Occurring of Erectile Dysfunction Post Prostate Cancer Treatment

What is Erectile Dysfunction?

The inability to form or maintain an erection is referred to as erectile dysfunction or impotence. Although erectile dysfunction is rarely life-threatening in and of itself, it might be a sign of a more serious underlying health problem that requires treatment.

Erectile dysfunction symptoms

  • Having difficulty obtaining an erection
  • Having trouble maintaining an erection
  • Sexual desire is lessened.

Causes of erectile dysfunction

Erectile dysfunction can be caused by a variety of physical issues, including heart disease, high blood pressure, high cholesterol, diabetes, metabolic syndromes, sleep disorders, tobacco use, certain prescribed medicines, Parkinson’s disease, tobacco use, and treatments for prostate cancer or an enlarged prostate, to name a few. Higher levels of stress, anxiety and depression can also lead to erectile dysfunction.

Treatment of erectile dysfunction

The doctor treats the underlying problem that causes or worsens erectile dysfunction. The correct treatment can be chosen based on the source and severity of the condition, as well as any other health issues the patient may have.

  • Oral medicine, such as Sildenafil, Tadalafil, Vardenafil, and Avanafil, is a commonly used treatment for erectile dysfunction. All four of these drugs work by increasing the effects of nitric oxide, a naturally occurring molecule in the body that improves blood flow and allows for erection.
  • Alprostadil is a chemical compound that can be self-injected into the penis or placed in the penile urethra as a tiny suppository. Both procedures can maintain an erection for roughly an hour.
  • A penis pump is a hollow tube with a hand-operated or battery-operated pump that creates a vacuum in the penis to aid in obtaining an erection.


Erectile dysfunction can lead to a variety of issues that can be discouraging or unpleasant; however, it is crucial to remember that, in the majority of cases, it is not a permanent condition that can be treated or simply reverted to normal sexual function over time. Some of them are as follows:

  • Anxiety
  • Embarrassment
  • Relationship issues
  • Stress

Prostate cancer and erectile dysfunction

The prostate is an exocrine gland that regulates the flow of urine and secretes fluids that are helpful outside of the body. It makes a fluid that carries and nourishes sperm as they go to the female ovum or egg to fuse. Prostate cancer is cancer that develops in the cells of the prostate gland. Prostate cancer does not cause erectile dysfunction; rather, it is the treatment approaches that cause this issue.

While prostate cancer does not cause erectile dysfunction, the disease’s therapy can result in this consequence. Erectile dysfunction is a common side effect of the following treatment approaches.


Erectile dysfunction is a common side effect among people who have had prostate cancer surgery. If cancer has gone beyond the prostate, prostate procedures may include the removal of the prostate gland, adjacent tissues, and even lymph nodes. The two types of procedures are radical retropubic prostatectomy and radical perineal prostatectomy, which differ in how the prostate is addressed.

Regardless of whether the nerves that govern the erection are injured by surgery, erectile dysfunction might be seen soon afterwards. If the nerves are not harmed, erectile dysfunction can be resolved within one to two years of the treatment; however, if the nerves are affected, erectile dysfunction is unlikely to be resolved. Even if an erection is obtained following surgery, there may be little to no ejaculation, resulting in “dry” orgasms.

If desired, vacuum devices for erectile dysfunction drugs can be used to speed up the return to normal sexual function. Sperm banking is also an option.

Radiation therapy

The most prevalent side effect of radiation therapy is erectile dysfunction. Erection issues do not appear immediately after prostate radiotherapy, although they do develop over time. When younger men are administered radiation to treat prostate cancer, they are more likely to develop erectile dysfunction. More advanced therapies, such as brachytherapy, IMRT, or 3D conformal radiation, reduce the prevalence of erectile dysfunction.

Hormone Therapy

Androgen deprivation therapy (ADT) or androgen suppression therapy are terms used to describe hormone therapy. It tries to reduce androgens, which are male hormones, and their impact on prostate cancer.

Erectile dysfunction and decreased drive are common side effects of hormone therapy for two to four weeks after treatment. This is due to the fact that the treatment tries to reduce androgen levels, and as a result, testosterone levels are frequently reduced. Men with erectile dysfunction do not respond well to any treatment aiming at curing erectile dysfunction, however, there is limited evidence to support this.

Aspects of erectile function that are affected:

The following are the four primary components of erectile function that are influenced by prostate cancer treatments:


Hormone therapy or any other therapeutic procedure that lowers testosterone levels might impact libido or sex drive. Even if one has a low libido, one can have an erection, but maintaining it is more challenging. When testosterone levels return after a few months of treatment, the drive returns as well; however, it is crucial not to become overly stressed as a result of this condition.

Mechanical ability

Mechanical ability refers to the ability to achieve a hard erection, which is governed by the nerves and arteries that surround the prostate and penis. Surgery and radiation therapy, as well as cases of nerve damage, have a significant impact on this.


Orgasm may be difficult to achieve immediately after therapy, particularly if the patient’s libido is harmed. This, however, is only a temporary problem that will return to normal a few months following therapy. There may be no need for treatment or medicine in this case.


After treatment, the patient may have little or no ejaculation, especially if the prostate or seminal vesicles are removed or irradiated (in surgery or radiation therapy respectively).

Dr. Paavas Sharma
Dr. Paavas Sharma
Articles: 211
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