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Prostate cancer and its treatments can cause a loss of interest in sex. This is also called a low libido or sex drive.
Your sex drive might be lower because of a number of reasons. These include:
- tiredness
- anxiety about having prostate cancer
- loss of confidence and self esteem
It may also be a side effect of hormone therapy.
How hormone therapy causes a loss of libido
Hormone therapy blocks or lowers the amount of testosterone 
in the body. This can cause less interest in sex.
Different hormone therapy drugs can cause different side effects. So your doctor might suggest changing your treatment to try to improve your side effects.
You can also ask your doctor about intermittent hormone therapy if you’re struggling with low libido. For example, you have 6 months of hormone therapy, then have a break, and then start treatment again. Or you only restart when your PSA level starts to rise.
Some studies have shown that intermittent hormone therapy can reduce sexual problems. But there might be a risk that this may not control the cancer for as long. It is difficult to predict whether your interest in sex will improve with a break in treatment. It may take some time before this happens.
You can talk to your doctor about some of the treatments for erection problems. They might also help your low libido. Your doctor might recommend you try treatment with a:
- PDE 5 drug such as tadalafil (Cialis) or sildenafil citrate (Viagra)
- vacuum pump
Coping with a low sex drive
Many of these problems will disappear once your treatment finishes and your desire for sex will go back to normal. But it may take some time, so don’t worry too much if you don’t feel like having sex for a while.
Talking and staying close
It’s important to talk to your partner about how you feel if you are in a relationship. Many people find it difficult to talk about sex even with a long term partner. But not talking about it can affect your relationship with them. Even if you are not interested in having sex, you can still enjoy physical contact.
Hugging, cuddling and kissing are comforting and can help you relax. If you have physical contact it might help to be clear with your partner about how far you want to go. Some men find that feeling relaxed and having physical contact can gradually lead to them becoming aroused.
It may also be helpful to speak to a counsellor or therapist, either separately or together.
Coping with leaking urine during orgasm
Prostate surgery causes some men to leak urine during arousal or at the point during orgasm. For some men, this is only temporary. But it could be a long term problem for some.
It’s normal to feel embarrassed about it. You might have less interest in sex as a result.
It might help to talk things through with your partner if you have one. Discussing it with a new partner may be particularly difficult. But there are things you can do to help you cope with this. It might help to pass urine before you have sex or you could use a condom.
Help and support
If you’re worried about anything to do with your sex life or sexuality, you may want to talk through how you’re feeling. You could do this with a counsellor or therapist. Or you could contact some of the organisations that offer support and information.
