Erectile dysfunction may occur after prostate cancer, especially when gland removal affects nerves involved in erection — understanding prostate cancer and impotence.
Difficulty achieving an erection can be among the possible side effects of prostate treatment. This is because the nerves responsible for erection may be affected during prostatectomy.
In addition, both chemotherapy and radiotherapy can compromise erectile function by impacting nerves, blood vessels, and hormone production.
Keep reading to understand how male sexuality may be affected after prostate cancer.
The relationship between prostate cancer and impotence
An article published in the Journal of the American Cancer Society analyzed 2,636 men treated with definitive radiotherapy or prostatectomy.
The questionnaire-based study found that 85% of these participants reported difficulty with erection.
Another study on erectile dysfunction after prostate cancer highlights that sexual effects vary according to the treatment method adopted.
For example, rates of impotence are higher after radical prostatectomy, particularly when nerve-sparing is not performed.
With three-dimensional conformal radiotherapy—an approach that uses 3D imaging to target the tumor precisely and reduce damage to healthy tissue—the incidence of erection problems after three sessions can range from 7% to 72%.
The link between impotence and prostatectomy is related to the risk of injury to the erectile nerves, which control the blood flow required for erection.
When these nerves or the blood vessels are damaged during surgery, erectile function may be compromised.
Side effects can also arise from other oncologic treatments, such as chemotherapy and radiotherapy, which can harm nerves and reduce testosterone levels, directly impacting sexual function.
Main prostate cancer treatments and their sexual effects
Learn about main prostate cancer treatments and sexual effects:
- Radical prostatectomy: removal of the prostate and, in some cases, adjacent structures. The procedure may impact erection.
- Radiotherapy: uses radiation to destroy cancer cells. Treatment can trigger inflammatory reactions that harm nerves and blood vessels.
- Hormone therapy: reduces testosterone levels, often leading to decreased libido and erectile dysfunction.
- Chemotherapy: use of medications to target diseased cells. It may cause erectile dysfunction, reduced libido, and ejaculation issues.
Myths and facts about sexual function after prostate cancer
Find out what is myth and what is fact about prostate cancer and impotence, based on scientific evidence.
“Ejaculation is always lost” – Fact
After prostate removal, men no longer ejaculate.
A study on sexual dysfunctions after prostate removal shows that patients lose this function because the gland produces part of the seminal fluid.
“Impotence is inevitable” – Fact
This may occur because the surgeon might need to remove one or both nerve bundles attached to the prostate, which are essential for erection.
However, Cancer Research UK explains that seeking urological help for erectile rehabilitation after prostatectomy is important and may involve sexual therapy, medications, and vacuum devices in selected cases.
“Only surgery causes dysfunction” – Myth
An article in Clinical Oncology clarifies that more than 80% of men present erectile dysfunction after prostate cancer.
The symptom is not limited to surgery: it can also occur after radiotherapy and hormone therapy.
Impact on male sexual and emotional health
Understand how to cope with the impact of prostate cancer on male sexual and emotional health:
Self-esteem and intimacy
Reduced self-esteem is common after prostatectomy.
Sexual issues observed after treatment affect self-perception and may lead to anxiety and depression.
Both patients and partners benefit from urological and psychological support to address erectile difficulties and low libido.
How to communicate with your partner
Honest conversations about changes, feelings, and expectations help create a supportive environment for sexual and emotional well-being after prostate surgery. This communication can reduce couples’ anxiety and stress.
The importance of ongoing medical follow-up
Care does not end with surgery and adjuvant treatments.
Continuous follow-up is essential to monitor side effects and enable early detection of possible cancer recurrence.
Follow Dr. Paulo Egydio’s channel for more on men’s health
Prostate cancer has treatments available, and sexual side effects can, in some cases, be managed with appropriate medical care.
Since information supports a healthier life, follow Dr. Paulo on YouTube for up-to-date content on men’s health.
*This content is for informational purposes only and does not replace medical consultation. Each case must be evaluated individually by a qualified health professional.
