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Question:
My boyfriend is a 49-year-old cancer survivor. He has trouble maintaining an erection for intercourse for the past four months. It comes and goes, but it's never hard enough for penetration. Could this be a result of chemotherapy and radiation treatments or the medication he's on? He told his doctor and his medication was changed. The doctor also suggested that he needed more stimulation, but nothing seems to work. Any other ideas?
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Answer:
by Megan P Fleming: (05/26/2004)
It would be helpful to know the type of cancer for which your boyfriend received treatment, and how long it has been since he completed treatment. Occasionally, systemic chemotherapy interferes with testosterone production. Rarely, however, does chemotherapy play an obvious role in erectile dysfunction. Some types of chemotherapy may cause nerve damage, but few reports indicate permanent loss of erections post treatment.
Radiation, depending on targeted site and dosage, may also negatively impact sexual functioning. Pelvic radiation has been associated with difficulties for men in attaining and/or maintaining an erection. Often these sexual changes are subtle, with changes noted over six months to one year after radiation as scarring and thickening develops. The risk of erectile dysfunction is greater in men who had compromised quality of erections prior to their cancer diagnosis. Other risk factors that are not specifically cancer-related include cigarette smoking, history of hypertension, and/or diabetes.
You also mentioned that your boyfriend was taking medication, but did not indicate which one(s) he is taking, at what dose and for which medical condition. Many medications have known sexual side effects. It sounds like his doctor prescribed a new medication, but it is not clear when the change was made and if your boyfriend has noted any subsequent improvement in the quality of his erections. It was wise for him to consult his doctor relative to medications that impact sexual function, as there are often other medications to treat the same illness with less sexual side effects. A good reference of medications that affect sexual function is Sexual Pharmacology: Drugs that Affect Sexual Function by Crenshaw & Goldberg (1996).
Does your boyfriend notice any change in his libido, or interest in sexual activity? Has there been any change in his ability to reach orgasm? These are other aspects of sexual functioning that may also be affected by medication, chronic illness, and/or psychological distress. Does your boyfriend experience the same difficulty maintaining his erection with self-stimulation? Sometimes concerns regarding sexual performance, issues of intimacy, and/or a focus on pleasuring you may contribute.
If your boyfriend has not consulted with a urologist, I would recommend that he make an appointment to discuss the range of treatment options. Depending on the degree of erectile dysfunction, options include: oral medication, topical or intraurethral medication, vacuum constriction device, intracavernous injection, and penile prosthesis. Counseling is also an option for you and your partner to learn other ways of experiencing sexual pleasure and satisfaction without erections or intercourse. Many men with erectile dysfunction are able to have orgasms with manual or oral stimulation and many partners are similarly satisfied and orgasmic with non-coital stimulation.
Reviewed by Sexual Health Editorial Team
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