When You Can Have Sex After Prostate Cancer Treatment

Notwithstanding complications, you can usually have sex a couple of weeks after undergoing radiation therapy for prostate cancer, or a month or so after undergoing surgery for prostate cancer (known as radical prostatectomy).

With that said, people who undergo prostate cancer treatment often experience sexual dysfunction, including the loss of libido (sex drive) and erectile dysfunction (ED). For these individuals, it can sometimes take a year or more before they can engage in satisfying sex, during which time counseling, ED medications, and other treatments may be needed.

Recovery times can vary based on a person’s age, general health, emotional health, and sexual function prior to undergoing prostate cancer treatment.

This article takes a look at the types of treatments used for people with prostate cancer and their impact on sexual function. It also offers tips on how to overcome sexual problems after undergoing prostate cancer treatment.

Prostate Cancer Treatments and Sex

There are two main forms of treatment for prostate cancer: radiation therapy and radical prostatectomy (the removal of the prostate gland). Hormone therapy may also be used as an adjuvant (add-on) treatment.

Radiation Therapy

Surgeons generally recommend waiting a couple of weeks after undergoing external beam radiation (in which radiation is delivered from outside of the body) before engaging in sex. This allows your body ample time to heal from the immediate effects of radiation.

Radiation therapy doesn’t inherently mean that you will experience sexual dysfunction, but many people do. Studies suggest that 30% to 40% of people who undergo radiation treatment for prostate cancer will experience some degree of erectile dysfunction.

Even so, the same study suggests that ED medications like Cialis (tadalafil) can improve symptoms in 73% of people who have undergone radiation therapy while increasing sexual desire and overall satisfaction with sex.

If you were treated with brachytherapy (implanted radioactive seeds), you can also have sex about two weeks after the procedure. However, you should use condoms for the first several weeks to reduce radiation exposure to your partner.

Radical Prostatectomy

For people who have undergone prostate cancer surgery, many surgeons recommend avoiding sex for anywhere from four to six weeks to allow for proper healing.

As with radiation therapy, radical prostatectomy can significantly increase the risk of ED. Some studies suggest that up to 85% of people who have undergone the procedure will experience some loss in their ability to achieve or maintain an erection suitable for sex.

Because of this, penile rehabilitation should start immediately following radical prostatectomy if you have ED. This not only involves ED medications but also psychological counseling to overcome distress that can further compound the symptoms of ED.

Treating Sexual Dysfunction After Prostate Cancer Treatment

Within one year after prostate cancer treatment, nearly people will experience substantial improvement of sexual function. In rare instances, complications from surgery (such as nerve damage) may result in permanent ED.

But even then, there are solutions your healthcare provider may recommend, including:

• PDE5 inhibitors: These ED medications are taken by mouth to improve blood flow to the penis. Options include Cialis (tadalafil), Levitra (vardenafil), and Viagra (sildenafil).
• Intra-urethral suppository: MUSE (alprostadil) is a medicated pellet you place in the urethra (urinary opening) of the penis. It works by increasing blood flow to the penis. 
• Penile injections: Injections can have one or up to four different medications to assist with erections. It is injected into the shaft of the penis with a tiny needle to increase blood flow. Caverject (alprostadil) is an injectable form of the same drug used in MUSE. Trimix is a popular compounded medication for the same purpose.
• Vacuum pumps: These are mechanical devices that draw blood into the penis using suction. A plastic cylinder is placed over the penis and activated with a manual or battery-operated pump.
• Penile implants: These are permanent devices surgically placed inside the penis to enable intercourse with a sexual partner.

Counseling and changes in sexual practices can also help you engage in sex more confidently. This includes exploring sexual fantasies or engaging in sex that doesn’t require a constant erection (such as mutual masturbation and toys).

If you are concerned about your sexual function after undergoing prostate cancer treatment, speak with your healthcare provider. If they don’t have answers for you, they may be able to refer you to a sex therapist or a specialist in male reproductive health known as a urologist.