Getting support for sexual problems
Help and support for sexual problems after treatment for prostate cancer.
Getting support for sexual problems
Some treatments for prostate cancer will cause problems with sexual function.
These problems include:
Getting or keeping an erection (erectile dysfunction)
Dry ejaculations
Reduced penis size
Loss of sexual interest
What support should I be offered for my sexual problems?
The National Institute for Health and Care Excellence (NICE)
NICE provides guidance on:
- How different conditions should be treated.
- What treatments should be made available.
Learn more about NICE and what they do by visiting their website (this link will open in a new tab).
NICE has put together guidelines for the diagnosis and management of prostate cancer.
Please note that these are just guidelines and are not a legal requirement.
You can use this information to help you to ask questions of your healthcare team.
Before deciding on a treatment, your healthcare team should:
Tell you about the risk of dry orgasms and fertility issues after some treatments for prostate cancer. This should happen before you make your treatment decision.
Offer you the chance to freeze your sperm.
You can learn more about sperm banking from the Human Fertilisation and Embryology Authority (HFEA). You can visit HFEA’s website here (this will open an external tab).
Cancer Research UK (CRUK) also have information about sperm collection and storage on their website. You can visit CRUK’s website here (this will open an external tab).
If you are having problems getting an erection, you should be offered:
Access to specialist services that can help you.
Medication called PDE5 inhibitors (for example, Viagra or Cialis).
If tablets don't work you should be offered the chance to try:
- A vacuum erection device (penis pump)
- Alprostadil - this improves blood flow to the penis. It comes as cream, pellets or an injection.
You should also be offered the chance to talk to a psychosexual therapist.
Getting support for erection problems (erectile dysfunction)
- Speak to your consultant about your erectile function before you start any treatment for prostate cancer.
- This will give them baseline information.
- They can then compare how things have changed once you have had surgery.
- Your doctor may ask you some questions about your erectile function before and after surgery.
- If you have a partner, it is a good idea to include them in any discussions.
- Visit our page on prostatectomy to find out more about the risks of erectile dysfunction after surgery.
- Visit our page on hormone therapy injections to find out more about the risks of erectile problems when on hormone injections.
The following cartoon strip shows the different options available to you if you have problems getting an erection.
- It introduces Michael, a 60-year-old man who has had a prostatectomy. He is having problems getting an erection.
- This is affecting his self-esteem and feelings of masculinity. He also feels like it is affecting his relationship with his partner.
- He has gone along to see his doctor.
(A) Visiting your doctor and first line treatment - tablets.
- PDE5 inhibitors are usually the first line treatment to help you improve your chance of spontaneous erections.
- You can be prescribed these by your hospital team or GP.
- Some doctors prescribe a low dose to start with and then increase it.
- Patients are also advised to try the tablets about eight times before deciding that they do not work.
- Some sexual stimulation is still needed for the erection.
- They may not work for those who are having hormone therapy and have a decreased sex drive.
(B) When the tablets don't work - referral to a sexual dysfunction service.
- Your GP or hospital team can refer you to a specialist sexual dysfunction service.
- This service may not be available in all areas. Check our local services tool to see if there is one in your area. (the link will open in a new tab).
- These clinics are often nurse led.
- They can be conducted face-to-face or over the telephone.
(C) Visiting the sexual dysfunction service and trying a vacuum erection device (VED).
- A vacuum erection device is a mechanical pump that fits over your penis. It can help you to get an erection.
- It can take a few minutes to get a full erection.
- Once you have an erection, you slide a constriction ring to the base of your penis. This should not stay in place for more than 30 minutes.
- You may see some discolouration of your penis.
You can read the leaflet from the British Association of Urological Surgeons (BAUS) for more information about VEDs and how to use them. This is a PDF document and may not be compatible with screen readers. Listen to the PDF on VEDs
- Vacuum erection devices (VEDs) may be available on the NHS in some areas. Ask your GP for more information.
- Availability will depend on local prescribing policies. These are developed by your local integrated care board (ICB).
An ICB is also responsible for:
- Managing the local NHS budget
- Arranging for the delivery of health and care services locally.
You can ask them:
- What NHS specialist services are available in your area
- Why you are unable to access VEDs on the NHS.
- You can find their contact details on the NHS England website.
(C) Exploring other options - creams, pellets and injections
- If you do not get on with the tablets or VED, you may also be offered Alprostadil.
- This comes in different forms:
- A cream (Vitaros)
- A pellet (Muse)
- An injection (Caverjet).
CREAM (VITAROS)
PELLETS (MUSE)
INJECTION (CAVERJET)
- Alprostadil is available on prescription. Check with your GP.
- Your healthcare team or GP will talk to you about the different options. You can discuss the best option for you.
(D) Tackling relationship concers - referral to a psychosexual therapist.
- Your GP or hospital team can refer you for psychosexual counselling if they think it will help you.
- This is not available on the NHS in all areas. Use our local services finder to find services near you.
- An NHS clinic may only offer a limited number of therapy sessions.
- You can also find a therapist privately, which you'll need to pay for.
- It's important to see a qualified registered therapist. Look for one who is a member of the College of Sexual and Relationship Therapists (COSRT) or the Institute of Psychosexual Medicine.
- Click the resources tab for more information on support.
(E) Don't be afraid to go back to your healthcare team if you need more support.
About this information
- This information was published in July 2024. Date of next review: March 2026.
- References and bibliography available on request.
- If you want to reproduce this content, please see our Reproducing Our Content page (this link will open in a new external tab).
The toolkit is an information resource for people affected by prostate cancer. The development has been funded through an educational grant from Advanced Accelerator Applications (A Novartis Company).
Prostate Cancer Research
In 2021 Prostate Cancer Research, in collaboration with Tackle Prostate Cancer, developed a webinar series Living Well with Prostate Cancer. We have two webinars dealing with sex and intimacy.
- Sex and intimacy - general
2. Sex and intimacy - LGBTQ community
Movember True North
- Movember is a global men's health charity. They fund a programme called True North which supports people through their prostate cancer journey.
- They have a section on sex and intimacy after prostate cancer. This covers subjects such as:
- Erectile dysfunction
- Marriage and relationships
- Emotional and mental health
- Low sex drive
- Dry orgasms.
- Find out more by visiting the True North-Movember website (link opens in new external tab).
Sex with Cancer
- Sex with Cancer is an online shop, an artwork and a public campaign exploring how people living with and beyond cancer can take control of their own health and wellbeing. Visit the Sex with Cancer website (link opens in new external tab).
A Touchy Subject
- A Touchy Subject is run by Victoria Cullen, a sexuality educator. She has:
- A Touchy Subject YouTube channel
- Touchy Subject website (links open in new external tabs).
- There are lots of free-to-access videos about living with erectile dysfunction after treatment for prostate cancer. There is also a free online rehabilitation course.
Cancer Research UK
- Cancer Research UK have a section on sex and erection problems and less interest in sex (low libido) (links open in new external tab).
Prostate Cancer UK
- Prostate Cancer UK have a page on sex and relationships (link opens in new external tab).
- Prostate Cancer UK also run a sexual support service. You can talk to one of their specialist nurses about the impact of treatment on your sexuality and relationships.
- They can discuss possible treatments or ways to deal with the changes.
- To sign up for the service, contact their specialist nurses on 0800 074 8383.
- You can also fill in a form on Prostate Cancer UK's website (link opens in new external tab). One of their specialist nurses will assess whether or not the service will suit your needs.
Macmillan Cancer Support
- Macmillan Cancer Support have information about how cancer can affect your sex life (link opens in new external tab). This includes practical tips on how to manage some of the more common problems.
Relate
- Relate have a network of Relate Centres across the UK (link opens in new external tab) and a group of licensed local counsellors who provide face-to-face counselling and support.
- They also provide phone, email and live chat (link opens in new external tab) counselling so you can choose the support that works for you.
- They also offer sex therapy (link opens in new external tab).
Cambridge University Hospitals NHS Foundation Trust
- Cambridge University Hospitals NHS Foundation Trust have a Vacuum erection assistance devices: frequently asked questions webpage (link opens in new external tab).
Orchid
- Orchid is a charity for those affected by male cancer. They have a page about erectile dysfunction and how it can be managed (link opens in new external tab).
College of Sexual and Relationship Therapists
- COSRT is the UK’s only professional body dedicated to psychosexual and relationship therapies.
- They have a page of information and downloadable fact sheets (link opens in new external tab) on subjects such as:
- Cancer, sex and relationships
- Common sexual problems
- Therapy approaches
- Psychotherapy and counseling.
- They also have a ‘find a therapist’ section, (link opens in new external tab) where you can look for a therapist in your area.
The Institute of Psychosexual Medicine
- The Institute of Psychosexual Medicine (IPM) trains doctors and related health professional who see patients with psychosexual issues.
- They deal with problems such as:
- Erectile dysfunction
- Loss of interest in sex
- Difficulty with orgasms.
- You can find an IPM specialist near you by vising the IPM's website.
Cancer Council NSW
- Cancer Council NSW is an Australian cancer charity. They have lots of information about sexuality, intimacy and cancer (link opens in new external tab). This includes information on:
- Treatment side effects and sex
- Sex after diagnosis.
They also provide information for partners.
- They have a set of questions that you can ask your doctor. As well as online information, they have a downloadable booklet and a podcast.
The Sexual Medicine Society of North America
- The Sexual Medicine Society of North America (SMSNA) explore sensate focus and how it works (link will open in a new tab).
- Sensate focus is a technique used to:
- Improve intimacy and communication between partners around sex
- Reduce sexual performance anxiety
- Shift away from ingrained sexual patterns that may not be useful for the couple.
The Human Fertilisation and Embryology Authority (HFEA)
- HFEA are the UK’s independent regulator of fertility treatment and research using human embryos.
- They have a dedicated webpage all about sperm freezing and banking. Visit HFEA’s website to find out more (this will open an external tab).
- Cancer Research UK (CRUK) also have information about sperm collection and storage on their website. Visit CRUK’s website for more information (this will open an external tab).
About this information
- This information was published in July 2024. We will revise it in March 2026.
- References and bibliography available on request.
- If you want to reproduce this content, please see our Reproducing Our Content page (this link will open in a new external tab).
The toolkit is an information resource for people affected by prostate cancer. The development has been funded through an educational grant from Advanced Accelerator Applications (A Novartis Company).
