Sex after cancer

Is your partner interested in sex?

Could menopause be the problem?

If you’ve had treatment for prostate cancer, you probably know it can be hard to get hard (or stay hard).

Assuming that you want to have sex, what do you do if your partner isn’t interested? If your partner is female, perhaps her reluctance has something to do with menopause (or perimenopause).

My wife, Fiona, has gone through menopause. You may have watched her interview with Victoria Cullen about sex after prostate cancer. Anyway, she has just finished reading a new book about menopause which she really loved. I’ve included Fiona’s book review below.

Me & My Menopausal Vagina
By Jane Lewis (PAL Books)

What a wonderful book!  Thank goodness for Jane Lewis girding her menopausal loins and writing such an enlightening expose about vaginal atrophy.

Why do we need this book?  Everyone probably knows about the hot flushes and the dry vagina, right?  Well, it’s not until you actually reach “the change” yourself that you discover the not-so-lovely truth.  Slathering on some extra lubricant before sex just won’t necessarily cut the mustard.

Facing sex after your partner has been treated for prostate cancer can be challenging to start with.  Add menopause (or perimenopause, the start of the whole journey) to your existing challenges and sex gets a whole lot trickier.

Vaginal atrophy – ouch

I bought this book because I now suffer from vaginal atrophy (VA) and that causes me pain when I have sex with my husband.  Even when I use a lot of lubricant and he is very gentle, my vagina struggles to open as it used to.  It hurts and I really want to fix the problem – we both want to keep having penetrative sex.

Jane’s book is really funny (yes, really) and has some great illustrations.  Best of all, Jane is really frank, honest and she has been there.  Nothing beats information from someone who has actually experienced their subject first-hand.  The book is like a user manual for women and covers everything from basic anatomy to laser treatments, moisturisers, physiotherapists and HRT.

This book is easy to read and gives lots of helpful advice.  Naturally, one size never fits all, so Jane’s suggestions offer avenues to explore.

I recommend this book to all women and many men.  Reading about the effects of menopause may help some couples to understand why their sex life has gone off the boil.

You can purchase Me & My Menopausal Vagina from the Pelvic Floor Exercise website for AU$24, which is where I bought my copy.

Alternatively, the book is available (in paperback or as a Kindle edition) from Amazon.

If you’d like to find out more about the book and the author, check out Jane’s website.

Man and woman embracing with happy smiles

What about my partner?

How do partners experience sex and intimacy after prostate cancer treatment?

Following surgical removal of the prostate gland, men and their partners experience a “new normal”.  Firstly, they need to deal with urinary incontinence, which can last from a short period of time to a considerably longer period of time (how long is a piece of string?).  Anyone want to see a photo of me in my big undies? (JOKE)

The next major journey of mutual discovery involves sex.  Intimacy and sex change after a man undergoes a prostatectomy.  Gone are the days of reliable erections on-demand!  Also gone is the semen – from now on, any orgasms will be a dry affair.

So far, so straightforward.  I have already discussed in several past posts (and in my book) how prostate cancer treatment can affect a man, on all levels.  It is not so common, however, to hear from a partner about their experience of a relationship post-treatment.

Last night, Victoria Cullen ran a live webinar featuring my own wife, Fiona.  In that webinar, which lasted for only 30 minutes, Victoria gave Fiona the opportunity to talk about the challenges she faced since 2011 when we “lost my prostate, mate”.

Man and woman embracing with happy smiles
Image courtesy of Justin Leijon

Life before prostate cancer treatment

As some of you may know, I married Fiona in 2008.  When my final prostate cancer diagnosis was made in January 2011, we were approaching our third wedding anniversary.  We had a happy and healthy sex life, which both of us enjoyed a great deal.  Now and again, my penis had its wobbles – as men get older, it is common for them to experience difficulty getting an erection and keeping it.  Overall, things were quite rosy.

Along came prostate cancer – and then …

Life changed dramatically – for both of us.  Rather than repeat Fiona’s story, you may wish to view the webinar on YouTube.  Just be aware that the contents are for adults only.

All I will say here is that menopause added another layer of difficulty to our sex life.  Don’t be dejected though, because there is definitely a future for sex and intimacy, in spite of all life’s little challenges.

Courtesy of Victoria Cullen and A Touchy Subject

Webinar: Adjusting to the new normal

Free Webinar

This coming Wednesday (3rd of April), I will be the guest on a live webinar broadcast by Victoria Cullen, Sexual Function Specialist.

Victoria Cullen talking about life after prostate cancer surgery
Victoria Cullen, Sexual Function Specialist

The webinar will start at 7:00pm (AEDT) and you can register to watch (or participate) via the link below.

Button to register for free webinar on life after prostate cancer surgery

Victoria and I will be discussing life after prostate cancer surgery, ranging across issues such as:-

  • the physical, emotional and psychological impacts of surgery;
  • how prostate cancer surgery can affect relationships;
  • sex and intimacy after prostate cancer surgery;
  • incontinence and erectile dysfunction.

The webinar is free and we would love you to join us with your questions and comments.  You can, of course, just sit back and watch without joining in – it’s all up to you.

If you’d like to check out our promo video on YouTube, click on the link below.

Check out the promo video on YouTube

Is there sex after prostate cancer?

What about my sex life?

This is the most frequently asked question and the thought uppermost in men’s minds when they are first diagnosed with prostate cancer.

There is no straightforward answer, because it depends on the stage of the cancer and the treatment that the man decides to undertake (and of course, it depends on what your definition of ‘sex’ is).

So, let’s deal with men who opt for radical prostatectomy, that is surgical removal of the prostate gland.  Most men will experience sexual dysfunction after the operation.

Who do men and their partners go to see about this?

What if every cancer patient had a sexual recovery specialist?

“What if every cancer patient had a sexual recovery specialist?”  These are the words of my colleague, Victoria Cullen, who specialises in dealing with sexual dysfunction after any treatment for cancer, but with a special interest in prostate cancer.

Victoria Cullen - Sexual Recovery Specialist

After hearing Victoria speak at the Asia-Pacific Prostate Cancer Conference in 2017, urology surgeon Declan Murphy invited her to provide sexual recovery consultations to all his private prostatectomy patients.

Almost every man experiences a change in sexual functioning after prostate removal surgery. In particular, most men will not have erections for at least a year (usually longer, and sometimes permanently). The impact of this loss on quality of life and self-esteem can be devastating.

The aim of Victoria’s approach is to help patients recover as much function as possible and have a fulfilling sex life regardless.

This is the first time an Australian surgeon has prioritised this aspect of quality of life recovery within ‘usual care’.

Victoria is based at Cancer Specialists in Richmond.  I recommend checking out Victoria’s website.  She also has a blog post on the Cancer Specialists’ website which explains the work that she does and why she does it.

As well as checking it out for yourself, it might also be helpful to pass on to others who are interested in sexual recovery after prostate cancer treatment.

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