This will depend on what type of treatment you have had and how you feel. Some men will have problems with their erections (erectile dysfunction) and some may never get back the ability to achieve or maintain an erection without the help of treatment. For more information about the effect of each treatment on sex and masturbation read our treatment pages.

Some men worry that cancer can be passed on when having sex. It is not possible to pass cancer through intercourse. Having sex will not affect your cancer or the success of your treatment.

What is erectile dysfunction?
Erectile dysfunction (ED) is when you have difficulty getting or keeping an erection. It is also known as impotence. It is more likely to occur as men get older. It can have many possible causes, including treatment for prostate cancer. For more information on the risks of ED with prostate cancer treatment, read our Treatment pages.

How does prostate cancer treatment cause erectile dysfunction?
Surgery, external beam radiotherapy, brachytherapy, high intensity focused ultrasound (HIFU) and cryotherapy can all damage the nerves and blood vessels that are needed for an erection. Hormone therapy reduces levels of the hormone testosterone, which is needed for sexual desire and erections.

Other medical conditions, stress and anxiety can also cause ED

Treatments for erectile dysfunction
There are a number of treatments available for ED including lifestyle changes, tablets, injections, pellets and vacuum pumps.

You can ask your GP or hospital specialist to refer you to your local ED clinic. If you are single then treatments for ED are available to you as well, for masturbation or if you are sexually active or thinking of starting a relationship in the future.

Men with prostate cancer can get treatment for ED free on the NHS no matter what age they are.

There is a limit to the amount of treatment GPs can prescribe. If you are receiving treatment from your GP and you need more, or treatment has not worked, let them know. They may refer you to a specialist for further advice, support and further treatment.

Read more about treatments for ED

Hormone therapy
Hormone therapy for prostate can reduce, or cause you to lose your desire for sex. This is because of the decrease in testosterone, which is the hormone responsible for giving you your 'sex drive'. One study suggested that about one out of two men (50 per cent) taking a type of hormone therapy called LHRH agonists or who have had surgery to remove their testicles (orchidectomy) will lose their interest in sex.

You could discuss 'intermittent hormone therapy' with your doctor or nurse. For some men desire for sex may return after hormone treatment is stopped, but this varies. It can take three to nine months or sometimes longer for side effects of hormone therapy to wear off. You can read our booklet Living with hormone therapy: A guide for men with prostate cancer for more information.

Physical and emotional impact
Testosterone is not the only factor that can affect your sex drive. Both physical and psychological factors can effect how you feel about sex. Read more

If you have had surgery (radical prostatectomy) you will not be able to ejaculate afterwards. This is because the prostate gland and seminal vesicles, which store and transport semen, are removed during the operation. Instead you may experience what is sometimes called a 'dry orgasm' where you feel the sensations of orgasm but do not release any semen from the tip of the penis. This may feel different to the orgasms you were used to. Occasionally, some men will find that a small amount of liquid comes out from the tip of the penis during orgasm, which may be fluid from glands lining the urethra.

If you have had radiotherapy or brachytherapy you may notice that you produce less semen after you finish treatment. You should still be able to have an orgasm but you may find that it feels different to before treatment. Some men find that they have less intense orgasms when they are having hormone therapy.

Read our Treatment pages for information on the side effects of each treatment.

Some studies have shown that around five out of ten men (50 per cent) will find that their penis is shorter after treatment with surgery (radical prostatectomy). This happens because of changes to the tissue inside the penis. Men may be less likely to experience these changes if the surgeon has tried to save the nerves that control erections during surgery (nerve sparing surgery). Some studies have shown that encouraging blood flow to the penis after surgery may help you get erections and prevent your penis becoming smaller. In particular using a vacuum pump might be helpful.

Other types of prostate cancer treatment such as radiotherapy and hormone therapy may also cause changes to the size of your penis. There is not as much research into this but it may be less common than changes to men's penis size after surgery.

Changes to your body and your penis can feel difficult to cope with. Talking to someone about this might be helpful. Read more about what support is available to you below.

Treatment for prostate cancer can affect your ability to produce sperm or ejaculate and lead to infertility. It may be possible for you to store some sperm before treatment so that they can be used later to fertilise an egg. Other infertility treatment options may also be available to you.

If you are planning to have children you should seek further information from your GP or doctor or nurse. If you have a partner, talk to them about your plans for having children and what this would involve.

Read more about fertility.

Having problems with erections or losing your desire for sex are problems that many men have at some point in their lives. Men deal with these changes in different ways.

Some men on hormone therapy find that because they no longer have a desire for sex, it is easier for them to come to terms with problems getting an erection. For other men who have had treatment for prostate cancer, the ability to get an erection, to have sex or to masturbate is an extremely important part of their lives. Losing the ability to have sex or get an erection can be difficult to come to terms with. See page below for ways to get support.

If you have a partner, or are starting a new relationship, talking about the changes may help reduce worries and help them understand what you are going through.

There are many other ways of having an intimate relationship without having penetrative sex. If you are used to a close physical relationship, physical contact - through hugging and kissing - maintains intimacy, provides support and does not have to lead to intercourse. Some men find they become closer to their partner.

If you have any questions about any of the issues described in this fact sheet you can call our confidential Helpline to speak to a specialist nurse. Some people feel embarrassed about discussing personal issues over the phone. You can also send a query to the Helpline by using our email contact form.

You could also try our telephone peer support service or sign up to The Prostate Cancer Charity online community, where you can share your views and experiences with others affected by prostate cancer.

Counsellors are trained to listen and can help you to understand your feelings and find your own answers. Your GP may be able to refer you to a counsellor or you can see a private counsellor. Contact British Association for Counselling and Psychotherapy.

If you are the partner of a man with prostate cancer you the services described above are also open to you.

The Sexual Advice Association has further information written for partners. Talking about sex can be difficult, even for a couple who have known each other for a long time. If you or your partner is finding it difficult to approach the issue of sex, you may find it helps to see a psycho-sexual counsellor. Contact the College of Sexual and Relationship Therapists.

• How could my treatment for prostate cancer affect my sex life?
• How soon after prostate cancer treatment can I have sex or masturbate again?
• What are the treatments for erectile dysfunction and which will be best for me?
• What are the side effects of treatment for erectile dysfunction?
• What happens if the treatment does not work? Are there other treatments I can have?
• Which drugs and equipment can I get from my local NHS?
• What other support is available to me?
• Can my partner also get support?