Sexual dysfunction and prostate cancer

WELLBEING

Sexual dysfunction and prostate cancer

Published June 2021

If you are experiencing sexual dysfunction after treatment for advanced prostate cancer, you're not alone. Sexual dysfunction is a common consequence of most advanced prostate cancer treatments.¹

Many people feel sadness and shame around their sexual dysfunction and often don't discuss their feelings with their partners. It can be psychologically distressing for those who experience it, which in turn affects intimate relationships.¹

What exactly is sexual dysfunction?

Sexual dysfunction is any problem that interferes with your ability to enjoy a sexual relationship. The cause can be physical or psychological in nature, or both.²

How and why does it happen in advanced prostate cancer?

If you are receiving treatment for advanced prostate cancer, your sexual function is likely to be affected because current treatments for advanced prostate cancer (surgery, chemotherapy, hormone therapy and targeted radiation therapy) directly impact key parts of a man's sexual response.³

The hormone testosterone regulates these functions, so without a normal level of testosterone in your body, your sexual organs may not work properly.²

What physical implications of sexual dysfunction can men with advanced prostate cancer experience?

These can include:

Erectile dysfunction²
Difficulty in achieving orgasm²
Loss of sexual arousal²
Infertility due to effects of treatment.³

What are the psychological effects of sexual dysfunction?

Living with advanced prostate cancer may challenge your concept of what intimacy means, as changes to your body from treatment can affect how you and your partner communicate sexually.¹

This may mean that you have to be more flexible in how you approach things: intimacy can be expressed through more than just penetrative sex and your healthcare team should be able to point you in the right direction.²

After cancer, you may become dependent on others for psychological and emotional support — something that can feel opposite to the way men are often portrayed in society with the expectation of being strong and self-sufficient.² As a result, people who have advanced prostate cancer may experience:

Loss of perceived masculinity - not feeling 'man' enough^{1 ,2}
Experience of shame or feeling embarassed²
Depression and sadness.¹

Sexual dysfunction can affect intimate relationships by impacting your expectations of yourself or your partner. It is really important to remember that this is already a very stressful time and that there are many different factors that make a relationship sucessful. Remember that sexual function and desire are not the only drivers of intimacy and feeling close to a partner. Talk with your healthcare team to learn about the support available to help you adjust to any sexual dysfunction related issues.

SOURCES:

Roth, A, Weinberger, M, and Nelson, C. Prostate Cancer: Quality of Life, Psychosocial Implications and Treatment Choices. Future Oncology. 2008;4(4):561-568.
Donovan KA, Walker LM, Wassersug RJ, et al. Psychological effects of androgen-deprivation therapy on men with prostate cancer and their partners. Cancer. 2015;121(24):4286-99.
Cancer.or. Sexual Concerns. Avaliable from: https://www.cancer.org/cancer/managing-cancer/side-effects/sexual-side-effects.html. Accessed October 2025.

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