22 October 2025
Living with erectile dysfunction: Focus on sexual function and relationships
Erectile Dysfunction (or ED) refers to difficulty getting or maintaining an erection.
There can be many reasons for ED, including medical conditions such as diabetes and high blood pressure, lifestyle factors such as smoking, excessive alcohol intake, obesity or lack of physical activity, psychological or emotional issues such as stress, anxiety, depression or relationship problems, as well as the impact that treatment for prostate cancer can have.
Erections require functioning nerves and blood vessels, and are also influenced by hormonal factors – all elements that can be influenced by both physical and psychological factors.
Open communication with your doctor: Discuss a treatment plan
A diagnosis of prostate cancer and treatment for prostate cancer can impact men’s sexual function, which can mean many different things for different people. For some men these changes can be very distressing, while others feel unconcerned.
A man’s reaction to sexual function issues may depend on how important it is to the man and his partner. Some men and their partners find physical intimacy through affectionate touching, hugging and holding deeply satisfying, absent of penetrative sex, and may choose not to purse ED treatments, while others may feel a sense of loss. For these men and their partners, seeking treatments for ED is important.
If you are experiencing impacts on your sexual function, it's important to talk to your doctor or a PCFA Prostate Cancer Specialist Nurse (PCSN), who has specialised training in all aspects of sexual function concerning men impacted by prostate cancer.
Discussing concerns about erections with your health care team might feel awkward at first, but it's important to remember that for your health care team, no topic is taboo when it comes to your wellbeing.
Treatment options for post-prostatectomy ED
Following some treatments, such as a radical prostatectomy, penile rehabilitation programs are one treatment option for restoring erectile function.
It may take 18 to 24 months for the nerves to fully recover following a radical prostatectomy.
Penile rehabilitation involves the use of medications (tablets and/or injectables) and/or a vacuum erection device (VED) to encourage blood flow to the penis. This improves oxygen supply to the tissues of the penis and helps to prevent permanent damage to these tissues and potentially improve the return of erectile function following treatment.
Starting a penile rehabilitation program shortly after surgery can give men a better chance of recovering spontaneous erectile function. Ideally penile rehabilitation should start within a month of surgery.
Staying physically healthy; getting enough exercise, eating a healthy, balanced diet, sleeping well and looking after any medical conditions like diabetes and high cholesterol are important in maintaining fitness and can help with achieving good erectile function.
Seek psychological support
There may be times in a man’s prostate cancer journey when men feel more emotional or stressed and need more support, especially if they are also experiencing side effects such as erectile dysfunction. Some men may find they still feel ‘down’ and/or emotional even after the treatment has finished. It is important to tell your healthcare team if you are struggling emotionally so they can provide support and assistance.
All men will cope differently with the changes they experience from their prostate cancer diagnosis and treatment. Many find men applying strategies like improving general health and wellbeing through diet and exercise empowering; others talk about their feelings, and others take time out to relax and rest.
Speaking to your GP can help. Your GP can provide support and information and refer you to other healthcare professionals such as psychologists, psychiatrists or counsellors.
Specialist Nurse support can also be of great assistance. If you have been linked in with a PCFA Prostate Cancer Specialist Nurse (PCSN) they can listen, provide information and support. If you have not been linked in to a PCSN you can contact the PCFA telenursing service on 1800 22 00 99 and they can provide information and support. If there is a PCSN near you, they can also refer you on to that nurse for additional support locally.
A sex therapist (sexologist) can provide sex therapy and relationship counselling to individuals or couples dealing with intimacy or sexuality issues or relationship concerns.
Physiotherapists, especially those that specialise in pelvic floor exercise training, can provide information about available treatment options for sexual function issues also.
Your urologist, surgeon or oncologist can also provide answers to many questions about the impact of erections, both short and long term, changes in libido and physical alterations of the anatomy associated with the different treatments for prostate cancer.
The PCFA team - with specialist nurses and counsellors - is specially trained in this area. You can call our Telenursing Service on 1800 22 00 99 or consider involving your partner and communicating your feelings
It’s important to keep the lines of communication open between you and your partner, including any concerns related to sexual function. If speaking to a doctor or nurse we recommend also including your partner, ideally starting from the time of diagnosis.
Talking and asking questions can assist in understanding the impact of prostate cancer treatments on sexual function, and ways to reduce their impact. Changes in sexual function and the worry of facing cancer can take a toll on the happiest of relationships. These strategies can ease those stressors and make a positive difference to the journey.
Men navigating sexual function impacts without a partner
Some men who develop prostate cancer do not have a partner and therefore face the prospect of commencing a new relationship after prostate cancer. While there is no best time to reveal your medical history to a prospective partner, it’s a good idea to wait until you feel comfortable before you discuss your treatment for prostate cancer and the effects of treatment on your sexual function.
References
Ref: PCFA booklet (Understanding sexual issues following prostate cancer treatment).
https://www.prostate.org.au/health-wellbeing/sex-fertility/
PCFA booklet – Understanding health and wellbeing from page 5.
Rashid, P, A guide to prostate cancer; The disease Treatment options and outcomes; 4th Edition.
Ref: PCFA booklet (Understanding sexual issues following prostate cancer treatment).
https://www.prostate.org.au/treatments-side-effects/pre-rehabilitation/
