Breaking barriers: a collaborative response to male sexual difficulties

Here are some cases of men’s responses to the sexual side effects of prostate cancer treatment, gathered as a resource for the Institute for Psychosexual Medicine ACM on 11 November 2023. Based on personal experiences.

The context

My story

My experience of prostate cancer diagnosis:

Living with ED feels like a wasteland – from my Psychology Today blog

Recovering Men global support group

Rare case: easy and full recovery

George’s story: As good as it gets

Adaptive responses

Better sex in 80s after prostate cancer treatment

Dating after prostate cancer

Erectionless sex

Better sex without erections

Sensuality after ADT


Sexless marriage and deep yearning

Assumptions: Invitation to health care professionals

  • Don’t assume it is all fixable
    • Even though we collude with you in believing so
    • Recognise that many treatments leave us with fundamentally new bodies
  • Don’t assume older men are “past it”
  • Don’t assume we don’t care about sex just because we don’t talk about it
    • Astonishing what rich sex lives go on behind the picket fence (reality and imagination)
  • Don’t assume we can’t talk about it just because we don’t
  • Don’t assume it is over when the other primary issue (e.g. cancer) has been dealt with

Breaking down barriers – a starter kit for health care professionals

What seems to help

  • Holistic care teams
  • Early inclusion of psychosexual and physiotherapy care
  • Support groups
  • Involving partners

What health care professionals can ask

  • How important is sexual function to you?
  • Who else matters in your sex life, and can we include them in this conversation?
  • What do I need to accept about your sexuality for you to feel comfortable talking to me about your sexual health?
  • Who else can you talk to about your changing sexual self and how can I support you?

What health care professionals can say

  • Tell us the truth about the outlook for my quality of life after treatment
  • We have a range of interventions that can help you regain some aspects of sexual function but it won’t be the same as it was before
  • Consider how you can get psychological and emotional support to adapt to these changes.

Allied health professionals supporting systemic change

Check out Soft Cock Week, including my podcast with founder and sex educator Michelle Renee on the power of peer support amongst men.