Prostate, bladder, and colon cancer are often treated with radiation to the lower belly. This can cause problems with erections. Radiation can damage the vessels that carry blood to the penis. As the treated area heals, scars can form inside. The walls of the blood vessels may not be able to stretch enough to let blood rush in and make a firm erection. Besides causing blood vessel damage, radiation may harm the nerves that control erection.
About 4 out of 10 men who get radiation will notice that their erections change for the worse. This change often happens slowly, over the first year or so after treatment. Some men will still have full erections but lose them before climax. Others no longer get firm erections at all. The older you are, the more likely it is you will have problems with erections after radiation.
In older studies that looked at men who had firm erections before treatments, about half had good erections after 5 years. There are now new methods that cut down the amount of radiation that hits parts that are easy to damage. It is not yet known whether these methods will help more men keep their erections.
A few men will make less testosterone after radiation. But testosterone levels usually go back up within 6 months after radiation. Extra hormones may not be needed. (Men with prostate cancer should not take testosterone, since it can help prostate cancer cells grow faster.)
After radiation to the prostate, some men put out only a few drops of semen. Near the end of radiation treatments, men often feel a sharp pain as they ejaculate. This should go away over time after treatment ends.
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