Erectile Dysfunction Erectile dysfunction can be a side effect of prostate cancer treatments. There are options to treat and overcome this side effect. Jump To Jump To Talking with Your Partner Treatment Options Resources What is erectile dysfunction?Erectile dysfunction, also sometimes called impotence, is when a man cannot achieve or maintain an erection for satisfactory sex. Erectile dysfunction can limit your intimacy, affect self-esteem, and impact your relationship with your partner.Watch Dr. Lowentritt of Chesapeake Urology discuss erectile dysfunction in this video. What causes erectile dysfunction?Most men who undergo treatment for prostate cancer will experience some erectile dysfunction for the first several months after treatment, even despite nerve sparing surgery or precision radiation. This is because the blood vessels that control an erection are easily affected by any trauma to the area.Knowing that this is a potential and common side effect, be sure to discuss your management strategy for erectile dysfunction with your doctor. Erectile dysfunction can be a difficult topic to discuss, but being open and honest about the problems you are having will allow your doctor to make the best treatment recommendation for you. Side effects from prostate cancer treatments are often different from one man to the next. Talking with your partnerMost men find that their sex life is different after prostate cancer treatment. Some men question their manliness when they cannot have an erection or find that they are not interested in sex. This can happen even if you are not currently in an intimate relationship.You may find this upsetting. Even if one of the medications or erection aids is helpful, having sex using these things may take some getting used to. It may not feel entirely natural. You can talk with your doctor or healthcare team about these feelings. Counseling may also help.This may seem unnecessary in long-term relationships as people tend to assume they know all there is to know about their partner but this is not always the case. With time, you and your partner may be able to find satisfying ways to have a sex life even though you have erectile dysfunction. Your partner will also have concerns about your sex life as well as concerns about your health. Talking about your feelings is very important during this time.If you have an intimate partner, it is important for you to talk to your partner about how you are feeling. There is an old saying that a “problem shared is a problem halved.” Not everyone wants a sexual relationship. Don’t try to guess or assume what your partner wants. Have an open and honest discussion with your partner.If you are not sure how to begin a conversation with your partner, consider using the questions below as conversation starters.I miss being physically intimate with you. I want us to stay close, so what can we do while I look into treatments to solve this problem?This is not easy for me – first prostate cancer, then surgery, now erectile dysfunction. I do not feel like myself. How do we move forward as a couple?Your partner can be a valuable support if you’re feeling a little nervous about doing all the talking. Take them with you when you see your doctor. Talk to your doctor or healthcare team about how you are doing with intimacy.How erectile dysfunction may affect sexual relationshipsProstate cancer and its treatment can affect your desire for sex. Every man is different but the feelings caused by having cancer and the physical stress of treatment can affect the way you feel about your body and your relationships. Some men talk about feeling a loss of their role within the partnership. For others, the physical effects of treatment may lead to tiredness and a lack of energy. Physical changes after some treatments can also affect the way you feel about your body and appearance (your body image). All of these things may result in a lack of interest in sex.If you are feeling tired or under stress, tell your partner how your feel. Loss of interest in sex does not mean you lose interest in a loving and supportive relationship. There are ways to remain physically intimate without having sex. If you are used to a close physical relationship, it is important to remember that hugs, cuddles and kisses maintain intimacy, provide support, and do not have to lead to sex.If you have a partner, it is important that you involve them in any decisions you make about treatment for erectile dysfunction. The loss of sex in a relationship, changes in the way a couple have sex, or starting sex again after prostate cancer treatment can all affect a relationship. Your partner can go with you to your doctor appointments to learn more about your prostate cancer treatment and how to manage your side effects. Relationship therapy may also be available to you. Between the Sheets column 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. Read our Between the Sheets column Can erectile dysfunction be treated?There are several treatment and management options for erectile dysfunction. However, your ability to have an erection after prostate cancer treatment can be affected by several things:How good your erections were before treatmentOther medical conditions like high blood pressure and diabetesOther medicines you may takeYour lifestyle, drinking, or smokingThe type of treatment you had Treatment options for erectile dysfunction As you consider your treatment options make sure you and your doctor consider all of the options. You may want to seek out a prosthetic urologist. These physicians specialize in the treatments for erectile dysfunction and urinary incontinence. They can be an excellent source of information about the risks and benefits of each treatment. Expand All Physical therapy By working with a physical therapist, you can find out if kegel exercises may help relieve your erectile dysfunction. You can also try kegel exercises on your own. Learn more on our Physical Activity and Exercise page. Oral medications There are a number of prescription medications available that may improve blood flow to the penis. Commonly used medications are Viagra, Cialis, and Levitra. Combined with sexual stimulation, this can produce an erection. These drugs are not for everyone. They can interfere with other medications you are taking and negatively impact your health. Injections With injection therapy a needle is used to inject medication directly into the base or side of the penis. The medication allows blood to flow into the penis, creating an erection. See image on left, below. Vacuum erection devices A plastic cylinder is placed over the penis, and a pump (either manual or battery operated) creates a vacuum suction within the cylinder, drawing blood into the penis to create an erection. A stretchable tension band is placed at the base of the penis to help maintain the erection. Intraurethral suppositories An applicator containing a small, medicated pellet or suppository is inserted and released into the urethra through the opening at the tip of the penis. The pellet is about the size of a grain of rice and dissolves to increase blood flow to the penis, creating an erection. Penile implants A medical device that is implanted into the penis. Entirely contained within the body, a pump fills two cylinders and creates an erection. Once activated you can maintain an erection as long as you desire.Penile implants require a surgical procedure by a physician, typically a urologist who has been trained and is skilled in penile prosthetics. There are three different types of penile implants: 3-piece inflatable implant, 2-piece inflatable implant, and a 1-piece bendable (malleable) implant. Because each type of implant offers unique features, the risks and benefits should be discussed with the physician to help choose the most appropriate option. Resources Support and resources from EdCure Find additional support and resources at EdCure. Sex after prostate cancer Men who undergo procedures not designed to spare nerves will fare worse when recovering from erectile dysfunction following treatment. Read this interesting article about Sex After Prostate Cancer from the Chicago Tribune. Videos and webinars Watch our playlist of educational videos and webinars to learn more about erectile dysfunction. Erectile dysfunction survey In October 2022, ZERO, in partnership with Boston Scientific, conducted a survey of prostate cancer patients regarding their experience with erectile dysfunction as a side effect related to prostate cancer treatment. Here are the results of the erectile dysfunction survey.