Sexual satisfaction after prostate cancer: new UK study shifts focus

“Research on sexual outcomes in prostate cancer survivors has focused on the restoration of erections after treatment,” notes a brand new peer-reviewed article by William Kinnaird and others. “The aim should be to support patients and their partners in creating a satisfying sex life rather than trying to re-establish pretreatment levels of sexual function.”

According to a pre-print release from the May, 2025 Journal of Clinical Oncology, men actually have much broader concerns about sexual satisfaction after prostate cancer treatment than only erectile function. These concerns are not limited to those who are younger or have less severe forms of the disease. This new UK research expands on a 2002 US study which found more men concerned about orgasm than about erection problems after prostate cancer treatment. Yet standard medical treatment rarely goes beyond prescriptions of erection pills or offers of erection injections and implants.

Focusing only on penile rehab mirrors the way the erect phallus often gets exclusive focus in male sexual behaviour and its representation in porn. Penile rehab was also my first concern after my prostate cancer treatment. However I’ve discovered that good sex doesn’t depend on hard erections. As a result, the 2025 team’s finding “evidence of a need to place more emphasis on holistic sexual care rather than solely penile rehabilitation” comes at an opportune time.

This fits with my own experience over the last five years. It also aligns with the concerns of hundreds of men and couples I’ve listened to in the Recovering Men global support group and during research for my book on living well with erectile differences.

UK study: top concerns about sexual satisfaction after prostate cancer

The 2025 article draws on responses from 654 UK men diagnosed with prostate cancer. Respondents included a variety of ethnicities and sexual orientations and were aged from under 50 to over 80. Of these, 50% had radical prostatectomies, 46% had radiation treatment, and 44% androgen deprivation treatment (ADT). There were also respondents on Active Surveillance, focal therapy and chemotherapy. The majority (66%) reported no baseline sexual dysfunction before prostate cancer treatment.

Here are some key findings from the survey:

• 78% of all respondents reported sex and sexual activity were fairly or very important (including half of those with advanced prostate cancer).
• Of all their current concerns, more respondents included sexual problems in their top three than any other concern (such as urinary problems, lack of energy/fatigue and disease recurrence).
• 78% wanted to discuss treatment-related sexual problems with a healthcare professional.

I am struck by the deep needs laid bare by this data. Men do care about sexual satisfaction after prostate cancer, even if they are on ADT (“chemical castration”) or have ongoing advanced prostate cancer. And we do want help from medical professionals that goes beyond promises of quick fixes. I encourage you to read the full article. It is already online, entitled Sexual Dysfunction in Prostate Cancer Patients According to Disease Stage and Treatment Modality.

In the full published article, you will also find detailed analysis of the different kinds of help men are asking for. For example:

Participants said they wanted to be informed about the complete spectrum of physical and psychosexual side effects beyond erectile function.

These wider concerns align with the earlier findings of a US study categorizing the forms of sexual distress men reported after prostate cancer treatment.

More distress about orgasm problems than erection problems after prostate cancer

In 2002, Dr Leslie Schover and others reported on a survey of 2636 men treated at the US Cleveland Clinic for prostate cancer. They looked at relatively long term outcomes – respondents averaged about four years after treatment. Of those who responded, the figures that struck me most were the top three areas of sexual distress:

• 64% rated themselves distressed about orgasm problems.
• 61% rated themselves distressed about erection problems.
• 60% rated themselves distressed about desire problems.

Only one of these is treated by erection drugs. And erection problems are not even at the the top of the list. Yet these PDE5i drugs (originally patented as Viagra, Cialis and Levitra) remain the first and often only treatment offered to men with sexual difficulties after prostate cancer.

You might be forgiven for thinking that for men, sex is entirely about their hard penises. But this data suggests that it’s time for men with erectile differences and their partners, and the healthcare professionals treating them, to go beyond quick fixes on erections towards a much more holistic exploration of sexual satisfaction and new ways to physical intimacy.

[Editor’s note: This post also appears on PsychologyToday.com]