Sexuality Health Article

Cancer and male sexuality

Radiation therapy of the pelvis can impair sexual function. Circulating testosterone levels may come down temporarily and during this time men may have a loss of sexual desire. But this does not seem to be a permanent effect in all cases. It may be possible to get aroused by taking more time and experimenting with different kinds of caressing and love making. If erection does not occur after a significant period of time the doctor may suggest tests to check for sleep erections. Some are take-home tests and if they suggest that erection occurs normally during sleep, it is clear the physiological mechanism is intact and sexual counseling may relieve the problem. Sexual counseling may also be helpful to allow enjoyment with sexual caressing in the absence of erections. Men with medical impotence may also be helped by the use of Viagra. Men need replacement with hormones in only very rare cases. In fact, extra testosterone can cause undetected prostate cancer to grow.

Surgery for various cancers can cause sexual problems. Surgery for bladder cancer can lead to decreased sexual desire, lowered ability to obtain an erection, and less frequent or less intense orgasms. Surgery for penile cancer and testicular cancer can result in decreased fertility and desire, difficulties with erections and orgasms, and decreased volume of semen. In treating prostate cancer, the biopsy obtained to confirm diagnosis may decrease semen levels, and, after a man has had his prostate gland removed (prostatectomy), he may be unable to obtain an erection. However, new surgical advances and new chemotherapy options may help reduce these effects.

If, during surgery, the blood supply to the penis is affected, the surgeon may take an abdominal artery and try to connect it the penis. This operation is only successful in a quarter of the patients. Penile injection therapy and vacuum devices have been used to produce erections in the absence of sufficient blood flow. Medications that produce erections are risky and may lead to the formation of scar tissue. Vacuum erection devices are safer but intrude in the lovemaking. Medical erection problems may also be treated by penile prosthesis. This is one of the best ways to treat a permanent erection problem.