Can you have sex after prostate removal?

Good news: you can have sex after prostate removal — but it may take time, and your body might respond differently than it did before surgery. Erections can be harder to get or maintain after surgery, and things like ejaculation and orgasm may change. That said, many people are still able to have a satisfying sex life with the right support and, sometimes, treatment.

In this article, we’ll walk through what sex after a prostatectomy can look like. You’ll also learn about the most common sexual side effects and the treatment options that can help you regain function and confidence over time.                                     

Yes, you can have sex after prostate surgery, but it may take time and some adjustment.

In the weeks and months after a prostatectomy, your body is still healing, and sexual function doesn’t always bounce back right away. Many people notice changes in how their erections or orgasms feel, especially early on. It’s also normal for symptoms to improve gradually rather than all at once.

The timeline and experience can vary a lot from person to person. Factors like your age, overall health, and the type of surgery you had all play a role. Even if you experience sexual dysfunction after having your prostate removed, there are several treatment options and strategies that can help support your recovery and get you back to a satisfying sex life over time.

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Like any surgery, a prostatectomy comes with potential risks and side effects, and some of those can affect your sex life. The most common is erectile dysfunction (ED), which means having trouble getting or keeping an erection firm enough for penetration. Some people may also notice changes in orgasm or lose the ability to produce semen after surgery. 

These changes can feel frustrating at first, but they’re common and often manageable with the right support.

Erectile dysfunction and prostate surgery

ED is the most common sexual side effect of prostate surgery. Research has shown that up to 85% of men who’ve had the whole prostate removed (radical prostatectomy) have problems with erections after surgery.

Why exactly does this happen? Tiny nerve bundles that are crucial for an erection run along the side of the prostate.

In some cases, the surgeon may use a nerve-sparing approach during the procedure to avoid injuring these nerves. But the nerve-sparing approach isn’t always an option for those with cancer that has grown very close to these nerves. If all of these nerves have to be cut, you’ll no longer be able to have spontaneous erections. 

That said, some men are able to have erections again with the help of certain treatments, which we’ll get to a little later on. 

If you only have nerves on one side of the prostate removed, you may still be able to get spontaneous erections, but it’s less likely than if no nerves were cut. Whether you can get an erection spontaneously again depends on a few factors, including your age and your ability to get erections before surgery. 

All men who’ve had a prostatectomy will experience some decrease in their ability to have normal erections, but younger men are more likely to regain function. But again, every person is different. If you are able to regain spontaneous erections, it will probably happen slowly, and it can take anywhere from months to a few years.  

Inability to produce semen

After surgery, some men will lose the ability to produce semen. This most often happens after a radical prostatectomy for prostate cancer. That’s because the procedure typically involves removing not just the prostate, but also the seminal vesicles (the organs that help make semen).

After this type of surgery, orgasms are still possible, but they’ll be “dry,” meaning no semen is released. This is a permanent change, and while some people find it affects how satisfying an orgasm feels, others are able to adjust to this new normal over time.

If these changes are affecting your sex life, there are treatment options and strategies that can help support your sexual function and overall experience (more on that in a moment).

A few treatment strategies may help you get erections following prostate surgery. 

Your healthcare provider may recommend what’s known as penile rehabilitation, or penis rehab for short. Many health experts theorize that the sooner you’re able to get an erection after surgery, the more likely you are to get back full control of your penis and erections. 

The goal of penile rehabilitation is to preserve erectile function as much as possible through medications or devices, which we’ll explore below. The success of penile rehabilitation depends on a lot of different factors, especially on the number of nerves that were removed or preserved during surgery.

Penis rehab generally begins once the body has had a chance to heal, which is usually several weeks after the operation. It’s an ongoing process that can last up to two years, and trying to get regular erections to help keep the tissue in your penis healthy is part of the journey. 

ED medications

For some people, prescription drugs are recommended to manage ED after prostate surgery. Oral medications known as PDE5 inhibitors are the most common treatment for ED. The most well-known is sildenafil (brand name Viagra), but others include tadalafil (brand name Cialis), vardenafil (formerly known by brand name Levitra), and avanafil (brand name Stendra).

Ro also offers options like Ro Sparks, a fast-acting treatment that combines sildenafil and tadalafil and dissolves under the tongue, and Daily Rise Gummies, a lower-dose tadalafil option designed for daily use. While the United States Food and Drug Administration (FDA) doesn’t approve these specific formulations, their active ingredients are individually approved for treating ED. These options can be helpful if you’re looking for a formulation that’s more convenient and offers more spontaneity.

It’s worth noting that these PDE5 inhibitors don’t always work right away after prostate surgery. In the first few months, your body is still healing, and nerve function may not be fully restored. But over time, often around 18 months post-surgery, these medications may become more effective in helping you get a firm erection. 

Speak to your healthcare provider about the exact type of surgery you had for more personalized expectations.

Medical devices

In some cases, a specific type of device, called a penis pump or vacuum therapy, may be helpful in restoring erections. This treatment uses a vacuum pump to draw blood into the penis. Because a penis pump causes erections regardless of nerve damage, it can be an important tool to help restore erections.

Lifestyle changes

Certain lifestyle changes can support erectile function and play a role in penile rehabilitation after prostate surgery. While none of these are quick fixes, they can make a meaningful difference over time, especially when combined with other treatments.

Some of the most helpful habits include:

• Staying physically active: Regular movement supports blood flow, which is key for healthy erections.

• Eating a balanced diet: Prioritizing whole foods, healthy fats, and nutrient-dense meals can support overall vascular health.

• Maintaining a healthy weight: Obesity is linked to a higher risk of ED, and weight loss can help improve erectile function.

• Quitting smoking: Smoking can damage blood vessels, causing less blood to flow into the penis.

• Limiting alcohol: Excessive drinking can interfere with sexual function.

• Managing underlying health conditions: Conditions like diabetes, cardiovascular disease, and high blood pressure can contribute to ED.

• Supporting your mental health: Stress, anxiety, and depression can all affect sexual performance.

Sex after prostate removal is possible, but it’s not always immediate and may not be quite the same as before. Recovery can take time, and some changes may be long-term. But there are effective ways to adapt and improve your sexual health along the way. Here’s what to keep in mind:

• Yes, you can have sex after prostate surgery, though erections and orgasms may feel different.

• Erectile dysfunction is common after prostate surgery, especially early on, but can improve with time and treatment.

• Dry orgasms (ejaculation without semen) are a permanent change after some types of surgery.

• Treatments like ED medications, penis pumps, and penile rehabilitation can help support recovery.

• Lifestyle changes and managing underlying health conditions can also improve outcomes.