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When RoseMary\u2019s* husband was diagnosed with prostate cancer 22 years ago, the couple faced a lot of uncertainty, and they knew the diagnosis could change their lives. <\/p>\n
What they couldn\u2019t fully anticipate was how much treatment might change their sex life, or how they would eventually learn to redefine intimacy together.<\/p>\n
Her husband, first went to the doctor because he was urinating more frequently. Testing eventually led to a biopsy and a prostate cancer diagnosis.<\/p>\n
After considering his treatment options, he chose surgery \u2014 a full removal of his prostate. RoseMary said they went into the procedure knowing there was a possibility of side effects, including urinary incontinence<\/a> and erectile dysfunction.<\/p>\n Her husband experienced both.<\/p>\n More than two decades later, he still has urinary incontinence<\/a>, and his erectile function never returned. But he remains cancer-free and has no regrets about his decision.<\/p>\n \u201cThe dignity and grace of this man despite what he went through,\u201d she said. \u201cThis is a Marine who never complained once.\u201d <\/p>\n For RoseMary, however, being the partner of someone going through prostate cancer meant learning that surviving cancer is only one part of the story. Couples may also have to figure out what comes next, including how to navigate changes in sex, intimacy and their relationship.<\/p>\n Prostate cancer treatment can affect sexual health<\/strong><\/p>\n<\/h3>\n Sexual changes<\/a> after prostate cancer treatment are relatively common, according to Nazanin Moali, Ph.D.<\/a>, a clinical psychologist and sex therapist who has worked in the field for 15 years. Depending on the person and treatment, whether it be surgery, chemotherapy or hormone therapy<\/a>, changes can include erectile dysfunction, erectile unpredictability, loss of libido<\/a>, changes in desire and difficulty experiencing orgasm<\/a>.<\/p>\n Some people may discover that the type of stimulation that worked before treatment no longer works afterward.<\/p>\n That can require couples to rethink what sex looks like.<\/p>\n \u201cYou can still have a healthy, fulfilling sex life regardless of the outcome,\u201d Moali said.<\/p>\n The key, she explained, is being willing to communicate about what feels good, what has changed and what each partner needs, and to seek professional help from a sex therapist when necessary.<\/p>\n<\/div>\n There can be grief on both sides<\/strong><\/p>\n<\/h3>\n The physical effects of treatment happen to the person with prostate cancer, but the emotional, relational and sexual effects can involve both partners.<\/p>\n Moali said some women and partners she\u2019s worked with feel enormous gratitude that their partner survived cancer while simultaneously grieving the sex life they had before treatment. Others become sexually frustrated but feel guilty acknowledging it.<\/p>\n There can be complicated dynamics around initiating sex, too. A man experiencing erectile dysfunction as the result of treatment may feel shame or anxiety about sexual performance. His partner, meanwhile, may avoid initiating intimacy because she doesn\u2019t want to pressure him or make him feel uncomfortable.<\/p>\n And when a woman has also taken on a caregiving role, the transition back to being romantic or sexual partners may be challenging.<\/p>\n Those seemingly contradictory emotions \u2014 gratitude, sadness, frustration, grief, guilt and desire \u2014 can exist at the same time, Moali said. Rather than suppressing them, she encourages couples to acknowledge, understand and accept the various layers of emotions, express what they\u2019re feeling, and talk about what sex and intimacy mean to them now.<\/p>\n RoseMary remembers experiencing some of those complexities herself.<\/p>\n Her husband still had sexual desire after surgery, she said, but erectile dysfunction changed how he saw his ability to perform sexually. She sensed his frustration and sadness, even if he didn\u2019t always talk about them directly.<\/p>\n \u201cThere was a need for some encouragement on my side,\u201d RoseMary said. \u201cWe developed a different way that we could couple.\u201d <\/p>\n Over time, they learned to communicate differently and became more inventive about intimacy.<\/p>\n Read: Prostate Cancer Taught My Husband and Me What Real Intimacy Is >><\/a><\/em><\/p>\n<\/div>\n Expanding the definition of sex<\/strong><\/p>\n<\/h3>\n For RoseMary and her husband, adjusting meant taking the emphasis off intercourse and finding other ways to give and receive pleasure.<\/p>\n \u201cWe became inventive,\u201d she said. <\/p>\n Massage, touch and other forms of sexual stimulation became a more integral part of their relationship. So did something much simpler: kissing.<\/p>\n \u201cI could devour him right now,\u201d RoseMary laughed, and said of her husband today.<\/p>\n She said they also relied on openness, communication and even humor as they figured out what worked for them.<\/p>\n That flexibility is something Moali regularly encourages with her clients. She said engaging in \u201csexual exploration\u201d is important. <\/p>\n \u201cThere are different ways of experiencing an orgasm,\u201d Moali explained. \u201cInstead of defining sex solely as penetrative intercourse, couples can consider a much wider range of sexual and sensual experiences, including kissing, touching, sensual massage, oral sex, mutual masturbation and sex toys.\u201d<\/p>\n She encourages couples to think about the underlying meaning of sex in their relationship. Is it about pleasure? Feeling desired? Connection? Sensuality? Once couples identify what they\u2019re actually seeking from sex, they may find there are multiple ways to achieve it.<\/p>\n\n\n
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