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Prostate cancer: Let's talk openly about sexual health and fertility after treatment

Published Jan 20, 2026 • By Candice Salomé

Prostate cancer is the most common cancer in men, mainly affecting those over the age of 50, with an estimated 313,780 new cases in the United States in 2025. Thanks to advances in screening and treatment, outcomes are generally favourable. Yet beyond statistics and medical care, this disease can deeply disrupt men’s intimate lives, affecting both sexual health and fertility. These topics are still too often left unspoken, even though they play a major role in quality of life after cancer.

In this article, we explore how prostate cancer can impact sexual health and fertility, the effects of different treatments, and the options available to help couples regain intimacy and well-being after cancer.

Prostate cancer: Let's talk openly about sexual health and fertility after treatment

Prostate cancer: Why sexual health and fertility are often overlooked

The prostate is closely linked to male sexual health and reproduction. When cancer affects this organ, an essential part of intimacy and masculine identity can feel threatened. Yet these issues are often pushed aside during the care journey. Whether due to embarrassment, lack of time, or fear of shifting focus away from cancer treatment, sexuality and fertility are not always discussed.

Concerns vary depending on age, personal circumstances, and life plans, which makes personalized information and open discussion essential for every patient.

How can prostate cancer affect sexuality?

Sexual changes are common and vary from one man to another. A decrease in sexual desire may occur, linked to treatment side effects, fatigue, or psychological stress. Erectile difficulties are also frequent, especially after surgery, radiotherapy, or hormone therapy.

After certain treatments, orgasm may still occur without ejaculation, which can be surprising or unsettling. Pain, discomfort, or changes in sexual sensations may also affect pleasure and intimacy.

Sexual health and prostate cancer treatments: Different effects depending on the treatment

A prostatectomy can lead to erectile dysfunction and eliminates ejaculation, even though orgasm may still be possible. The effects of radiotherapy or brachytherapy on sexual health are often more gradual and may appear several months after treatment ends.

Hormone therapy acts directly on testosterone levels and frequently causes a marked drop in libido, significant fatigue, and changes in body image. Depending on the situation, these effects may be temporary or long-lasting.

Prostate cancer and fertility: What you should plan ahead

Prostate cancer treatments can affect male fertility. After a prostatectomy, the absence of ejaculation makes natural conception impossible. Some treatments may also alter sperm quality.

For men who wish to have children, fertility preservation options, such as sperm banking before treatment, can be considered. In some cases, medically assisted reproduction makes it possible to pursue parenthood after cancer.

Rebuilding your sexual life after prostate cancer: A gradual process

Recovering a satisfying sex life after prostate cancer is often possible, but it takes time and adjustment. Pelvic floor rehabilitation and sexual rehabilitation programs can help improve erectile function. Solutions are available to manage erectile difficulties.

Redefining sex beyond penetration also allows many couples to maintain intimacy and a fulfilling sexual relationship.

The psychological impact of prostate cancer on intimacy

Sexual changes can affect self-esteem, feelings of masculinity, and self-confidence. Anxiety, fear of sexual failure, or depression may make it harder to resume an intimate life.

Psychological or sex therapy support can help men and couples navigate these changes and develop a more peaceful relationship with sexuality.

Relationships and intimacy after prostate cancer

Open communication in a relationship is essential when facing changes brought on by the disease. Sharing feelings, fears, and expectations helps prevent misunderstandings.

Partners often play a key role in rebuilding intimacy by offering support, patience, and understanding. Even when sexual health changes, emotional closeness and sensuality can still be maintained.

Talking about sexual health and fertility with healthcare professionals

Discussing sexual health and fertility with healthcare professionals is an integral part of cancer care. Asking questions before and after treatment helps anticipate side effects and access appropriate support.

Sexual health is now recognized as a vital component of quality of life after cancer and deserves to be addressed openly and without shame.

Key takeaways

The effects of prostate cancer and its treatments on sexual health and fertility are real but vary from one person to another. Having a healthy sex life is still possible, though it may be approached differently.

Information, anticipation, and open dialogue with healthcare professionals and partners are essential to navigating life after cancer with greater confidence and well-being.

If you found this article helpful, feel free to give it a “Like” and share your thoughts and questions with the community in the comments below!

Take care!

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