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 of a man's reproductive system
Diagram showing men's sex organs. 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 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’ve had radiotherapy or surgery to the testicles (your ‘balls’).
It also sometimes happens if you’ve 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.
- If you’ve had treatment for bone or muscle tumours in your limbs or back, it can sometimes be more difficult to get into a position to have sex.
- If you’re in pain for any reason this can make having sex more difficult.
- Your interest in sex may be lowered if the levels of the sex hormones (testosterone or oestrogen) in your body have been reduced by your treatment.
- 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 interest in sex, feel unattractive or worry that you’ll never be able to be sexually active.
- These feelings may also happen due to any changes in your body after the cancer and treatment.
what can help?
If you’re having problems getting an erection, this may 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 that are put over the penis
A vacuum pump is a device that 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 a bit strange to think of using a vacuum pump, it can be very effective.
It's also important to remember that you don't need to have a fully erect penis to have sex.
There are many other ways of having satisfying sex. You can talk about this with the doctors or nurses at your hospital, the nurses on Macmillan Cancer Support's free information helpline or the British Association of Sexual and Relationship Therapy.
Hormone levels can usually be kept almost normal by taking hormone tablets, using skin patches or having injections.
If you’re put off having sex because you’re in pain, it’s worth checking with your doctor if there is anything that can get rid of or reduce 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 the same as for many other young people treated for cancer, and getting help may solve or reduce them.
