Prostate Cancer’s Impact on Couples

The following is an excerpt from Yes You Can: Dr. Barb’s Recipe for Lifelong Intimacy by Dr. Barb DePree, founder of MiddlesexMD.

Midlife can pack a few punches for women. We can experience some health changes, including those that come with menopause, right at the time we're juggling the needs of aging parents and growing grandchildren.

On top of that, some of us deal with the challenges that come when a husband is diagnosed with prostate cancer. Although prostate cancer is very treatable today, it's still terribly scary.

And if that weren’t difficult enough, along with it may come some major issues regarding a man’s sexual performance, adding even more stress and worry to the situation. Some possible side effects of surgery and/or other prostate treatments include challenges to:

• The ability to get an erection (erectile dysfunction)
• The desire to have sex
• The ability to ejaculate and have an orgasm

This affects men not only physically, but emotionally, too, since men’s feelings of masculinity are often tied to their sexual performance.

And as you probably know, men are not always good at talking about sensitive subjects like this. So they often don’t delve too deeply into these side effects, even with their doctors. Or they may be so distraught about the cancer itself that it just doesn’t seem important at the time.

But it is important. And that’s where you can help. Communicating about it is the first step to dealing with prostate cancer and its impact on your lives. In fact, prostate cancer is often called the “couples disease” because of its broad-reaching effects in the bedroom — and elsewhere.

So while these side effects may be extremely difficult for your partner to deal with, they obviously affect you, too, especially if you have had an active and satisfying sex life. It can be a devastating loss to you both.

The good news is there are lots of ways to maintain sexual intimacy after prostate cancer. So instead of looking at it as the end of your sex life, look at it as a new beginning. I recommend three steps to get you started: educate, explore, and experiment:

First, educate yourselves about the range of solutions available that might help with the physical limitations you’re now living with, including drugs such as Cialis, Viagra, and Levitra. Penile implants also have a good success rate. While that procedure may be expensive, insurance will often cover some of the costs. Penile injections are also worth considering.

There’s a lot of information online about these solutions, and several books, too, such as Saving Your Sex Life: A Guide for Men with Prostate Cancer by Dr. John Mulhall. Your spouse’s urologist should be able to help, too. Set aside some time just to investigate what’s out there and what might work for you.

You might also want to consider going to a sex therapist, who can help you in your next phase: exploration. If the above solutions don’t appeal to you, or don’t work for one reason or another, start exploring other ways to satisfy your sexual appetites given your new limitations. A sex therapist is trained to offer guidance and may have suggestions you hadn’t thought of. Even if you do decide to try some of the above solutions, a sex therapist can be a tremendous help and a valuable resource. (Visit the American Association of Sexuality Educators, Counselors and Therapists website for references.)

As for experimenting, if you’ve never tried a vibrator, this might be the time to start. And yes, your partner can be part of the enjoyment. In fact, there’s a wonderful column about this by journalist Michael Castleman, who has written about sexuality for 36 years. He wrote a post called, “Gentlemen, Let’s Welcome Vibrators Into Partner Sex,” in which he says, “vibrators are as natural as music or candlelight...” as he encourages men to experiment with their partners’ favorite sex aids.

Remember, too, that cuddling, caressing and kissing all go a long way to maintaining intimacy. The important thing is to work together to find solutions and not let these physical constraints negatively affect your emotional connection.