The male body and sex

The male sex organs are mostly located outside the body and include the penis and testicles. The breasts, nipples, and other areas of the body can also be sensitive to touch.

When you are sexually aroused, your body goes through different stages. Cancer or cancer treatment can cause physical and emotional changes that affect your sex drive. This may make it harder to reach orgasm.

Changes to sex hormones can cause:

  • lower sex drive
  • tiredness
  • erection problems
  • sensitivity on breast tissue

Your doctor can give you advice on the different ways to cope with these physical changes.

Our sex drive is closely linked to how we feel. If you are anxious or depressed about cancer, it may be difficult for you to become sexually aroused. It can be useful to talk to someone about these difficult feelings.

Effects of surgery on men

Surgery of any type can impact your sex life. Having an operation in the sex parts of your body can cause certain changes:

Prostatectomy - surgery to remove the prostate gland. This may make it hard to get an erection.

Cystectomy - surgery to remove the bladder. This can damage the nerves and make it difficult to get an erection.

Abdominal-perineal resection - surgery to remove cancer of the rectum. This can affect the nerves that control erections.

Local resection - surgery to remove rectal cancers at an early stage. This can cause problems with erections.

Orchidectomy - surgery to remove one or both testicles. If both are removed, you will not be able to have children and may have erectile difficulties.

Penectomy - surgery to remove part or all of the penis. Surgeons may be able to reconstruct the penis.

Surgery affecting visible areas such as the face can have an impact on your sexual self-esteem and the way you communicate during sex.

Effects of chemotherapy on men

- Chemotherapy and sexuality

Chemotherapy is the administration of cancer-fighting medication (cytotoxic drugs) to destroy cancer cells. Some of the side effects of chemotherapy can reduce your sex drive. These side effects include feeling unwell, weakness, depression, tiredness, and a lack of energy. Many of these can be eased or stopped with drugs.

There is generally no medical reason to stop having sex during chemotherapy. But if you have a low number of platelets or have a low blood cell count, you may be advised to refrain from having penetration intercourse until your blood count shows an improvement.

- Effects of chemotherapy

You may find that your sex drive is reduced while you are having chemotherapy due to the tiredness and sometimes because of nausea. It normally goes back to normal soon after the treatment is finished. Some types of chemotherapy lower the amount of testosterone produced by the body, though this also returns to normal with time.

Some antiemetic pills can cause a low sex drive. Once you stop taking them, your libido should return.

Some chemotherapy drugs can affect the nerves in the hands and feet. This is called peripheral neuropathy. It can cause tingling or numbness and pain If your hands are uncomfortable or numb, you may find certain types of contact or certain sexual positions to be difficult. Peripheral neuropathy is usually temporary, though it can be permanent.

Some chemotherapy drugs can cause nerve damage. This is known as neurotoxicity and can affect your ability to get and maintain an erection. Your doctor can tell you the likelihood of this happening based on the chemotherapy drugs you are being given.

Once you finish chemotherapy, your sex drive usually comes back. However, if the chemotherapy has caused your hair to fall out, if you have lost weight, or if you have a central line or PICC, you may not feel very sexy.

Effects of radiotherapy on men

Radiotherapy can cause side effects that affect your sex life. They can cause skin reactions. The treated area can become painful and develop a stinging sensation, which may make sex difficult. This can also affect the way you see yourself.

Radiotherapy can also cause extreme tiredness. This can continue for weeks or months. You may find you are too tired to have sex.

Radiotherapy that specifically targets the pelvic area (prostate, anus, rectum, or bladder) can cause these side effects. These may include:

  • diarrhea and nausea
  • pain or bleeding in the bladder or rectum
  • difficulty getting an erection
  • ejaculation problems
  • difficulty urinating

Most of these side effects are temporary, and there are ways to manage them. Following pelvic radiotherapy, many men have erection problems. Talk to your specialist about this. There are treatments that can help.

Effects of hormone therapy on men

- Hormone therapy and sexuality

Some cancers are influenced by the hormones produced naturally by the body, which is why hormone therapy is given to change hormone levels. The hormones that are most commonly affected by cancer or its treatment are sex hormones:

  • Testosterone.
  • Estrogen.
  • Some hormone therapy drugs are given as pills, while some come as injections.

- Effects of hormone therapy

If you have prostate cancer, you may be given a treatment to lower your testosterone level. This can be done by giving you pills or injections or removing your testicles. We have more information about prostate cancer.

Hormone therapies can lower your sex drive, and even if you do feel like having sex, you may not be able to get and maintain an erection. You may also notice that you produce less semen, don't have to shave as often, and have less muscle strength. These effects usually go away 12 to 18 months after you complete your treatment.

If you are having hormone therapy, you may develop an inflammation of the breast. Contrary to what some men fear, hormone therapy will not make your effeminate.