This information will help you understand how the male reproductive system works (before treatment) and some of the words your doctor or healthcare provider might use.

Male genitals (the penis and scrotum) are outside the body. The scrotum contains the testicles, which make sperm and testosterone. During ejaculation, sperm travels through a tube (vas deferens) to the prostate gland. White, milky fluid called semen is added there, and the sperm and semen travel down the urethra and out the penis.

During a vasectomy, the vas deferens is cut and tied.

 

What happens during an erection?

The prostate gland has a bundle of nerves around it. When you get turned on (aroused) or interested in sex, or when the penis is stimulated, a message is sent to these nerves that makes blood flow to the penis. The tissue of the penis is like a sponge, which can absorb blood. When this spongy tissue fills with blood, the penis gets hard.

Pelvic surgery or pelvic radiation can often damage these nerves. After surgery, the nerves might be bruised or inflamed. These nerves can heal, but it’s a slow process which can take up to 2 years. If nerves are cut, they won’t grow back together and the damage is likely permanent.

Cancer treatments don’t damage the nerves that control orgasms or feelings in the pelvic area and penis. You can still enjoy having your penis or genital area stimulated and you can still have an orgasm without an erection.

How does an orgasm happen?

When some nerves are stimulated, it gives the body a feeling of pleasure. For example, when the penis is touched in a sexual way, you feel pleasure. The nerves that help you feel pleasure are different than the nerves that cause an erection.

• Many people think ejaculation and orgasm are the same thing, but they aren’t. Even if nerves are damaged after surgery or pelvic radiation, you can have an orgasm without having an erection or ejaculating.
• If the prostate or both testicles have been removed, you can still have an orgasm, but you won’t ejaculate. This is called a dry orgasm. Some people say that the quality of the orgasm is different, but many say it’s just as enjoyable.
• If you are taking part in sexual activities like stimulating the penis with a hand and your penis is not hard, it’s a good idea to use a lubricant. If you don’t, the friction can be painful and you might not enjoy it as much.

Testosterone

Testosterone is a hormone that affects sex drive and interest. The testicles make sperm and testosterone. Some testosterone is also made by the adrenal glands. Testosterone normally decreases as you get older. It can also decrease for a short time if you are depressed, stressed, sick, or injured.

Some cancer treatments, like androgen deprivation therapy or having the testicles removed, can stop the body from making testosterone. Testosterone replacement is a treatment for low testosterone. If you have questions about testosterone replacement, talk to your doctor or healthcare provider.

You don’t need testosterone to have sex, but it does help you get aroused, have an erection, and have an orgasm. When testosterone is decreased, you may not be as interested in sex. You can still have sex without testosterone, but it can be challenging with low sex drive.

It’s important to talk about sex or other ways to be intimate so you know how your partner feels. There are ways to be intimate and improve your sex life by learning more about improving your sexual desire and erections.