 20mg of Cialis but it did nothing. I found a supplement with Tongkat extract (has heavy B6 and other extracts) that seemed to help for a while but not anymore. Is there anything to the advertisements I hear about supplements?
- October 2019 – I’m 71 years old and finished radiation therapy about six months ago. All went well and I am told that I have no evidence of disease. I do need to have nine months of hormone injections and, while I don’t really want to do this, I feel that I have to do what the doctors have recommended.
- September 2019 – At age 71 I was diagnosed with prostate cancer and had seed implants which were effective. After healing from the implants, I had no erection problems for 6-7 years but then it slowly began to be a problem. Viagra and Cialis were helpful, somewhat, for a while but then even those did not help. The frustrating and strange thing is I still wake up numerous times at night with erections. Articles about ED seem to center around blood flow to the penis or psychological problems. Are sleep time erections created from blood flow or some other function? If blood flow, why the problem during sexual activities but not during sleep?
- August 2019 – Since going on hormone therapy I have gained a lot of weight. I don’t know what to do about this – I have tried dieting and the weight won’t budge. I have had to buy new clothes and I can’t wear polo shirts anymore because of my bulging stomach; I look terrible in everything. I know that men aren’t supposed to bother about this, but I do and it’s costing me a lot of money!
- July 2019 – I had radiation along with hormone therapy two years ago and, since then, I have not had any erections. I expected this and this is bad enough but my penis has almost disappeared. I can hardly find it when I need to urinate and it has made things really awkward at the golf course or any public restroom. Why has this happened and what can I do about it?
- June 2019 – My partner and I are struggling with our changing sex life because of my lack of erection rigidity after my prostate surgery during sex. We have been together for more than 20 years and over the year since my surgery, I have begun to get partial erections, but they are still not hard enough for sex, even with the pills. Any advice on how we can continue to enjoy sex, given my lack of erection rigidity?
- May 2019 – Should my partner wear a condom while he is on Zytiga? … and … I am able to have the occasional erection but they are not reliable and, of course, this is making me frustrated. But what I did not realize is that I don’t have orgasms – nothing comes out! They didn’t tell me about this before the surgery!
- April 2019 – Until about six months ago, using the pump produced acceptable length and hardness. Since then, at age 79, there is usually insufficient length and hardness … I am just about ready to begin “the pill.” Any extra effects from the pill that I should be aware of?
- March 2019 – I’m 68, and have undergone laparoscopic surgery in 2007. I have bladder control 99% of the time. I do not have erections you can count on for sexual function…
- February 2019 – Can you provide information on rejuvenation therapies for erectile dysfunction…
- January 2019 – Ever since my surgery (open radical prostatectomy) my orgasms are pretty non-existent…
- December 2018 – After my surgery, I was surprised to find that I had an orgasm…
- November 2018 – Ever since my surgery I leak urine during sexual activity…
- October 2018 – Erections after nerve-sparing prostate surgery…
- September 2018 – Struggling with managing post-treatment side effects of ED and incontinence…