The short answer
Cancer treatment can affect a man's sexual health — for example, lowering sex drive or making erections harder to get or keep. Many changes are temporary and improve after treatment, while others last longer. There are treatments, devices, and support that can help, and a care team can explain the options.
Cancer treatment can lower sex drive or make erections harder to get or keep.
Chemotherapy can lower testosterone and libido but does not usually affect erections.
Radiation to the pelvis, hormone therapy, and some surgeries can cause erectile dysfunction.
Some pain and depression medicines can lower sex drive.
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The full explanation.
The simple version
Men being treated for cancer may notice changes that affect their sexual life — during treatment and sometimes after. According to the National Cancer Institute (NCI), you may not have the same energy or interest in sex that you had before, but feeling close to a partner often stays important. Many changes are temporary and improve once treatment ends; others may be long term or may start after treatment.
Whether you have problems depends on the type of cancer and treatment, the dose and length of treatment, your age, the time since treatment, and other health factors.
How treatments can affect sexual health
NCI describes several ways treatment can affect a man's sexual health:
- Chemotherapy may lower testosterone and libido during treatment. A condom may be advised because semen can contain traces of chemotherapy for a time. Chemotherapy does not usually affect the ability to have an erection.
- Radiation therapy to the pelvis can affect sexual function. If blood vessels or nerves are damaged, it may be hard to get or keep an erection (erectile dysfunction), and if the prostate is affected you may have a dry orgasm.
- Hormone therapy can lower testosterone and sex drive and make erections harder to get or keep.
- Surgery for penile, rectal, prostate, testicular, and other pelvic cancers may affect the nerves involved in erections. Nerve-sparing surgery can sometimes prevent these problems.
- Medicines used for pain and depression, and drugs that affect the nerves and blood vessels, can lower sex drive.
Other health problems — such as heart disease, high blood pressure, diabetes, and smoking — can also contribute.
Ways to manage sexual health issues
Most men can be sexually active during treatment, but NCI advises confirming this with your doctor. At times when the risk of infection or bleeding is higher, you may be advised to abstain, and condom use may be advised.
Your care team can help you:
- Learn about treatments. Once a problem is diagnosed, an oncologist or urologist can advise on options, such as medicines that increase blood flow to the penis or, in some cases, a penile implant.
- Learn about condoms and contraception. These may be advised to protect a partner from chemotherapy in semen or to prevent pregnancy.
- Manage related side effects. Pain, fatigue, hair loss, low mood, or trouble sleeping can all affect your sex life; speaking up helps you get support.
- Get support and counseling. Sharing concerns with people you are close to, and joining a professionally led support group, can help. A nurse or social worker can recommend groups and counselors.
Your care team is the best guide to what your treatment may mean and what can help.
Words to know
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Common questions
▸Does chemotherapy cause erectile dysfunction?
Chemotherapy can lower testosterone and libido during treatment, but NCI notes it does not usually affect the ability to have an erection. Erectile dysfunction is more often linked with radiation to the pelvis, hormone therapy, or some surgeries.
▸Why might a condom be advised?
Semen may contain traces of chemotherapy for a period of time after treatment, so a condom may be advised to protect a partner. Depending on a partner's age, contraception may also be advised to prevent pregnancy.
▸What can help with erectile problems?
Once a problem is diagnosed, an oncologist or urologist can advise on options. These may include medicines that increase blood flow to the penis and, in some cases, a penile implant. Nerve-sparing surgery can sometimes prevent problems.
▸Can I be sexually active during treatment?
Most men can be sexually active during treatment, but you should confirm this with your doctor. At times when the risk of infection or bleeding is higher, you may be advised to abstain, and condom use may be advised.
▸Who can help me cope?
Your doctor, nurse, or social worker can help, and you may also talk with a sexual health expert or urologist. Professionally led support groups and counseling can help you and your partner cope.
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