Gone missing: our sex life
Sexual problems are often a side-effect of prostate treatment . John Walker — who has written elsewhere on malehealth about living with prostate cancer — and his wife Christine speak plainly.
Christine: An element of our married life has gone missing
There have always been two people experiencing my husband's prostate cancer; himself and me, his wife. When it happened we weren't 'old' people in a relationship which had lost its sparkle. It was a cruel blow to a couple who, like everyone else these days, finds themselves bombarded by a commercial and media world geared towards eternal and virile youth.
At first the necessity to help someone cope with the shock of diagnosis and then afterwards nurse them back to full health, becomes the prime task. You share the elation that he survived the operation, and on a regular basis, that his latest blood test results show the cancer is still 'off the scene'.
You talk to other men's wives and hear how they are coping and feel so grateful that your husband has not been caught in the downward spiral of hormone treatment, radiotherapy and constant drugs.
As time passes you listen to others who chatter about how their particular husband has been able to return to full erectile function and how 'things are just great now'. In the back of your mind you know this probably can't be the case if they have had major surgery and vital nerves have, because of necessity, been damaged.
The trouble is, there is nothing wrong with my husband's head. It's just a part of his body which won't obey him and as a consequence of this a large element of our married life has literally gone missing.
The first few years after the operation were filled with repeated attempts to restore his ability to maintain an erection.
First there were various tablets then vacuum pumps, then injections.
We acted out of complex professional advice. Frustration and annoyance building for both of us at the lack of spontaneity and the complexity of forward planning, which often ended in failure and upset for both of us. I felt annoyed because there was nothing wrong with me and I guess he felt annoyed because he appeared to be letting me down and that I might think he didn't love me anymore.
When this point is reached it is essential that you take stock and look very carefully at your relationship and the myriad of everyday things which make it so unique and so special. This exercise can be very rewarding and in a curious way creates a bond between you both that is all the stronger because of the circumstances in which you find yourselves.
There is still the ability to display love and affection and you come to understand that important as the sexual side of the marriage was, it was not after all the foundation stone on which your marriage was built. For us this was an important outcome but there will, sadly, be some marriages and partnerships facing these difficult questions that are unable to overcome the problems.
John: Words cannot express the embarrassment
As a young man, I wanted to meet and bed as many beautiful women as I could. I suspect I was absolutely average in this respect and, in terms of achievement, I similarly suspect my success rate was similarly average. In short, optimism and reality were the opposite ends of my sexual spectrum. Just like everone else.
I remember the good and the bad sexual experiences with equal clarity. The good ones will last with me always and the bad ones won't go away, no matter how hard I try to expunge them. A good experience will want to be repeated, whilst repeating a bad experience is to be avoided at all costs.
What is a bad sexual experience?
Premature ejaculation, whilst proof of desire, is not something your partner will appreciate, especially if it happens repeatedly. Similarly, not enjoying the sex (or your partner being completely unexcited by what is happening) is also fairly depressing. Worst of all though has to be difficulty in obtaining or maintaining an erection. Words cannot express the embarrassment one feels at such moments.
Yes, I know it happens to everyone at some point in their sexual life, and the reasons for it are many and varied. But being in that position when you want to show your partner you love them, or simply prove your 'manliness', and not being able to hoist the flag, as it were, takes some getting used to.
As an average bloke, my days of sexual activity have reduced as I have got older. In my head I may be 17, but in reality I'm 53. I move in a world where my friends, colleagues and social activities are based loosely on my own age group. The opportunity, let alone the inclination, to be sexually rampant is tempered by all the things that as a young stud I never believed would ever happen to me. Too tired, disinterested, aching, something on TV, worried about stuff.
Lying to yourself about how great you are as a lover is one thing, but you are also immortal. So because you will live forever, the occasional lapses in sexual relations are temporary and will be rectified to the satisfaction of all parties at a later date.
I believed that at 46 and then I got prostate cancer. I've been through all the stuff about how I coped with the diagnosis, surgery and recovery elsewhere but seven years later I'm still coming to terms with the fact that my sex life is to all intents and purposes over. Perhaps more importantly, so is my wife.
The surgeon did a good job, but in 2002 the operation to remove my prostate was less nerve-sparing than it is now with the result that spontaneous erection is a fond memory. My world hasn't ended — I do manage to get an erection and orgasm is achievable — but the instantaneous buzz of sex and the ability to enjoy it free from worry have gone.
There are lots of drugs available to reinvigorate your sex-life post PC (assuming you have the prostate removed) but some have side-effects, some don't work for me and some appear on the face of it to be the results of a Dr. Frankenstein experiment. Vaccuum pumps take all the romance out of foreplay. Injecting your penis prior to sex may produce the desired effect but, romance apart, who in God's name would really deep down inside want to do this to themselves in the name of sexual relations?
Sex shouldn't be formulaic and expected to happen every Saturday night at the same time.
It has to involve desire, love and consideration. Having to plan for intercourse in the same way you might plan a car journey does take a lot of the mystery away for me.
PC tends to affect men much older than I was when I was diagnosed, and whilst I'd like to think God is paying me back for a youth filled with too much sexual excess (he isn't, but I can dream), the simple fact is that many PC sufferers don't rate the sex act as being so important at their time of life. In consequence, sexual counselling for post-PC sufferers is not particularly good.
Having said that, as with so many things you don't miss it until it's gone. My wife has been great about all of this, but I think in many respects I've been very fortunate. She decided to get her hip replaced to take her mind off it. The wives of others I know have not taken the news so well, with the result that there remains a tension between the partners that can never be properly resolved. Desperation leads people to do strange things so there will always be a home for pumps and needles.
Life without regular sex is not nearly as depressing as I imagined it would be.
Well, I have a vivid, fertile imagination plus some interesting websites in my homepage favourites (joke). I'm a realist in that without the surgery I could have died, so I balance the good with the bad and it makes me feel better.
Not having sex avoids potentially tricky situations such as etiquette and 'trying something different to keep it spicy'. I never swung or dogged so I'm not missing those opportunities now. I'm married, so going on dates isn't an issue. I'm not a milkman so the chance of being assaulted by a sex-crazed naked woman on the doorstep is unlikely.
I'm sure there are many men who continue to rail against the injustice of it all. I have no answers, but I do have a few suggestions. These include:
- being open and honest with your partner about the situation from day one when the diagnosis is made and the decision to remove the prostate made;
- finding out from the surgeon exactly what 'nerve sparing' actually means in this day and age,
- getting statistics on recovery and erections;
- contacting a local Support Group as they deal with all these issues everyday;
- trying the various tablets you can legally obtain from your doctor to assist erection disorders as soon as your surgeon says it is safe.
Other issues are prescription charges and availability of pills. At over £7 per prescription the cost of obtaining help like this is not cheap. The supply is regulated, so you can only obtain a specified number of pills each month and it won't be enough. I'm not aware of any free help in this area being offered for PC sufferers post-operation, but hope springs eternal.
Of course, the method of prostate removal is changing from the traditional 'cutting you open to extract it' way (radical prostatectomy) to a laparoscopic approach (keyhole). The new method is much more likely to save potency than the old one. It was just my luck to both get PC young and have my prostate removed in the traditional way.
I prefer laughing to analysing.
What happens does so for a reason and nothing I can do will reverse my history. So I live with it and smile ruefully from time to time. I still have my memories and good health. Other people will react differently when faced with the same problems I encountered. The bottom line is that we all have to make choices. How we carry on after these choices are made defines us as human beings. Sex is great but living well is better.
- Let us hear your experiences of post prostate surgery sex.
Page created on April 1st, 2009
Page updated on January 15th, 2010