It can help to know about the different parts of the sex organs and their names so that you know what we’re talking about in this section.
Diagram showing mens genitals. They are all in the lower half of the abdomen, with the testicles hanging level with the top of the leg within a sac called the scrotum. From the testicle is a tube called the spermatic cord this goes up and around behind the bladder and joins the urthra at the bottom of the bladder. The ejaculatory duct is at this join as well as the seminal vesicle. From the bladder the urethra then goes down through the penis. The penis contains erectile tissue.
In boys and men the sex organs are in the pelvic area (the lower part of the abdominal cavity). They include the prostate gland, the testicles and penis. Close by are the bladder, the lower end of the large bowel and some lymph nodes, also known as lymph glands.
It’s not common for cancer or its treatment to make it physically difficult to have sex but it does happen occasionally.
possible effects:
- It may be difficult to get an erection (a ‘hard on’ or ‘stiffy’) if cancer or the treatment has damaged the nerves and blood vessels in the pelvis. Radiotherapy to the pelvic area may sometimes cause this.
- Low levels of the male hormone – testosterone – can also make it difficult to get an erection. This can sometimes happen if you have had radiotherapy or surgery to the testicles (your balls). It also sometimes happens if you have had treatment affecting the gland in the brain called the pituitary gland. The pituitary gland produces hormones that control the production of testosterone by the testicles.
- Lowered levels of testosterone may reduce your interest in sex.
- If you have had treatment for bone or muscle tumours in your limbs or back, this can sometimes make it more difficult to get into position to have sex.
- Pain, whatever its cause, can make having sex more difficult.
- Many young people with cancer say that they feel 'washed out' and as though they have no energy for many months or even longer. If this happens to you, you may lose your interest in sex, feel unattractive or worry that you will never be able to be sexually active.
- These feelings may also happen due to changes in your body after cancer and treatment.
what can help?
There are often ways of dealing with the physical effects of treatment on your sex life. There is also lots of expert advice you can tap into. It is important to give yourself plenty of time to recover if you had treatment recently. If you are worried and want to talk to someone, it is fine to ask for advice at any time.
If you’re having problems getting an erection, this may well stop being a problem after a while. Treatments are available and these include:
- Tablets that can help you to have an erection, such as sildenafil (Viagra®), Vardenafil (Levitra®), Tadalafil (Cialis®) or apomorphine hydrochloride (Uprima®).
- Pellets that are put into the tip of the penis.
- Injections into the base of the penis.
- Vacuum pumps which are placed over the penis. A vacuum pump is a piece of equipment which you use to give yourself an erection – a doctor or nurse will show you the pump and explain how to use it. Although it sounds rather strange to think of using a vacuum pump, it can be very effective!
It is also important to remember that you don’t need to have a fully erect penis in order to have sex. There are many other ways of having satisfying sex. If you would like to talk about this, the doctors or nurses at the hospital can talk to you, or the nurses at Cancerbackup. You can also contact the British Association of Sexual and Relationship Therapy.
If you’ve had a testicle (one of your balls) removed as a result of testicular cancer, it’s sometimes possible to have an artificial replacement (prosthesis) so that your scrotum looks and feels the same as before the operation.
When hormone levels have been lowered by treatment in young men or women, the hormone levels can usually be kept at almost normal levels by taking hormone tablets, or using skin patches or, sometimes, having injections.
If you are put off having sex because you have pain, it is worth checking with your doctor if there is anything that can get rid of or lessen the pain. You can also experiment with sexual positions that may be more comfortable for you.
Perhaps the most important thing to realise is that your problems will be ones that other young people treated for cancer have had, and that getting help may solve or reduce these difficulties.
