Can you have sex after prostate removal? Yes. It just might feel a little different.
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Can you have sex after prostate removal? Yes. It just might feel a little different.
Recovery takes time, and everyone heals at their own pace. Some changes in sexual function are common after prostate removal, but with time and patience, many men return to a satisfying sex life.
Let’s break down what you need to know about sexual function, performance, and sex drive after prostate removal.
First, let’s do a male anatomy refresher. The prostate is a small, walnut-sized gland that sits just below your bladder and in front of your rectum.
It wraps around the urethra, which is the tube that carries urine and semen out of your body. The prostate’s main job is to produce fluid to nourish and protect sperm during ejaculation.
Because the prostate is near important nerves and structures, any surgery involving this organ (like a prostatectomy, or prostate removal) can potentially affect urinary control and sexual function.
The most common reason to have a radical prostatectomy is prostate cancer treatment. This procedure involves completely removing the prostate gland and some of the surrounding tissues, including the seminal vesicles.
But, doctors may also recommend prostate removal for:
Severe benign prostatic hyperplasia (in rare cases)
An infected prostate abscess
Severe and untreatable chronic prostate inflammation (prostatitis)
Traumatic prostate injury
Whatever the case may be, there’s good news: You can still have sex after prostate removal. But for some men, it might feel a bit different.
Removing the prostate doesn’t stop your sex life forever, but it can change how things work. For instance, you might experience erectile dysfunction (ED), especially if the nerves around the prostate were affected by surgery.
Orgasms are still on the table, but you might experience dry orgasm. Your sex drive might also fluctuate after prostate removal.
You can still have sex after a prostatectomy and likely achieve orgasm, but surgery might impact your erectile function.
Will you still be able to get a reliable erection after prostate removal? Maybe (hopefully). The experience varies from person to person.
Some estimates suggest sexual dysfunction following prostatectomy affects between 14 to 90 percent of men to varying degrees.
Let’s break down what can affect erectile function post-prostate removal.
The ability to achieve and maintain an erection after prostate removal can take a few months to a few years. It mostly depends on whether the nerves around your prostate were spared during surgery.
If your surgeon was able to perform a nerve-sparing prostatectomy, your chances of developing ED are much lower. In one study, when nerves were spared, between 87 percent of men eventually recovered erectile function.
If you do have nerve damage, don’t worry—there are options to help, which we’ll get into later.
Hormone therapy and radiation therapy are two common treatments for prostate cancer that your doctor may recommend before or after a prostatectomy. These can also affect sexual function.
Hormone therapy reduces testosterone levels, sometimes drastically. Since testosterone is the primary male sex hormone, this can have a direct impact on sexual desire and erectile function.
Radiation targets and destroys cancer cells, but it can also damage surrounding healthy tissues, including the nerves and blood vessels involved in erectile function.
Loss of or changes in your ability to perform sexually can feel like losing part of yourself.
It can stir up anxiety, frustration, or even a sense of grief. Your confidence might take a hit, and you may find yourself avoiding intimacy out of fear of “failing”. These are all normal feelings.
One study found that one in three men experienced feelings of depression after prostatectomy — and there’s a link between depression and lower sex drive.
An important first step is to talk about your concerns with your partner, because intimacy isn’t just about sexual desire — it’s about connection.
It can also be helpful to seek outside support from a sex therapist, who can provide a safe space to work through the emotional impact of surgery and help you find new ways to connect with your sexual self.
For most men, it takes around six weeks after prostate removal before it’s safe to attemptany sexual activity. But, that’s just a general guideline — your specific timeline might look a little different, so please follow your personal physician’s guidelines.
Factors like the type of surgery you had (nerve-sparing or not), your overall health, and how quickly your body is healing can all play a role.
Here’s what you can expect during recovery:
Initial healing (weeks 1-4). This period is all about rest and recovery. Focus on letting your body heal and following your doctor’s instructions. No heavy lifting, no strenuous activities, and definitely no sex yet.
Reintroducing intimacy (weeks 4-8). If your doctor gives you the green light, you can begin exploring gentle intimacy. But keep your expectations realistic, as things may not work perfectly at first.
Long-term recovery (months 2-12). For some men, sexual function gradually improves over the months following surgery. For others, it can take longer, especially if the nerves around the prostate were affected.
Many experts think it’s important for men to try achieving an erection as soon as possible once the body has healed, usually several weeks after the procedure.
This is sometimes called “penile rehabilitation.”
The most important thing you can do while you heal? Stay in touch with your urologist, who can provide personalized guidance based on where you are in your recovery.
You’ve got options to address post-surgery sexual intimacy and/or erection problems.
Here are some science-backed solutions to gradually help restore your sexual function.
PDE5 inhibitors — like sildenafil (Viagra®), tadalafil (Cialis®), and vardenafil (Levitra®) — work by increasing blood flow to your penis, making it easier to achieve and maintain an erection.
You generally take these medications between 30 minutes and a few hours before sex, but be sure to follow your provider’s instructions.
This is essentially a vacuum pump for your penis. You place a clear plastic cylinder over your penis, use a pump to create a vacuum, and blood rushes in, giving you an erection.
A VED is a non-drug option and you can use it even if you have reduced nerve function. You’ll need to use a rubber ring around the base of your penis to maintain the erection once it’s pumped up.
This is a small injection of medication (usually alprostadil) that goes directly into the side of the penis. It increases blood flow and causes an erection within minutes.
If oral medications aren’t effective, penile injections are a next-step option that many men find helpful. Just be sure to follow your provider’s instructions, since injecting too much can lead to a prolonged, painful erection.
This is a surgical solution where an inflatable or semi-rigid device is placed inside your penis. When you want an erection, you activate it.
Penile implants are an option for men who haven’t had success with medications, VEDs, or injections. It’s a last resort, but it’s also one of the most effective solutions for severe erectile dysfunction.
This is a surgical procedure, so there is some downtime afterward.
You apply alprostadil cream directly to the tip of the penis. It helps increase blood flow to the area, similar to injections, but without the needle.
This can be a good option for men who don’t want to take oral meds or use injections. Just note that it comes with potential side effects, like mild pain or irritation where you apply it.
Sex after prostate removal may come with some changes, but it’s not the end of your sex life. With patience, communication, and the right support, many men regain satisfying intimacy, an important aspect of men’s health and quality of life.
Here are the key things to remember:
Expect adjustments. It’s common to experience changes in erectile function, orgasm, and even libido after prostate removal. But with time and support, many men can rediscover intimacy, even if it feels a bit different from before.
There are medical (and surgical) options. From PDE5 inhibitors to vacuum devices, creams, injections, and even implants, there are effective solutions to help you regain sexual function. Talk to your provider about what’s appropriate for you.
Mental health matters. Don’t underestimate the emotional impact of sexual changes. Consider sex therapy or talking to a counselor if you’re feeling anxious, frustrated, or disconnected — on your own or with your partner.
If you’re struggling with sexual function after prostate removal, it’s important to talk about it and seek support.
Talk to your urology specialist or healthcare provider about your concerns and explore the options that can help you reclaim a satisfying sex life. They can help you weigh the pros and cons of different treatment options.
For more info, check out our men’s sexual health resources or take our free online assessment to be connected with a licensed healthcare provider.
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