Orgasms After Prostate Cancer Treatment

Is it possible to have an orgasm after prostate cancer? How will prostate cancer treatment affect my sexuality? Yes! Nearly all men will be able to have an orgasm following prostate cancer treatment. This is true even in most cases of erectile dysfunction.

The nerves and blood vessels that are most commonly damaged by prostate cancer treatments are very important for achieving an erection but are not very important for achieving orgasm. Therefore, though there is the occasional man who may be unable to achieve orgasm after prostate cancer treatment, the vast majority will still have this sexual function.

It's important to note that the prostate is the gland that produces most of the fluid that makes up semen. Thus, once the prostate has been removed by surgery or destroyed by radiation, a man's orgasm will be nearly or completely dry.

Older man and woman sitting on a rock.
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Sex Life During and After Prostate Cancer Treatment

Sex after prostate cancer looms large in men's minds, but it can be hard to bring it to attention. Shouldn't you just be thrilled that you have a chance to beat cancer? Yet our sexuality is a very important part of our being.

Will your sex life be the same? No. There will be changes. But that doesn't mean it will be worse. It could even be more pleasurable in time. It can help to break down how cancer affects a man's sexuality into three main areas: desire, erectile dysfunction, and orgasm. Since we addressed orgasm up front, let's check out the other two areas.

Sexual Desire With Prostate Cancer

Desire plays an important part in the initiation of sex, as well as thought life even without sex. Yes, prostate cancer can affect desire in many ways. Some of these include:

  • Worry about performance
  • The psychological impact of a cancer diagnosis
  • Fatigue (which affects most people with cancer and is a side effect of most cancer treatments)
  • Self-image after prostate surgery
  • Fear of recurrence, progression, and death
  • If androgen deprivation therapy (ADT) such as leuprolide is used, testosterone is made very low which will lead to low libido

Desire is more difficult to quantify than erection and less spoken of in general. Yet without this step, the others often go unaddressed as well. This is a good time for men to do something some men hesitate to do. Have a heart-to-heart with your partner and your healthcare provider.

What is getting in the way of your desire? Is it fatigue? What can be delegated to someone else to allow you more time to dream? Are the emotions of cancer filling that place in your mind? Consider a support group—and if you don't feel like driving and sitting in a room with other men, there are some excellent online prostate cancer communities.

Perhaps seeing a counselor would help? I've heard it argued that every single person could benefit from talking with a therapist during cancer treatment. Self-image? Many men are relieved to hear that their partners are very interested in helping - but may feel uncomfortable initiating the conversation. If it feels physical, talk to your healthcare provider about coping. Approaches such as oxytocin treatments have helped some men and other options are available.

Erection and Ejaculation

As noted above, ejaculation will be different after prostate cancer surgery, but that's not necessarily bad. Erectile dysfunction (ED) is common for many reasons, but many options for erectile dysfunction are available.

First, it's important to determine the causes. Some of these are avoidable. Some medications, such as a category of drugs known as SSRI's to treat depression can cause not only a loss of desire but also ED. Are other options available? 

Certainly, some ED is unavoidable such as nerve damage from prostate cancer surgery and effects of hormonal therapy, chemotherapy, and radiation therapy but many options exist such as oral medications, penile injections and implants, vacuum constriction devices, and more. Check out the newest ways to treat erectile dysfunction.

Bottom Line

It's true that it's likely you'll have some sexuality issues to cope with as you go through prostate cancer treatment and beyond, but just because things are different, doesn't mean it has to be any worse. It could even be better if it opens up lines of communication.

After all, as mentioned at the beginning of this article, the most important physical sensation takes place far from your prostate -- between your ears. Orgasms after prostate cancer treatment are not only possible but the norm.

Desire may take a hit, but often returns in the months following treatment, and may improve earlier if you address possible causes. Erection concerns make take some creativity, but these too have many options. The 5-year survival rate for prostate cancer overall is now 99%. You have a lot of living left to do, and your sexuality is an important part of that living.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Macdonald K, Feifel D. Dramatic improvement in sexual function induced by intranasal oxytocin. J Sex Med. 2012;9(5):1407-10. doi:10.1111/j.1743-6109.2012.02703.x

  2. Higgins A, Nash M, Lynch AM. Antidepressant-associated sexual dysfunction: impact, effects, and treatmentDrug Healthc Patient Saf. 2010;2:141–150. doi:10.2147/DHPS.S7634

Additional Reading
  • American Cancer Society. How cancer treatment can affect ejaculation. Updated 08/19/13.

By Matthew Schmitz, MD
Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families.