Ask Amy … to Get a Woman’s Point of View

Sometimes even men can benefit from a female point of view on what appear, at first sight, to be exclusively male health issues.

ask-amy-sm.jpgAmy is the wife of a long-time prostate cancer patient who has agreed to offer her experience in whatever way she may be able to help. In particular, we believe she will be able to give suggestions and guidance to the wives, partners, mother, sisters, daughters, nieces, and female friends of prostate cancer patients as those patients go through the difficult processes of diagnosis and treatment for a disease that is emotionally unsettling for most men.

Please understand that Amy is not a physician. She is “just” a well educated laywoman with very personal experience of prostate cancer and its problems. She cannot provide you with medical advice. You should always talk to your doctor about your clinical condition and how it should be managed.

You may post your question for Amy using the comments / reply box below. Questions and answers are retained on this page for approximately 60-90 days from the time they are originally posted.

44 Responses

  1. Hi Amy.

    Well, my husband is still with us — sort of. His latest diagnosis (as if Stage IV metastatic prostate cancer isn’t enough) is Lewy body dementia. Wow — adding insult to injury in some respects.

    However, that being said — maybe it’s a blessing because he doesn’t really know / remember what is happening to his body. He had the last chemo in March of 2017 and he will never have it again, according to the doctors. There is nothing out there that can be tried on him at this point and, since he now has been diagnosed with Lewy body dementia — it merely complicates the possibility of any trial studies that might have been effective.

    We have Home Health / Hospice / Social Worker coming in now — to see if we can now get palliative care for him and to make sure I am doing OK.

    I had to retire in August due to his not wanting me to leave him to go to work. My sister had moved in with us — he would not have been alone, but he didn’t want me to leave him — I cried all the way to work and called in retired after my shift was over. Praise God!

    I told him that I retired when I got home and that I still had paperwork to do to process out, but that after that — all was good and I would be with him 24/7/365. Seemed to make him happy.

    The doctors are not ordering scans any more because there is not much they can do at this point — no matter where it’s spread or how much more it’s spread. His PSA has risen another 10 points in a month — kind of sad — and he’s starting to have some pain in his left upper thigh down to his foot — sad there as well. He doesn’t want to take pain medication so I give him Aleve or Tylenol (not at the same time or even on the same day). Eases the pain somewhat and Physical Therapy is coming in to help with that as well.

    Good news is that he is still able to walk a little — slowly — but since I had him taken off one medication his walk is getting a little better and he is able to be awake more, but his memory is messed up still. Some days — most days — he has no idea that I am his wife and that makes me sad as well. Still, I figure I can do the remembering for him along with our children and the grand-loves. We talk to him and show him pictures and talk about old times with him and it seems to bring him back to reality for a little while anyway.

    Guys: Please — do get your check ups. Prostate Cancer is totally curable if found early enough –

    Wives / Partners: Encourage and drag your man in for a yearly check up. A lot of the frustration I have read about in some of the posts could be avoided with a little prevention. Perhaps “prevention” isn’t the correct word. There is no “preventing” cancer — but if caught early enough, most of the things I’ve read, don’t have to happen. If caught early enough, prostate cancer is curable.

    I’m not trying to make anyone feel guilty — my husband had no symptoms or such vague symptoms that we were not really aware of — nothing that would lead anyone to think anything was amiss — until October 26, 2012 when he could not urinate at all. That’s when my husband’s journey began with this mean disease.

    My goal of posting now is just to ask you men to get your check-ups! (Wives / partners — you may have to drag them to a doctor to get this done.)

    While there is little that can be done to help my precious husband — if even one person is spared all he has gone through and what he will go through without a miracle — this post will be worth it.

    As my husband continues through this journey, I will be right here with him through every appointment — through the good and the bad, till death do we part. (BTW: My husband is what everyone would call a model patient. He’s calm, collected, and has not allowed this to drag him down. Praise God – I give all the glory to God for that.)

    God bless each and everyone of you. Ladies — my thoughts and prayers are with you all — caretakers of the world unite. Toughest job we have to deal with, but all I can really add is, “All it takes is for my husband to smile at me and say thank you for me to know that he is appreciative and just makes me want to help him even more”. I will love him forever … 39 years of marriage and counting. …

    *****

    Amy replied:

    Hi Ellen.

    I don’t think there is anything that I can usefully add to that!

    Amy

  2. My husband has had his prostate removed. It’s been 3 years now. He has no sex drive and cannot get an erection. He has for the past 22 years secretly (until caught) looked at porn. I recently found evidence that he still looks at porn. I’m hurt by this. We have not had sex in 3 years. He’s not interested in trying to please me by oral sex or toys. He has the injections he could use but doesn’t seem interested. My question is, if he can’t get a hard on, what is he getting from still looking at porn? I just don’t understand. We are just now in our 50s.

    *****

    Amy replied:

    Dear Sherri:

    For many men, the idea of being able to procreate is the absolutely driving and dominant force in their lives, and it is something they have limited control over. We are, after all, “just another animal”. Look at the way stags behave during the rutting season. They have just one thing on their minds, and anything that gets in the way is taking his/its life in his/its hands!

    Many human males live in a constant state of confusion between this biological priority and the (comparatively recent) social priority of monogamy. Some can deal with this easily. Others can’t. Arguably, male use of pornography is a way to help some men balance the two conflicting priorities. Many women — unsurprisingly — have a hard time understanding this.

    Your husband has had a third problem added to this mix. He can no longer “function appropriately” as a male. He has lost his ability to get and maintain an erection, and this means he not only feels emasculated. He also feels as though he has no status as a male among other males (let alone among women). For some men, this is devastating.

    Now your husband’s failure to “please” you is probably a consequence of the issues just described in combination with a lack of imagination and a profound degree of embarrassment. Being able to look at pornography may — in his mind — be his only way to pretend to himself that he is “still a man”. His imagination can still work in this area even if his body can’t.

    Please understand that I am not trying to absolve him of what I would like to think he would see as his responsibility to find ways to change how he thinks and behaves and to recognize that he isn’t the only one who is in need of missing sexual gratification. What I know is that, unfortunately, there are a lot of men who just don’t seem to be able to make this transition. They just don’t seem to “have the necessary wiring” in their brains.

    The only way real I know of that can help men like this to overcome their problem is through professional counseling. And sadly all too many such men absolutely reject the idea that they need such help — because it requires them to admit that they need the help in the first place. Catch 22!

    I have laughingly (and laughably) told people in the past that if I could find a way to resolve this particular problem I would be a deserving candidate for a Nobel Prize (for Marital Peace). But the problem is not funny at all. Overcoming it is all about communication between the couple. And that communication means you putting aside the anger about him looking at porn and him putting aside his sense that he is “no longer a man” and deciding to do something about it.

    One thing that I do know has worked for some couples is when the man gets a penile implant. It can give him back his sense of confidence in being able to “perform” as a male, and (I hear) it can give the woman back her sense of physical pleasure. However, it probably doesn’t work for everyone, and any man who wants to consider getting an implant would be wise to have this done by someone who specializes in this particular forms of surgery.

    Amy

  3. My husband had prostate cancer 5 years ago. He had the surgery and radiation. He has not touched me since. He got me to get stuff from the compounding pharmacy, but he won’t use it. He asked how I would feel if I had to put a needle in my privates. I am thinking of leaving. Please help.

    *****

    Amy replied:

    Dear Karen:

    I’m sorry to hear about your and your husband’s problems.

    The impact of diagnosis of and treatment for prostate cancer is well understood to be completely traumatic for many men. I addressed many of the reasons for this a few days ago in answer to a question about another, similar, situation. You might want to look at that question and my answer.

    I am assuming that the product you got for your husband from the compounding pharmacy was what is known as Trimix. It is administered by injection into the penis prior to sex, and it can work very well for some men. However, I can also tell you that for other men the whole idea is simply impossible to deal with, and the only thing I could possible compare it to would be you having to give yourself an injection of something into your clitoris each and every time prior to having sex. In all honesty, I’m not sure how well I could deal with that, so I do understand your husband’s question.

    Now don’t get me wrong, I also absolutely do understand your anger and frustration. But the only solutions that I know of for this problem are communication between you and your husband and (perhaps) a penile implant (as described in the prior answer above).

    If you and your husband have reached the point at which you can barely talk to each other at all about all this, then I suggest you both need some professional counseling … but I also have to tell you that there are no “easy fixes” for this particular problem.

    I don’t know if this will help, but you do need to be able to see this from your husband’s perspective … even if he appears to be being unsympathetic to you. He has been devastated by his inability to “perform” normally as a man.

    Amy

  4. Amy,

    My question is I have met a guy I really care about and have a great deal of feelings for. He is going through a divorce, and I just found out not long ago that he has had prostate cancer and is afraid to get involved with me. His words are, “You wouldn’t understand.”

    I’ve assured him I’m not going anywhere and that it’s not all about sex. He also has a bad tendency of shutting down. He will get really depressed and angry. Is there anything I can do to help him? I really care a lot about this guy and I enjoy what time we spend together. I also don’t want to scare him off with texting and calling him all the time to make sure he is OK, because when he gets depressed and angry I worry a lot about him.

    *****

    Amy replied:

    Dear Amy:

    I think that the first thing you need to appreciate is that he really almost certainly is depressed and angry. And he may be depressed and angry for a long time.

    He has been traumatized. He has lost a key physiological capability that was a big part of what made him a man. And to some extent he is right. No woman will ever really understand what that means to some men, just as no man will ever understand the emotional response that most women have to giving birth. So …

    If you really feel strongly about the gentleman in question, you are going to need to be very, very patient, and very, very gentle. Don’t bring up his issues at all. Only call him when you have something very specific that you’d like him to do for you, e.g., when you are going to a dinner or a party and you want someone as an “escort” or when you’d just like a companion to go with you to a movie or similar. Treat him as a friend and let him “make the running” when he is ready to do so.

    But equally you need to be aware that some men never get over this problem.

    Arthur and I (that’s the Arthur who also answers questions on this web site) have discussed this whole issue many times over the years. Arthur never got depressed about the biological changes that happened in his case, but he has always told me that he can easily see why it happens to a lot of men, but explaining it is almost impossible. The impact is so deeply embedded in what it means, biologically, to “be a male”. He tells me that there is really nothing rational or logical about it. It’s just something that happens to some men, and — for such men — recovering their sense of self worth and masculinity can just take time.

    Hope this helps a little.

    Amy

  5. Hi I’ve been going with my partner for 1 year. He has metastatic prostate cancer. He acts like everything is fine, which is good because he is getting on with his life. This includes relationship arguments which I’m sure is elevated because of his illness and stress from both of us.

    My issue is he demands my time constantly and I have been tugged between my daughter and him for my time. I have asked for time to myself but he doesn’t understand and gets upset. How do I deal with this or do I just try and keep my self as healthy as possible and try not to stress. It is sometimes hard to tell if he is jealous or just scared to be in his own. Any suggestions?

    *****

    Amy replied:

    Dear Therese:

    It really doesn’t matter whether he is being jealous or is scared to be on his own. If you don’t get “down time” to do the other things that you want and need to do, his constant demands for attention will just wear you out.

    This sounds like one of those situations when, if he was a 9-year-old, you would simply say that, “Mommy has to go out for an hour and you will need to be a big boy and look after yourself for a little while. There’s a peanut butter sandwich in the fridge if you get hungry.”

    Your partner “understands” just fine. He is simply being unrealistic, and you need to be polite and firm. A healthy relationship is one in which both parties agree to cooperate about some things and give the other party space and time to do other things on their own or with other parties (e.g., your daughter). Every time that you give in to his demands for constant attention is one more time that you reinforce his sense of entitlement.

    I understand that it can be difficult to negotiate these issues, but it is a necessary aspect of a healthy relationship. He needs to value your needs as much as he seems value his own.

    This probably isn’t particularly helpful. Unfortunately, however, it is a fact of life! :O)

    Amy

  6. Hi Amy, when I married my second husband he was 45 and I was 47. He had gone through chemotherapy for prostate precancerous cells and was given a clean bill of health. This was a few years before I had met him and we had no problem at all with intimacy.

    After 2 years he completely lost interest in intimacy, blaming it on his prostate. It has now been 9 years and he has not even wanted to try all the different meds there are for men. I just do not understand that for 2 years, with a clean bill of health, he was fine. I hate to admit this but I have found evidence contrary to what he has told me. It’s not another woman that I’m worried about; it’s if it’s a man, which makes me feel even worse. I honestly don’t know if I can live the rest of my life with not having intimacy or constantly wondering if he’s bi, gay, or whatever. I’ve asked him but he totally denies it and says he loves me. Now his best friend who is 10 years younger and his boss has been governing him real trendy clothes and they talk on the phone all the time. So, if you do gain back everything can it go away like he says or am I basically being a total fool?

    *****

    Amy replied:

    Dear Demi:

    I don’t think this is a situation that I am going to be able to give you much help with.

    However, for what little it is worth … I don’t think you are “being a total fool.” If anyone is doing that, it would seem to be your husband, because apparently he is unable or unwilling to explain to you what is going on in his head (quite apart from whatever may be going on in/with his genitalia).

    It doen’t sound to me as though your husband has a biological problem at all, but he may well have a psychological one if he is unable to give you a meaningful explanation for what is going on. If there is really a problem with his prostate, then why hasn’t he seen a physician about it? And if he has been seeing a physician about it, why hasn’t he been taking you with him to see that physician?

    Now I will also tell you that I don’t understand what you (or he) mean when you say that before he was married to you he had “gone through chemotherapy for prostate precancerous cells”. There is no such chemotherapy that I am aware of (or that Arthur is aware of either; I asked him). A man can have treatment for what is known as “benign prostatic hyperplasia” or BPH, but that isn’t precancerous or cancerous at all. So I have no idea what your husband was being treated for, and I have no reason to believe that whatever he had was actually any form of risk for prostate cancer.

    Amy

  7. I am sorry if this offends you but I need an answer.

    My husband had a biopsy. Looks like cancer. We are married 38 years. We have experienced lots of playtime and techniques as we have gotten older that help us to continue our happiness intimately. But now I am reading about throat cancer and blow jobs. … Can I get cancer from him?

    I am not foolish I understand you cannot give me a definite yes or no. We have not been with anyone else other than each other. Sometimes he gets a burning feeling since the biopsy from blow job ejaculation but not from vaginal ejaculation. Thus us why I am concerned. Please advise.

    *****

    Amy replied:

    Dear Any:

    Don’t worry. I’m not offended. You are far from the first spouse or partner or prostate cancer patient to ask about this.

    As far as anyone knows, it would be biologically impossible for you to “catch” prostate cancer from your husband as a consequence of oral sex. Similarly, it would be biologically impossible for your husband to catch vaginal or ovarian cancer from you if you had one of those forms of cancer and he was practicing oral sex on you.

    Female biology and male biology are very different and most cancers aren’t “communicable” in the first place. The only exceptions (as far as anyone knows) are the forms of cancer that are clearly known to be associated with viral disorders such as the HPV virus that can and does cause cervical cancer.

    I don’t think the burning sensation your husband is currently feeling after ejaculation when you have oral sex has anything to do with the cancer itself. It may have more to do with the strength of the ejaculation and some small — and probably temporary — changes to his prostate as a consequence of the relatively recent biopsy.

    Hope that helps

    Amy

  8. Amy:

    My husband just had an inflatable penile implant done three and a half weeks ago and my question is this: his penis and scrotum is very different in that you can feel the implant. … It doesn’t feel like his penis but like a penis with tubes and same with the scrotum. … Is this normal? He’s going to see his urologist on Thursday (4 days) but I wanted to see if this weird feeling is always going to feel like that or what?

    We’ve been married almost 48 years and he’s tried everything before this so it was both of our decisions. … I hope it was the right one. … We haven’t been able to have regular intercourse for many years. … I would appreciate your input and thoughts on this matter. … Thank you.

    *****

    Amy replied:

    Dear Kathy:

    I have no personal experience to go on with this question … and this isn’t exactly a cocktail party conversation one has with people. However, …

    I do think that his penis and his testicles are going to feel different. After all, they do indeed now have various bits of technical stuff implanted in them. Also, based on the “use it or lose it” paradigm, his penis probably became smaller over the past few years, and it may take time for his body to adapt to the implants. So, …

    I think the really important thing is for you both to take all of this slowly. You are both “out of practice” so to speak. I suspect that you are going to be able to adapt to the changes if you take it slowly and don’t expect everything to be exactly the same as it was 5 or 10 years ago (let alone when you were both in your 20s!).

    You are going to both need to be able to laugh about “re-learning” to have sex in a new way. If you take it too seriously and make it too important, then you may not be able to take advantage of the opportunity you have both been looking for. You are both going to need to find ways to believe that you really have taken the right decision, but that it’s rather like learning to be a snowboarder after years of being a skier. Some tings are the same … but some things are going to be distinctly different.

    Be patient with each other … be willing to experiment … the fact that there are different feelings for you (and for him) as a consequence of the implant may turn out to have benefits once you have adapted to the idea, after all!

    Amy

  9. Is it safe to give a man oral sex after he’s had prostate surgery? And it’s been removed! He’s in remission now.

    *****

    Amy replied:

    So long as that’s the only problem he has, then — as far as I know — yes. Prostate cancer isn’t a sexually transmissible disease. (See also my answer to this related question.)

    Amy

  10. I’m in a long-term relationship with someone who has been diagnosed. Can I continue to give him oral sex. TY.

    *****

    Amy replied:

    Dear Jane:

    Sure you can. If you want to and if he wants you to! Prostate cancer is not a communicable disease, and your biology wouldn’t allow you to have prostate cancer anyway.

    Amy

  11. My husband was diagnosed in 2015, 2 years after we were married. After his surgery he was fired from his job. He’s older (in his 50s) so this led to difficulties finding a job. He then became depressed because of that and due to that fact he was unable to get an erection.

    Our sex life prior was good, that is when he wasn’t constantly watching porn. The porn took a lot of the intimacy away. Well now 3 years later and still no erection, he still watches the porn but says it’s because he’s trying to get ready for me. :).

    I feel like he’s being selfish. I’m waiting patiently, but he can’t put the porn down long enough to even try to get a “hard on” naturally! With me! I find myself wanting to have sex with an old boyfriend just to relieve myself, but I know it would only cause problems. Help!!

    *****

    Amy replied:

    Dear Debra:

    I’m so sorry it has taken me two months to get back to you. Somehow I just “missed” your message and the sitemaster just brought it to my attention.

    I’m not exactly sure how anyone can really “help” with this situation. Your husband is being a typically male ass, and what he needs is a male acquaintance to tell him this … bluntly! However, I can see that that presents all sorts of possible problems.

    I am also not so sure that your strategy of “waiting patiently” is still viable. Your husband’s use of pornography as a “displacement activity” is really a method for him to avoid the reality of how to re-think what your sex life may need to become together. He’s probably terrified of actually dealing with this, and the best way to deal with that would be to drag him to see a sexual counselor or therapist, but getting him to do that could also be a struggle.

    The one thing that I am very sure about is that letting things go on as they are is going to get neither of you to anywhere near the necessary goal for all concerned … which is going to have to start with an honest conversation about what that goal needs to be!

    Amy

  12. What precautionary measures do you take for yourself when performing oral sex on your partner?

    *****

    Amy replied:

    Dear GGC:

    Well … I no longer have the opportunity to perform any form of sexual activity with my former husband since he died of his cancer some year ago. (There was no way you would have to have known this.) However, if you are referring to avoidance of any risk that I might “catch” my husband’s cancer as a consequence of oral sex, this is not actually a possibility. Or perhaps what I should say is that no one has ever identified a single case of prostate cancer being transmitted from one patient to another through oral sex.

    So, the only form of “precautionary measure” that I ever took was to make it very clear to my husband in my usual charming way that, if I ever found out he had been fooling around with someone else, he would be in deep doodoo at a depth that would make him distinctly unhappy!

    If you are really concerned about needing to take some form of “precautionary measure”, then the simplest one is to put a condom on for him. That will be a precaution against all sorts of things that are much more likely to be problematic than a risk for “catching” his cancer. One of the more common such risks is that men who have had surgery can leak urine when they have an orgasm … and that can be a distinct “turn off” (or so I am told).

    Amy

  13. Dear Amy:

    This will be my last post in here — my husband of 40+ years passed away a little more than a week ago from Stage IV metastatic prostate cancer.

    My hope is that all wives/partners will realize that this is a devastating disease for men. Everything they knew about intimate relationships changes — the rules change with a diagnosis such as my husband had.

    I believe it is important to talk about what loving someone is all about — for better, for worse, in sickness and in health, til death do you part. … For me, when I took those vows, I meant them — and I loved my husband so very much and still do — I respected him and he respected me — And I knew that if the situation were reversed, he would have been my primary caretaker too — We would have worked together, as we did with his disease and the prognosis.

    I am in no way trying to upset or shame anyone who is more concerned with the intimacy part than the person who is battling something so horribly devastating, but for me, sex was the last thing I was concerned with after receiving that diagnosis — We held hands — We took short walks together hand in hand — We kissed — We talked a lot — I wanted my husband to be healed so we could celebrate our 50th anniversary together. I wanted my husband and I to be able to dance together longer — It breaks my heart that he is gone, but I am thankful he went peacefully with me and our two children at his bedside.

    This is a life-changing disease, and it may take the men a while to absorb the impact. It will take the wives/partners a while to absorb the impact that this disease will have on both of their lives.

    Again, for me, losing intimacy was never important to me after we got that diagnosis — Stage IV metastatic prostate cancer — The issue for me was getting him the best treatment available to keep him as healthy as possible and let him know that he was worth my time — my love — my being at his side, to love him through it … til the very end.

    God bless each and every one of you! I am praying that the issues that are important to you are resolved in a positive way.

    *****

    Amy replied:

    Thank you Ellen … and I am so sorry to hear of your loss …

    Amy

  14. I commend you Ellen for your awesome stand that you took during this devastating time of your life. You will be rewarded for your actions. Stay blessed.

  15. Hi Ellen, your post reveals you have the goodness in a woman I have sorely missed all my life, so may your recover, and live on and with a fine memory of a good man. I am 71, and faced with a battle without partner or children, yet I find wonderment in each day of life I have.

    All the very best regards,

    Patrick Turner

  16. Thank you. One day at a time. God Speed! God bless you all.

  17. Hi Ellen.

    What a great post and perspective on love, and a tough journey. I am convinced that all women and caregivers handle this differently. It’s a ray of light to hear your husband’s, and your story. I also took care of my husband and his metastatic prostate cancer — for 13 years. Unique journey of extreme ups, and extreme downs. But I never gave up because I needed to know, in the depths of my heart, that I did everything humanly possible to help him.

    God bless.

  18. Patrick,

    My thoughts and prayers are with you. Enjoy your life to the fullest extent! Thank you for your kindness. Thank you too, Jan and Amy. Bless you all! Praying for all involved in battling prostate cancer and the caregivers and partners. It isn’t a “patient” only disease … but a “family” thing. God Speed!

  19. Hi Amy:

    My husband had his prostate removed 6 years ago. We have tried pills, vacuum pumps, and injections, but all to no avail.

    We also brought the pump that you use in the shower, but the worst of it is it’s just been sitting here only. We tried it once 6 years ago. It’s like he has lost interest and I am avoiding it all because I feel it’s going to be just like the rest a disappointment.

    Not sure what to do

    *****

    Dear Cherie:

    When one tries all sorts of ways to recover something one has lost, and one suffers a constant stream of failures to achieve the desired outcome, it is hardly surprising if one stops trying. This seems to be what has happened to you and your husband. And I am sorry that you have both had to go through this — both together and (in a sense) separately.

    So, what to do …?

    Perhaps it is time to take an entirely different approach, which is to rethink the nature of your and your husband’s relationship. Apparently you have, to a significant extent, maybe lost the sparks that brought you together in the first place. In which case you either need to re-find them or you need to find some new sparks. To roll out a tired old phrase, “The definition of insanity is doing the same thing over and over again, but expecting different results.” But you and your husband aren’t insane, you have simply run out of ideas to get yourselves charged up and willing to take risks.

    You need to turn yourself back into someone your husband really wants to “date”. So, what are you going to make him do with you that would be really fun? Things that will make you laugh together and hug each other with excitement, and make each of think, “NOW I remember why I married this man/woman. And if that all leads to sex, what risks are you both willing to take to make each other feel happy? Even if it involves things you have never done together before?

    And what can you drag him off to do that you know he has always wanted to do? Can you make him go skydiving with you?

    My point is that the “routine” of failure to have successful traditional intercourse is based on the delusion that successful, traditional intercourse should be the goal. I would respectfully suggest to you that, before you get there, you may need to get back to the sheer pleasure of being in each other’s company and doing things together you have never done before.

    And then … if you both really still need the whole “penetration” thing too, there are some really good types of penile implant available that some couples absolutely swear by … but they aren’t for everyone and if you go down that path make sure it is done by a surgeon who is really skilled at this.

    Hope this helps … if only a little …

    Amy

  20. Ellen,

    Thank you so much for your post. It is exactly what I needed. I love my husband of 30 years more than I can say, but have been feeling somewhat selfish regarding what our wonderful sex life is like now. I needed to see your post today so that I can pick myself up and focus on the love of my life and the father of our two kids … and I saw it just in the nick of time.

    Debbie

  21. I am so thankful that my post has given you what you needed today. God is never too late. It makes my heart happy to read your post. I am praying for both you and your husband and your two children as well. Tough road ahead, but I wouldn’t have missed holding hands, the walks, the talks with my husband — for anything in the world. Prayers and hugs for all of you! You are a gem! GOD BLESS YOU all!

  22. Amy,

    I have been recovering from having my prostate removed due to cancer. Before the surgery I really did not have any urge to have sex with women. I lost my wife 5 years ago due to cancer and I just kept busy by taking care of our home and also my wife’s grave. I am doing well in my recovery but cannot understand why I have these sexual desires? Is this a normal feeling that I should have?

    Thank you for your time

    Steve

    *****

    Amy replied:

    Dear Steve:

    The human body is a strange thing, and sometimes difficult to explain.

    As a woman, I am aware that men’s interest in sexual intercourse is driven by biological factors that can often (but not always) be rather different to those of women.

    Your prior disinterest in sex, after the death of your wife, may well have been a part of the grieving process, but it may also be that biological and endocrine changes induced by your surgery have led to re-stimulation of your testosterone levels, and that this has led to a renewed interest in sex.

    Can I tell you this for sure? No, I can’t. Do I know if this is “normal”? No, I don’t. Do I think you should be in any way concerned about this? No, I honestly don’t. And if you were to ask me if I thought this was in any way a “betrayal” of your prior feelings for and relationship with your wife, my answer would be, “No, I don’t.”

    I think this is just human biology doing what it does, and it can vary vastly from person to person.

    The degree to which you may feel you want to act on this set of feelings by seeking a willing partner is a whole different question that you are going to have to work out for yourself, however.

    Hope this is helpful … if not very informative

    Amy

  23. Hi Amy.

    I am at a loss for help with this issue. I am dating a man 7 years post-surgery. He is 69 and totally turns me on. I am 59. He did the injection once and I enjoyed it but I do not need it. My libido is healthy because he rocks my boat. But when he said he wants to do the injection I have said no because I do not need the erection because we do other things that cause me to orgasm. But am I wrong in saying please do not? Is his pleasure more stimulating after an injection? We are just dating and I am crazy about him but do not want to be harming his manhood unknowingly by asking him not to I inject because I do not need that. I just think ouch when I hear injection. Thank you!

    *****

    Amy replied:

    Dear Jennifer:

    Obviously I have no real idea why the gentleman in question feels the need to “boost” his capabilities by using penile injections … but I can guess.

    My suspicion is that this has nothing to do with you and everything to do with his own beliefs in his masculinity, and that actually, by telling him you don’t need him to do the injections, you may be limiting his ability to feel the same sense of arousal as you say you feel. On a purely anatomical level, of course, this makes no sense whatsoever, but on a psychological level, I can entirely see why actually being able to have a functional erection could make a man feel more “male” and therefore more “worthy” of your interest.

    Men’s psychosexual mindsets and behaviors are (unsurprisingly) very different to those of women. And I think you may need to be open to letting your “beau” take the lead on this one. Stop thinking about the “ouch” on his behalf (after all, it’s not like you have to do anything) and let him decide about that. Although maybe the trick is to tell him that you can’t watch while he is injecting himself and maybe he could do that in the bathroom or you could tell him you’ll be “up in 5 minutes”.

    Amy

  24. Hi Amy,

    My husband had just had his prostate removed due to cancer. It has been 6 weeks now.

    I just need advice on how to be patient with him as he knows that I want sex but I don’t want to pressure him.

    *****

    Amy replied:

    Dear Helen:

    Let me be very straightforward with you.

    The very fact that your husband “knows that you want sex” is already pressuring him. That is not going to go away — either for him or for you. The question that you are both going to need to work your way through is what “have sex” means for you both over the next few weeks and months. If it means “be intimate and have an orgasm”, that can be accomplished in many ways other than the missionary position, and you and your husband are probably going to need to do some exploration of what is going to “work” for you both.

    It is impossible to know how soon your husband will be able to recover a level of erectile function that will allow “traditional” penetrative intercourse to work well for either of you — but it will certainly take time, and it could take quite a long time. So — in the interim you are both going to need to “think outside of the box” about what you are willing to try.

    There are many things that can be done to help your husband recover a practical level of good erectile function — from little blue pills (i.e., Viagra or Cialis), to intrapenile injections, and right up to penile implants, but what is going to be more important than anything else is going to be how you communicate about all of this and whether you are able to try things that you may never have tried before.

    Obviously, I understand what you mean when you say that you don’t want to pressure your husband, but at the other end of the scale, he needs to appreciate that you have the same levels of biological interest in sex and ability to enjoy it as your did 6 months ago. He, on the other hand, may have a very high level of concern and insecurity about whether he is ever going to recover anything like the level of sexual ability that he had 6 months ago. He may well feel “emasculated” by his surgery, and you need to find a way to be honest and straightforward with each other about what is going on.

    This is not easy — particularly since many couples never actually talk about their sex lives at all. They just “do it” and have, over the years, established a routine (or an “unroutine”) that works for them both. So when they need to actually say to each other, “Would you like to try X or Y since Z doesn’t work at the minute”, it can be very hard to have those conversations.

    I am quite sure that this was not the answer you were looking for. Unfortunately it is the only good answer that I can offer. If you have a wise husband, he also needs to go find a urologist (often actually an andrologist, who is a urologist who specializes in things like male sexual function) who can help him with what is known as “penile rehabilitation” after his surgery.

    Oh … and one other thing. Your husband needs to get a message (well actually, probably lots of messages) from you that you still see him as “your man” and your friend and your lover. So, make him take you out on dates. Make him feel special and irreplaceable. Tell him you love him. And help him to fall in love with you all over again. He needs the ego boost!

    Hope this helps a little.

    Amy

  25. Dear Amy,

    I am not the woman I was when my husband married me 30 years ago. I am finding it very hard when people say that it is great that the operation was a success.

    I am grieving the loss of intimacy and the fact that my husband will not go down the road of thinking outside the box. I am getting depressed and angry about this. I can’t stop crying at times.

    Helen

    *****

    Dear Helen:

    You have all of my sympathy. I hear you. However much we may not want it to be the case, almost no man ever recovers full erectile and sexual potency after surgery for prostate cancer, and few of them (and few of their spouses and partners) are really willing to talk openly about the impact of the loss of intimacy (and sheer physical pleasure) over time.

    For many years almost no one talked about this, and sociocultural factors make all of this very difficult to address. A lot of people want to “blame the surgeon” for all of this, but it isn’t that simple.

    I don’t have any brilliant suggestions to offer you. I wish that I did. And I am so sorry that I don’t.

    Some women — and some couples — can gain help from counseling … but all too often the male patient is so traumatized by the loss of his “normal” (whatever that means) sexual capabilities that he just goes into complete denial.

    The one thing that I know is that the ability of the two partners to be able to talk to each other about the situation, and to decide what to do together, is at the heart of being able to “come out the other side” with a satisfactory solution.

    Somehow I think you were hoping I might be able to offer you more …

    Amy

  26. I’m a 9-year cancer survivor who had a racial prostatectomy. First, I’d like to say to Helen, “Hang in there with your husband.”

    Prostate cancer is a awful thing for a man to hear about from his doctor. The impact that it has on a man is devastating. So, now he’s feeling less than a man, and ashamed of his condition. It is and always will be a hard topic to discuss. Talk with him and let him know your desires and always encourage him. I went into a state of depression for a while but joining a support group really helped me. Let him know he’s not alone. If you like to respond to me directly please do so, I only want to help.

    I’ve been there where he is now. God bless both of you.

  27. My husband will be getting a bone scan this week and I will be discussing sexual issues before we even meet with the doctor to discuss results. I feel this will be easier now as he is more apt to talk not knowing prognosis, etc.

    Some of the advice here seems very sympathetic toward men looking at porn and shutting down completely without ever wanting help. I will be letting my husband know that these are not options for a continued relationship and to stay together for the family’s sake may be too much for one to handle especially when anger is allowed to reign. Maybe I have a low tolerance for dependency but when a man willingly sucks energy from a spouse without trying counseling it speaks volumes about the viability for a meaningful and successful relationship — as well as the previous strength of the partnership to begin with.

    If he will not hear me out given adequate time and compassion to work through issues perhaps it will be better for both of us in the long run to face our fears with someone else. I am not trying to be callous but many women here are suffering because of egos that are tougher than diamonds. I look forward to our talk before the scan or knowledge of the prognosis. Women seek out help now! Actually we can still care for our spouses but seek intimacy elsewhere if they refuse to meet us 50/50.

    *****

    Amy replied:

    Dear Bryan:

    Each man, each woman, and each couple is going to approach this issue in a slightly different way depending on all sorts of things — most especially the precise nature of the relationship between the two partners.

    What you seem to have read as “sympathy” for certain male behaviors would (in my humble opinion) be more accurately read as “understanding of” those behaviors rather than sympathy. It is perfectly reasonable to appreciate that things happen without endorsing them in any way.

    You undoubtedly will approach this situation in the way you describe. Depending on the nature of your relationship with your partner, this may be a very appropriate mechanism of action. Other couples with other interpersonal dynamics might not agree with you, however. There is more than one way to skin an onion.

    Amy

  28. I wish I saw this sooner. I don’t have a question. My dad died in summer of 2018. I was there every day for him … ‘n he was not all there. He was an amazing man.

    Anyways my dad never wanted to get married. He always told all of us four children that he wouldn’t ever do it again. He said if he wanted to marry he would have already. So the day he fell ‘n went into the hospital, … this chick he met (bar rat) was talking about marriage that same night. Me and my brothers and sister told her to please not right now. We want him to be “all there”. So he has proper consent.

    She told us the night before she married him that she was doing it in the morning without us. My daddy couldn’t even get up on his wedding day. His side of the family, he really doesn’t talk to that much. They are all naive. ‘N they keep the peace so to say …. He died … ‘n she took everything. ‘N on top of it, after he died, she had a benefit to make extra money even tho’ all his doctor bills were paid for which I have proof of ‘cuz I was on his coverage.

    I haven’t been able to live peacefully knowing this. I had to watch my dad’s last breath at 25 years old …. He barely even knew me on my birthday. … ‘N then she took everything. Every memory. Every piece of clothing. Everything. Her mom worked for a huge, well-known hospital for years … ‘n she knew someone who didn’t work for the care center he was in after the hospital. … But she somehow was scheduled in or got contracted in to help? My dad didn’t like this woman …. I just do not understand how someone can do this to him or his children. As times were already hard enough for all of us. …

    My point is, I really appreciate you doing this for people who are going through this and answering questions for them. I wish I saw your posts before all of this. But I’m happy to see the care people put forward to help others. Thank you for your love that you bring to the world in need. I’m sorry for what you and your family has been through as well.

    Thank you

    *****

    Arthur responded as follows:

    Arthur is very sorry for your losses and he thanks you for your kind remarks.

  29. I absolutely agree with the comments made by Bryan on February 9, 2019.

    I would like to mention that I am in the same situation as Sherri who posted on January 9, 2018, although my husband and I are in our 60s.

    Amy I appreciate your heartfelt and caring attempt to help all of us who are dealing with these devastating circumstances. However, I would just like to respectfully say that you are not every man and every woman. Neither is your relationship with your husband going to be similar to a lot of our relationships with our respective spouses. I would also like to mention that the majority of us spouses do actually understand how devastating prostate surgery is for our husband/male spouse.

    Sorry but what you seem to be overlooking is how devastating it is to both partners. Yes, the male partner looses his manhood, his male identity, his sense of what makes him a man; VERY TRAGIC! But, the partner also loses the person that she fell in love with, the person that she has known for maybe years, the sexual partner that she has enjoyed (for years, especially if they were sexually active). My point here is that both have lost, both are grieving, and both are hopeful that, after surgery and recovery, things will normalize and maybe not return back to how they used to be, but, that both partners will realize the importance of trying to return to normalcy.

    I have unfortunately found that after a year and a half of surgery and treatment, my husband has had no interest in trying to re-establish an intimate relationship. (But he’s quite happy going on porn sites.) I have expressed to him how important it is that we try to do so, for our marriage. He wants hugs, kisses, and affection but nothing more.

    I have explained that hugs, kisses, and affection are fine but I still have additional needs. My words fall on deaf ears. So, what is a partner to do in these circumstances? Couple’s therapy? The mere fact that you’re having to tell him that you have needs to me says it all.

    We can be sympathetic, sorry, and understanding, but, in the final analysis, we all have needs that need to be met.

    Amy, and others don’t. I think you need to recognize this too when you offer advice.

  30. Dear Monica:

    I am uncertain why you seem to think I am “giving men a pass” for their failures to acknowledge and act on the needs to their spouses and partners. I don’t. And there are plenty of examples in my “responses” above that demonstrate that. My suspicion has long been that many men are actually well aware of this problem but have no idea how to deal with it.

    On the other hand, each response that I write is not “generic”. It is a response to a very specific person (male or female) who has described a very specific problem that they are dealing with. And I try to address the individual problem.

    Am I perfect at this? Of course I’m not. And since my husband died a while ago from his prostate cancer, my personal relationships have very little to do with my responses. I will merely say that “things” were far from satisfactory from my perspective, but it wasn’t for lack of trying on my husband’s part because we were both able to at least talk about it.

    The situation you describe in your own relationship is common. Your husband, like many others, appears to be unwilling to try to deal with reality, but happy to indulge his fantasies, where he has no risk for or sense of failure. Could he be doing better that that? Of course he could, but he is likely to feel considerable shame and remorse. Do I have a simple answer to this? No, I don’t.

  31. Dear Amy:

    Great response to Monica. However, I’d like to add that it’s not a failure on men behave, it’s a medical and mental period that each man goes through. If by chance any of the women be there from Day 1 and attend doctor’s appointments, and to the the support group meetings, I believe they would have a better understanding of the mental anger that a man feels. I’m living very happily as a Stage IV prostate cancer survivor (after 9 years). It takes a lot of understanding and communication between the two. So please ladies be encouraging and patient with your mate, ’cause you have no idea the devastation he is going through.

    *****

    Amy replied:

    Dear Alfonzo:

    In an odd way you are making the same “error” that Amy was making, because you are assuming that all men behave the same way when they get a diagnosis of prostate cancer. They don’t.

    Some men cope with it extremely well and logically. For them there is no “devastating problem”. They can talk about it easily — with their spouse/partner and others, and regardless of the medical situation, they just get on with their lives. Oh, and they immediately say to their wife/partner, “Can you come with me to see the doctor today ‘cos two pairs of ears will be better than one.”

    At the other extreme, there are men who are utterly unable to even think about what is happening at all. They go into complete withdrawal (before and after whatever treatment — if any — that they decide to have). They refuse to let their spouse/partner come with them to medical appointments. They don’t go near a support group. And to all intents and purposes they try to pretend that what has happened hasn’t really happened at all. It’s not a “healthy” approach.

    And then of course there are all the different possible situations (including your individual one) in between.

    Now it is, of course, important for men to feel that their wives are being supportive and that the wives try as hard as they reasonably can to be patient and supportive too. But every situation is slightly different. I know of couples whose entire relationship turned out to be based on the quality of their sex life … and the woman was out the door as soon as it became clear that that was over. Similarly, I know of couples in which the man was utterly unaware of the ways he was abusing his wife by ignoring her, despite her having tried for years to accommodate to the complete change in his personality. Every couple has its own “special sauce” and dynamic. There is no “one size fits all”.

  32. Hi Amy. First, very sorry for your loss and thanks for your response. To be honest, I was not expecting you to have an answer to my problem. But, I want to thank you for at least having this forum because it obviously helps some people understand their circumstances.

    The thing that I find/found most helpful is the fact that there are others out there in the same situation as me. It does help one to have a different perspective and to look at their situation in a different light.

    Thanks again.

  33. Amy,

    My husband had his prostate removed 2.5 years ago. He has completely lost the ability to have sexual intercourse. We are both 62, so we were not quite 60 when he had his surgery and he’s doing great except we have no sex life whatsoever.

    I have asked him if he has the urge if I touch him or get close to him and he says there is nothing there. I am so very frustrated, because he doesn’t really try anything. He had the medication and the syringes that you inject into the penis, but refuses to let me give him a shot and he is scared to do it himself. He is not romantic and not loving at all, and he wasn’t before, but at least years ago we had a decent sex life.

    He still looks at women all the time and I wonder why; that has always hurt me. I am unfortunately starting to feel an urge to either move on or just have an affair. I don’t want to do either, but this is no way to live a life when you love sex and I have talked to him many times about my needs. He seems not to care.

    I am so stressed out about it all. What do you suggest?

    *****

    Amy replied:

    Dear Cynthia:

    Alas I am in no position to tell you what you should or shouldn’t do about the situation you describe. I don’t have a good answer to your question, and I also don’t make judgements, except for one:

    Whatever you decide to do, you need to let your husband know. If you don’t do that, then you are only compounding the problem.

    Every relationship is different. How each couple manages the ups and downs of their relationship over time is also going to differ. What works for Couple X would probably be okay for Couple Y (but not ideal) and complete anathema to at least one member of Couple Z.

    As a recent politician was fond of saying, “I feel your pain.” The problem is that after years of trying to help people like you and your husband, I can also feel his pain. He has also lost something that was crucial to him, and while I don’t “forgive” his inability to address your needs, I do recognize that this may be something he has no control over at all (rather like the way people can be afraid of mice or harmless insects).

    Amy

  34. Hi,

    Recently I started dating a man whom is a survivor of prostate cancer. He is using a pump, I think. He knows what he’s doing and it works.

    However, I need to know about getting erection during oral sex. I’m going to talk to him about it but I want to understand more about what I can do. I can feel it inside him different. I’ve looked at Adam & Eve products but it’s to stimulate what’s been removed.

    Experience tells me, use something without penetrating anally. I know the area between the testicles is very stimulating. Would using a vibrator help me. I just want to make sure the oral sex on my part is satisfying.

    Please get back to me as soon as possible.

    Thank you,

    Wanda

    *****

    Amy replied

    Dear Wanda:

    It sounds to me as though though you may have a lot more experience in this “area” than me. However, …

    If I know one thing about what “turns a man on”, it has much more to do with who is doing it and whether it feels exciting to that particular man than it does with exactly what is being done and when. So …

    Your plan to talk to him about this is almost certainly the most important thing … and if you are talking to him about it while you are experimenting, I would expect that would be an even better idea (as in “So how does that feel? Would you like it if …?”). You can also simply ask him whether he would like to experiment with specific toys and whether he thinks they would help. He may or may not be “into” that. And even if he doesn’t get an erection during oral sex, he may still enjoy the interaction.

    Amy

  35. Hi Amy,

    Husband is a awesome man, great and just awesome 36 yrs marriage. Had surgery for PC Stage 4 Robotic and never regained control also leaking, chemo. also has him bleeding every time he urinates. I am praying so hard and taking him everywhere for his full recovery he has really gone through it bless him. For the first 3 years he and I did nothing physical with me, his choice. I waited, period. I did nothing either, he is worth it and I believe in him.

    The doctor told me the medication he takes to heal will not allow him to want to do anything sexually. I understand. About 6 months ago he started initiating things with me. I was so thrilled everything happens so fast for me only though although there is no penetration because it has been so long without. I missed him terribly and still find him as sexy as ever. I tell him often. We talked about it after but he says he feels nothing. He wants to he says but can’t. I don’t want it to be a one-way street. I would like to do “things” for him to make him feel great even though I know no penetration can be done. Have you heard of situations like this before? What do women do to make their husband’s feel when the medication or situation doesn’t allow them to? How do they “blow his mind” when a husband says, I will do you but there is nothing there for me, and not to bother? He deserves to feel as great as I do in any way possible when he does “think of me and decide to satisfy me”.

    Can you let me know what others do?

    Thank you Amy.

    *****

    Amy replied:

    Dear Succe:

    So there are several things that a woman in your situation can do for a man in your husband’s situation … if she is willing and if he is interested.

    Even though your husband may not be able to get an erection because of his medications and his prior treatment, he may still be able to have a type of orgasm — and he won’t know that unless he is willing to try. However, the fact that he also has urinary leakage will be a problem for all concerned, and so if you are going to “try” different things (like oral sex or simply by stimulating him manually; see below), it might be wise for you to do this while he is wearing a condom so that neither of you get “grossed out” by any leakage of urine.

    Manual sex or a “hand job” is described in some detail in this article published in Cosmopolitan.

    Oral sex is properly known as “fellatio”, and if you look here you can find some very specific instructions.

    Both sets of these instructions apply to what a woman can do for a man who can still get erections, but most of them still apply in the case of you and your husband. He still isn’t going to get erections, but you might still be able to “blow his mind”. … However, do remember the condom because a mouthful (or a handful) of urine is probably not an experience that you would enjoy and it would probably embarrass the heck out of him.

    Just remember that a lot of what is great about sex goes on between the ears. So talk to him about what you are going to do and why (before and while you are doing it). Ask him what he would like you to do. Be “exploratory”. Make it romantic for him, and make sure it is fun for you both and not some sort of clinical exercise.

    The other thing that may be possible would be to talk to his doctors about him being able to have a penile implant. This would make something like real sex possible for both of you again. Many couples find that penile implants can completely rejuvenate their sex lives because the effects can feel so much like the real thing. However, I do have to tell you that other couples find them problematic, and the most important thing is to have a careful and detailed discussion with a doctor who specializes in this type of surgery, and to find out whether your husband’s insurance would cover the costs, because this is not cheap.

    Hope this helps you some.

    Amy

  36. Hi Amy.

    We are 30 years married this year.

    Throughout our marriage, my husband was always emphatic that a marriage without sex is no marriage. He felt is was imperative. Throughout the years, the ups and downs, while busy with the kids, no matter where we were emotionally, to deny sex was off limits. He would be very vocal about that particular issue, not just privately with me. I would even say to him over the years that extenuating circumstances inhibit sex, but a marriage could still be strong. He would just repeat that a marriage without sex is not a marriage.

    He began having physical limitations 2 years ago and has since been diagnosed with prostate cancer. Impotent and incontinent with hopes to keep this aggressive Gleason 9 at bay. I have been supportive and very patient. More than several times I have asked him to still be intimate with me. Nothing. Zero. Absolutely no affection whatsoever. I am emotionally spent. Every time I pleasure myself, I end up in a puddle of … tears.

    Recently, I was open with him about my needs. I had kept quiet because we were all about figuring everything out with the surgeries and protocol. I asked him to please not to forget my needs. Again, nothing.

    Please don’t suggest counseling. If the aforementioned synopsis doesn’t indicate his “old school” perspectives, I will say that there are a lot of family “experts” in psychiatry on his side of the family and he writes it off as psycho babble.

    Am I being selfish? Uncaring? Dismissive of his psyche? If he had not been so imperative for all these years about sex, I would say it simply isn’t occurring to him the importance to me. But he can’t pretend to forget it now that he can’t. Part of me is furious to think it was him being so selfish all those years. Part of me wants to run because how could he be so narcissistic? When he got diagnosed, he told me that I had to get back to work, that he didn’t want to worry about my future. Now that I am working full time, he gets angry about that.

    *****

    Amy replied:

    Dear Delores:

    Of course you are not being selfish! Your husband’s behavior has been ridiculous from Day 1 and demonstrates just how utterly stupid some men are about sex and about their relationships with women in general and their wives/partners in particular. However, …

    Sadly, I have no idea what you can do about it unless you know someone who your husband will listen to and who you trust to be able to tell and if you feel sure that doing that doesn’t come with other risks (such as physical violence on the part of your husband).

    I have discussed the type of problem you describe on several occasions with “Arthur” (of Ask Arthur, also on this web site). Neither of us have ever been able to find a good way to address these problems other than counseling. Some men simply have such archaic ideas about male-female relationships that it is like trying to talk to a brontosaurus.

    I obviously don’t know your husband, so I have no idea how angry he might become if you were to do this, but someone needs to point out to him in words of one syllable that he apparently has no idea how to “care” — or maybe even think about — anyone except himself, and that at 65 years of age it is high time for him to learn at least something about the needs of others.

    I realize that this doesn’t help much, but please don’t think for one moment that you are being “selfish”. The one who is being selfish — and who has apparently been selfish, at least in regards to sex, for his entire adult life — is your husband.

    Amy

  37. Thanks Amy, your response was very comforting. I’ve given it a lot of thought and I think he is really upset with himself for spending the last 2 years more concerned with testosterone shots and less on his PSA. This is why the cancer had time to spread. I think he feels like his own masculinity betrayed him. Having all of the health issues wrapped up in such a male:sex encompassing perspective makes it difficult to address sexuality in a clear minded way. Thanks again for your input. You have such a nice way of adding a bit of humor to an upsetting topic.

  38. Any,

    I have a special man in my life who has had prostate cancer. I’m madly in love with him and also nervous about having sexual experiences. I would love advice from you as you seem to have knowledge.

    *****

    Amy replied:

    Dear Ondihoo:

    If you are “nervous about having sexual experiences” with this “special man”, I respectfully suggest you consider that he may be even more nervous than you are!

    There is only one way to deal with this sensibly, and that is to talk about it with him so that appropriate expectations are set for all concerned. So I suggest you make it very clear to him that you are interested in taking this relationship to that level but that you think it would be a good idea if you were to have a conversation about exactly what he is and isn’t capable of up front so that everyone’s expectations could be addressed.

    Normally. these things “just happen” when everyone is willing, but in this situation he may well be scared to death by the fact that he thinks you have expectations that he may feel very concerned about fulfilling (or even know that he will not be able to fulfill). The whole situation needs to be placed into the context of “Well doing X together would be great even if we’re not able to do Y”.

    If you are both prepared to be risk takers, one way to do this is just to be honest with each other and say, “So let’s go to bed together but take things very slowly and talk about it as the event progresses with a very clear and mutual understanding that some of the things we might like to happen just can’t, and we’ll find out what those are over the course of the event.”

    As a whole, many of us are not very good at talking with our partners and spouses about our sex lives. However, this is a situation in which being able to have those conversations (in some detail) is really important, so maybe you need to just be blunt, and the next time you go to dinner you could say, “So I would like to go to bed with you, but I am really nervous about that and I suspect you may be too. Given the prostate cancer, how well does everything work for you these days?”

    At least that way the cards have to get put on the table.

    Amy

  39. My husband no longer gets erections and his sexual performance is horrible. I am 2 years out from breast cancer and my hormones have been forced to stop. I have no sex drive; he has a huge sex drive but can’t perform. Yet he gets angry at me for not wanting sex at $75 a pop for the injection for sex I hate. Terri.

    *****

    Amy replied:

    Dear Terri:

    That doesn’t sound like a situation that is doing anything very positive for anyone! It sounds to me as though your husband needs some serious counseling, but I don’t suppose he would even consider that because he probably thinks he is in some way “entitled” to make you do something you have no interest in.

    I wish I had some sort of sensible answer for you …. Alas, I don’t.

    Amy

  40. My husband is going into treatment for a recurrence of prostate cancer after a radical prostatectomy. It’s been 3 years and his PSA has gone from 0.01 in fall of 2018 to 0.06 ng/ml this past month. We are of course concerned about this and the treatment sounds ugly: hormone therapy plus radiation. We are worried about our quality of life: sexual function and continence. Can you tell us what to expect over the next year during treatment? Thanks so much.

    *****

    Amy replied:

    Dear Laura:

    Does your husband understand that his original surgery has not yet formally “failed”? The formal definition of failure of surgery is a PSA level of 0.2 ng/ml and rising.

    The question of when to start radiation therapy after early signs of a rising PSA is a very complex one, and depends on your husband’s original diagnosis; the findings at the time of surgery; and exactly how fast his PSA level is now rising (his PSA doubling time). I hope you and your husband have had a careful discussion about all this with his doctors. I am assuming that if the doctors think they should initiate salvage treatment as soon as is being suggested, that your husband’s original cancer was an aggressive type of cancer with a relatively high Gleason score.

    The combination of radiation therapy and androgen deprivation therapy (ADT, also known as “hormone” therapy) can be extremely effective at placing a man like you husband back into remission … sometimes for ever. Also, the risk for side effects from the radiation therapy component is now much, much lower than it was about 20 years ago. Most of the side effects from the radiation should be relatively minor (some diarrhea, for example) because radiotherapy can now be given with great accuracy. However, …

    The side effects associated with the ADT can be a lot more problematic. And those side effects depend in part on exactly how long the doctors plan on keeping your husband on the ADT, which could be as little as 6 months or as long as 2 or 3 years. The first thing you both need to get very clear about with the doctors is how long they think he is going to be on the ADT.

    If he is only going to be on the ADT for 6 to 9 months, then a year from now he should start to see his testosterone level rise again after treatment and he should be able to recover a similar level of erectile function to that which he has now … although this may take a little time. If he is going to be on the ADT for longer than about 9 months, then he is going to be at greater risk for longer-term loss of erectile function; weight gain; loss of libido; and a whole bunch of other side effects. Regardless of how long he is on the ADT, he may also be significantly impacted by “hot flashes”. The problem with the side effects of ADT is that they can vary considerably from person to person. Some men barely get hot flashes at all. Others get them so badly it is a real problem. There seems to be no way to predict this beforehand.

    I hope this helps a little.

    Amy

  41. Amy,

    My boyfriend has prostate issues. It’s difficult for me sometimes. I try to be understanding, but I have sexual needs and when he doesn’t initiate sex (or if I initiate it he’s not receptive), it sometimes makes me feel like he’s not attracted to me.

    *****

    Amy replied:

    Dear Wanda:

    There is no real value in trying to assign either “responsibility” or “blame” to anyone for your and your boyfriend’s current situation. The problem is that you are both still trying to function as though your sex life should be “normal” (in whatever way that was for you both in the past), but that isn’t going to happen if your boyfriend has serious prostate issues that are affecting both his desire to have sex (his libido) and his ability to “perform” (i.e., his erectile function). In fact, he is probably just as concerned about all this as you are because he probably feels that he has “lost” much of his “maleness”.

    What you and your boyfriend need to be able to do is talk to each other about this situation and work out how to deal with the problem in ways that are acceptable to both of you. (Although I do understand that his can be very difficult for a lot of couples to do because so many of us are taught from an early age that actually talking about sex is in some way “taboo”.)

    The chance that your boyfriend is no longer attracted to you is probably very low. What is much more likely is that he is scared to death that you will lose interest in him because he can’t “perform” at a level that he considers that you will think is necessary. Most men are going to lose some level of their sexual “performance” capabilities as they get older (for all sorts of reasons). Being able to accept this is hard for them. So maybe one thing you should think about doing is just making it very clear to him that you are still attracted to him (and not just in the bedroom). But this is going to take time to work out between you, because he is going to have to be willing to think about doing things he may never have done before … and the same may be true for you. There is more to sex than the “missionary” position, and most of the best things about sex actually go on between the ears of the participants as opposed to between their genitalia!

  42. My husband had surgery in 2017. The radical I call it. At first he was doing the shots, which made it bend and have scar tissue and now it doesn’t work at all. That’s the last time we’ve had sex.

    He doesn’t have any sex drive. He doesn’t want to help me. No nothing. I feel like I’ve lost everything.

    My husband has always been a big flirt — which he says he’s not — and a gym buff. I had just caught him talking on Snapchat with another very young married preacher’s wife right before being diagnosed. I always say that’s God’s wake up call to him. But I feel all the betrayal in this 28-year marriage. I’ve always stood by him and now I feel he should be making up to me!

    *****

    Amy replied:

    Dear Donna:

    One of the most problematic issues to deal with when it comes to prostate cancer is its impact on couples’ sex lives.

    I understand entirely why you feel the way you do. … Alas, I have no “magic bullet” that can help you deal with this problem. The only things that might work are: (a) being able to actually talk with your husband about all of this (with or without some professional help) and (b) finding a specialist who could evaluate your husband for the possibility that he could have a penile implant (which would be able to allow his to “do something” again). Some couples have discovered that the man getting a penile implant completely changed their lives for the better, but they don’t work for everyone … and some men simply can’t deal with the idea at all.

    The other question will be whether your husband’s insurance would cover a penile implant. This varies by insurance provider. TH costs can be significant.

    Amy

  43. Hi Amy,

    Can you please help me. Me and my husband have been together for 5.5 years and married for 2.5 years. He is 56 years old and I am 53 years.

    He was diagnosed with prostate cancer mid last year, and had his prostate removed April 2019. I have been very supportive and always said that him surviving this was more important that what goes on in the bedroom.

    He is now 4 months post-op, with no erection, and we are aware it can take 12 months or more to recover. We have been having some playtime to keep us aroused, more so on my husband’s side as I have to admit I do have a low libido and was like this even before the operation. We have never talked about this as I have never felt there has been a need as he senses and jokes about this and I have always thought that was OK. We always did have intercourse at least on average twice a week until the operation 4 months ago.

    I came home unexpectedly tonight, to what I sensed was he was up to something, as I heard a bang down the side of the sofa as I walked in. During the evening he was on edge all night.

    I came downstairs as I couldn’t sleep and switched on the iPad to find he had been watching porn.

    We never argue; are on the same level to our future together; have our plans set out. He is so thoughtful, loving, and caring, I thought I’d found my perfect man.

    Please Amy what do I do? If I don’t say anything he will continue to watch. For me it is betrayal. I don’t know where to start

    Regards

    *****

    Amy replied:

    Dear Diane:

    The answer to this is very simple. You and your husband need to talk about this.

    I’d be very surprised if this has anything to do with you at all — and you may be over-reacting to feel “betrayed”. A man of your husband’s age who is used to having regular intercourse and who loses his ability to get erections is commonly psychologically devastated by this. It may be no more that your husband seeing if there is anything (short of actual infidelity) that can help him to accelerate recovery of erectile function.

    Now this may be difficult for you to accept or understand, but if you don’t talk with your husband about it, it is going to fester. It is obviously something that he is embarrassed by, or he wouldn’t have tried to hide it from you — which he seems to have done a pretty poor job of. However, I would strongly suggest that you tried to “play this cool” and simply tell him that you know he’s been experimenting to see if he could find a way to get his erections back sooner. If you’re feeling brave you could also ask him if there is anything else you could be doing to help.

    I understand that this may be somewhat outside your normal “comfort zone” … but there is every reason to believe it is outside your husband’s too! Talk to him about it.

    Amy

  44. I am totally ignored by my husband who has metastasized prostate cancer.

    *****

    Amy replied:

    Dear Kate:

    Obviously I know nothing about the exact state of your husband’s disease. However, …

    If your husband is receiving even just standard therapy for metastatic prostate cancer, with regular injections of a drug called an LHRH agonist (e.g., Lupron) for the treatment of his condition, it is far from surprising that he may seem to be “totally ignoring” you. Drugs like this suppress a man’s normal testosterone levels in order to delay progression of the cancer.

    However, a normal effect of suppressing testosterone levels is that this also has a whole spectrum of other emasculating effects. He probably can’t get an erection any more; his libido has probably been suppressed (meaning that he has lost all interest in sex). He may well be very depressed because he doesn’t “feel like a man” any longer. He is likely to feel ashamed about this. He is likely to be very worried about the fact that other men will find out about this. And he is potentially scared to death by the idea that any attempt at intimacy on his part will be a failure — which will then make him feel even less like a man (and be unsatisfactory for you too). This is a lose-lose situation for many men because they have been taught all their lives that their sexual capabilities and functions are the defining characteristic of “maleness” (however stupid that may sound).

    Somehow or other, you and your husband need to be able to talk about this together … and that can be extremely difficult for many couples because — even if they have enjoyed a very healthy and satisfying sex life over time — they may never have actually talked about what they like, what they don’t like, what is OK or not OK between them, and a whole bunch of other related stuff.

    The bottom line here is that your husband needs your help and your understanding. He needs to know that you still love him anyway, and that you don’t see him as “less of a man” because of what he is going through. Find “male” things for him to do. Tell him how much you appreciate it that he can do thin gs for you that would be difficult for you to do yourself. Bolster his ego and try to make him feel better about himself. If you can get him to feel more like a “man”, it may be possible for you to open the door to a conversation about whether he even understand that he has been ignoring you and what you can do about it together.

    I hope this helps a little. Unfortunately there is no “magic cure” for these effects on many men with metastatic prostate cancer. If there was, I would most certainly tell you.

    Amy

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