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Maintaining Intimacy after Prostate Cancer

by Dr. Barb DePree MD

Our last post talked about the side effects of prostate cancer treatments for your partner, including loss of libido and erectile dysfunction, and the fact that both of you are affected. While these problems can be devastating to couples who have always enjoyed a healthy sex life, it doesn’t have to mean it’s all over. The important thing is to work together to find solutions that work.

I recommend three steps that happen to start with E: educate, explore, and experiment.

First, educate yourselves about the range of solutions available that might help with the physical limitations you’re now living with, including drugs such as Cialis, Viagra, and Levitra. Penile implants also have a good success rate. While that procedure may be expensive, insurance will often cover some of the costs. Penile injections are also worth considering.

There’s a lot of information online about these solutions, and several books, too, such as Saving Your Sex Life: A Guide for Men with Prostate Cancer, by Dr. John Mulhall.  Your spouse’s urologist should be able to help, too.  Set aside some time just to investigate what’s out there and what might work for you.

You might also want to consider going to a sex therapist, who can help you in your next phase: exploration. If the above solutions don’t appeal to you, or don’t work for one reason or another, start exploring other ways to satisfy your sexual appetites given your new limitations. A sex therapist is trained to offer guidance and may have suggestions you hadn’t thought of. Even if you do decide to try some of the above solutions, a sex therapist can be a tremendous help and a valuable resource. (Visit the American Association of Sex Educators, Counselors, and Therapists website for references.)

As for experimenting, if you’ve never tried a vibrator, this might be the time to start.  And yes, your partner can be part of the enjoyment. In fact, there’s a wonderful column about this by journalist Michael Castleman, who has written about sexuality for 36 years. He wrote a post called, “Gentlemen, Let's Welcome Vibrators Into Partner Sex,” in which he says, “vibrators are as natural as music or candle light…” as he encourages men to experiment with their partners' favorite sex aids.

Of course, oral sex is another option as is mutual hand stimulation. Again, this is the time to experiment and look for alternative ways that are satisfying when penetrative sex is no longer possible. It can actually be very freeing and exciting to experiment. In fact, some couples find they become even closer after they can no longer have “normal” sex.

Remember, too, that cuddling, caressing, and kissing all go a long way to maintaining intimacy. The important thing is to work together to find solutions and not let these physical constraints negatively affect your emotional connection.


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