It’s often difficult talking with your partner about sex after prostate cancer. I am curious to hear from readers, what is it like for you?

For me and many people I have spoken with, it can feel like having to cover up with a mask all over again. So much has changed for both of you. And typically, for the one who had prostate cancer treatment, there has been significant body change including loss of sexual function. What might previously have come naturally might now be fraught and awkward.

It’s not for nothing that prostate cancer is often called “the couple’s disease.”

Yet there are ways for couples (of any gender) to recover meaningful intimacy, with some adaptations. It all starts with talking, and that can be a big barrier to cross for either or both members. It can feel like being asked to discuss the undiscussable.

What either partner might think but not say after prostate cancer

  • I’d rather just give up on sex
  • I crave loving touch
  • I feel as if you have withdrawn since the diagnosis
  • Do you still love me?
  • How can you be into me if your penis doesn’t show it?
  • How can I satisfy you without an erection?
  • I get so frustrated when we try to have sex but I can’t have an orgasm
  • I am embarrassed to admit that self pleasure is the way I get off easiest

A million reasons why not to talk to your partner

Here are a few of those very real reasons partners don’t talk about intimacy and sex after prostate cancer:

  • This is personal, too deep inside to speak.
  • It’s embarrassing.
  • People make horrible jokes about men who can’t get it up.
  • Nobody can help me with this.
  • My partner isn’t interested in sex anymore.
  • I have sexual fantasies my partner would disapprove of.
  • No use talking about sex when I can’t finish what I have started.
  • Sex is painful for me.
  • It makes me feel vulnerable to say what I want.
  • My partner is distancing from me.
  • It will be too painful if I open up and get rejected.

Partners discussing the undiscussable

All the above are good reasons why not to talk to your partner. It hurts now, and talking about it will draw attention to that pain. Maybe it will be easier just shoving it away.

But humans are both social and sexual beings. Being intimate with a partner can be a healing gift. Those who get over the awkwardness and into conversation, usually find their partners actually want to collaborate.

Getting help: partners talking about changes affecting relationship

In most countries your doctor won’t address the impact of medical changes on your mental, emotional and relationship health. Your health insurance probably doesn’t offer professional help with the way your medical treatment whacks your self esteem or your relationship. Worldwide, health care systems tend to be splintered where holistic care is needed. But just like any other problem, there are professionals who can support you – even though at its heart this is a very private journey.

Some partners just assume they are in this with you, and that includes adapting your shared sex life to suit your new body. Here’s an example from a 59 year old French doctor who took the lead when her husband lost his prostate. You can also read my own partner’s frank and supportive story on this website, starting from sharing the impact of cancer diagnosis and including a woman’s perspective on remaining intimate with a changing body.

Others are offered professional help and accept that offer. Here is a rare example from the UK where wonderful help was asked for and received by a pioneering husband and wife. They braved the term “psychosexual therapy” without thinking it meant they were somehow to blame. Just like one asks for help with a broken limb, or failing eyesight, so one can ask for help for a relationship to navigate one partner’s new and different body.

If you and your partner need some help but can’t afford to pay

We need more allied professionals helping with the relationship aspects of prostate cancer recovery.

For those who want to broach these awkward subjects and are not getting help through their national health plan or private health insurance, please don’t give up. You can ask for and get help. My resources page offers a window onto free support groups worldwide. You may also have access to wise, caring and confidential support from elders in your extended family, religion or cultural group.

My free offer to partners struggling to adapt

And to help getting the ball rolling, in the first half of 2024 I am bringing my international certification and more than ten years’ practical experience as a relationship systems coach to bear with a free offer: Frank, free, confidential collaborative coaching for couples adapting to sexual changes after prostate cancer.

And if none of these avenues sounds right for you, I would love to hear from you. What would feel like really useful help for couples navigating changes after prostate cancer? Particularly in those difficult and private areas of the relationship including sex and intimacy.