Even after being given the all clear from prostate cancer, many men face the reality that they may never get an erection again.
That’s the discussion former TV presenter Gabby Logan had with rugby hero husband Kenny 52, due to the impact prostate cancer treatment had on their sex life.
The BBC star, 51, revealed all on The Chris Evans Breakfast Show on Virgin Radio in a strikingly frank interview, admitting she wasn’t as patient with the former Scottish international as she’d liked to have been.
Gabby’s confession will undoubtedly have struck a chord with many — with more than 52,000 men diagnosed every year in the UK and 299,000 in the US.
More than two-thirds of men undergoing prostate cancer treatment suffer erectile dysfunction — and these are problems that can affect self-esteem, relationships and quality of life, says MailOnline GP columnist Dr Ellie Cannon.
Former Scottish rugby international Kenny, 52, was diagnosed with cancer in February 2022 after Gabby, 51, urged him to go to the doctors
Prostate cancer is one of the most common forms of the disease, striking thousands of British and American men every year. Needing to pee more frequently, blood in your urine or semen and hesitancy when going to the toilet are all telltale signs of the disease.
Yet according to the charity Prostate Cancer UK, fewer than half get effective treatment.
Surgery to remove the prostate gland, called a radical prostatectomy, can leave men with damage to the nerves needed to get an erection and ejaculation problems, Cancer Research UK says.
Hormone therapy and radiotherapy also lowers the amount of testosterone in the body, which can not only affect how well a man is able to maintain an erection but also the intensity of the orgasm, according to the charity.
But doctors say there are a few methods that can help get your sex life back on track.
Talk about it
Opening up to a partner or friend about your struggles in the bedroom could be the first step you take.
Speaking on The Chris Evans Breakfast Show, Gabby Logan said: ‘I think the reason why I wanted to talk about it candidly was because, of course, if you’ve been together with somebody for a long time, and that’s a big part of your relationship then it is something that is going to affect the dynamics.
‘It’s huge. I’m trying not to use the wrong words. It’s huge.
‘He was obviously wanting us to be the couple that we were before and obviously was facing up to this potential huge physical change.’
In February 2023, Kenny spoke candidly about the after-effects of treatment, and said they left him ‘black and blue downstairs’
If you are worried about your sex life speaking to a counsellor or therapist can help, Cancer Research UK says.
But the charity explains you may need to go on a waiting list if you are referred within the NHS.
‘Just because someone has lost their ability to have an erection and to have penetrative intercourse doesn’t necessarily mean they’ve also lost the ability to enjoy intimacy,’ Dr Richard Viney, a consultant urological surgeon in Birmingham told MailOnline.
He explained that in some cases having an open conversation with your partner about other ways of enjoying sex and reaching orgasm can help them have a sex life after prostate cancer.
He added: ‘I think if you have an open conversation, I think a lot of people get a lot more out of all the stuff that goes around it rather than the actual act. Particularly we’ve got a bad back, bad knees, bad hips. All that kind of stuff as you get older.’
If you are worried about your sex life speaking to a counsellor or therapist can help, Cancer Research UK says
Healthy living
Keeping active and having a healthy weight, can improve your sex life.
That’s because it can improve your interest in sex and your ability to get an erection, according to Cancer Research UK.
But it’s not just weight management that can help, quitting smoking can too.
‘Quitting smoking and cutting back on alcohol have been proven to reduce the issue,’ Dr Cannon said.
Smoking can cause erectile dysfunction, as it damages the blood vessels that supply blood to the penis, the NHS explains.
Blue pills and creams
Pills such as Viagra that increase blood flow to the penis can help with erectile dysfunction, but you should visit your GP to make sure you are taking effective medication.
‘There are plenty of adverts for creams and pills to treat erectile dysfunction. Sadly, few actually work and some could even be risky – products online might not be subject to the same, rigorous regulations as prescribed drugs,’ Dr Cannon warns.
Pills such as Viagra that increase blood flow to the penis can help with erectile dysfunction
The drugs don’t work immediately and foreplay is usually needed, Cancer Research UK explains.
Because medication works best in men who have sexual desire, they might not help those having hormone therapy, as this can dampen libido.
PDE 5 inhibitors, such as sildenafil citrate (Viagra) or tadalafil (Cialis) also come with side effects and can cause back pain, indigestion, headaches, sickness and dizziness, the charity adds.
Dr Cannon explained that medications like Viagra can be tried ‘as and when’.
But she added that doctors can also prescribe a daily low dose of a similar drug, tadalafil, to men with prostate cancer.
‘Some prostate surgeons recommend an “as and when” dose on top, but it’s important to have a proper consultation before embarking on anything like this,’ she said.
Another medication, alprostadil, which comes in cream form, can help men achieve an erection within five to 30 minutes, which can last for one or two hours, according to Cancer Research UK.
More than 52,000 men are diagnosed with prostate cancer every year in the UK and 299,000 in the US
Vacuum pumps
‘Vacuum pumps – which induce an erection – can put men off, but they are a recognised treatment and worth exploring,’ Dr Cannon said.
They work by fitting over the penis and draw blood into the penis to form an erection.
A soft plastic ring called a constriction ring is then fitted to the base of the penis, which helps to keep the erectors form. But this should not be left on for more than half an hour.
That’s because the ring restricts blood flow and using it for longer can damage the tissues.
About 70 per cent of men who use them find they are effective.
For someone with prostate cancer, they are often available free of charge at NHS-funded clinics.
However, Cancer Research UK warns that they don’t suit everyone. The charity said the pump can cause the penis to have a ‘blue tinge’, but it explains this is normal.
Dr Viney says men who have had prostate cancer should be using the pump on daily basis.
He said: ‘It draws blood in and out of the penis in a way very much like the early morning erection does, and of course, they will have lost their early morning erections.
‘That’s quite important event in the penis, it’s good for the circulation. It’s like taking your penis to the gym.
‘If they are not working out it is going to become hopeless.’
He explains that if the penis is not used, like any muscle, it can cause muscle wastage.
Injections
It may sound daunting, but an injection into the shaft of the penis can help.
Injections are also known as Caverject or Viridal Duo and they can help men get an erection within 15 minutes which can last for up to 40 minutes.
Dr Viney explains the drug is ‘extreme’ and works by constricting the blood vessels to hold blood in the penis.
‘It is quite a powerful drug and it can impact on blood pressure,’ he added.
Dr Cannon said: ‘Injections sound frightening but, in reality, many find they don’t hurt.
‘A very thin needle is used and men can learn how to do this themselves. They often work best in men with an active libido.’
Another option is Pellets about the size of a grain of rice containing alprostadil called MUSE.
These are put in the opening of the penis using a small plastic device, according to Cancer Research UK.
It is absorbed into the surrounding tissue and can help men get an erection within 10 minutes which can last up to an hour.
Implants
If other treatments haven’t worked implants or penile prostheses can be an option for men who have had prostate cancer.
The implants are put into the penis during a short operation.
Most of the time inflatable implants are used, these are made up of two to three cylinders in the penis, a pump in the scrotum and a bag of saline which may be put behind in your tummy, explains Cancer Research UK.
In some cases malleable rods are used, which means the penis will always be erect but it can be repositioned.
