Home > Services > Supporting pelvic health & abdominal related concerns (SPARC) > Sex intimacy and cancer (SPARC) > Erection difficulties (SPARC)

On this page:

Some people during and after cancer treatments can notice problems with gaining or maintaining an erection, which can be either temporary or permanent. This can be due to:

  • Damage to the nerves and blood vessels that make the penis hard (erect) when you are aroused due to surgery or radiotherapy. These nerves are also affected by things like blood pressure and diabetes, and so any pre-existing difficulties can be exacerbated by cancer
  • Changes to the level of hormones such as testosterone due to hormonal treatments, immunotherapy or chemotherapy, which impacts on desire and the functioning of the erectile system
  • Anxiety about one’s ability to gain or maintain an erection.
  • Feeling tired
  • Low mood

Some people experience an impact on their emotional wellbeing due to difficulties with erections. In addition to difficulties with gaining or maintain an erection if you are experiencing changes to your ejaculation or to the shape or size of your penis, you may also be impacted emotionally. It can be common to feel:

  • Embarrassed about changes to your penis, erections or ejaculation
  • Anxiety about your ability to gain or maintain an erection and provide pleasure through penetration or during masturbation
  • Feeling less masculine (some people describe this as “feeling less of a man”)
  • An impact on your romantic relationships
  • An impact on your self confidence.

For many people erections can be an important aspect of their sex and intimate lives. There are lots of different things that may be able to help you both physically and emotionally to manage changes to your erections.

What can help:

  • Remembering this can be a normal side effect of treatment for many people and often improves over time
  • Masturbation, if possible and right for you, can be one way to keep the penile tissue healthy and to improve the working of the erectile system. It can also sometimes feel easier to start with masturbation, before gradually brining in a sexual partner
  • There are lots of things that can help you gain an erection including tablets, creams, a pump, injections. It is important to find the right approach for you. Speak to your cancer team about the options or ask for support from your GP who may be able to help and refer onwards if needed.

The Macmillan website has information about the various options available:

Erectile dysfunction, sex life and cancer treatment | Macmillan Cancer Support

Practicing pelvic floor exercises can have an impact on your ability to get an erection as well as help with incontinence.

This video explains how to do pelvic floor muscle exercises

  • Communicating with your partner about your difficulties, feelings and what can help
  • Thinking about trying different sexual activities other than penetration to gain (or provide) pleasure
  • Soft penetration – where you guide your flaccid penis into a vagina or anus, and then create intimacy through touch, grinding or kissing. This can take the pressure off from needing to be hard (erect), can help to build confidence and help to regain some control over your body and pleasure
  • When you are feeling low or anxious due to cancer, or due to being unable to get an erection, this can lead to a vicious cycle where it becomes more difficult to get an erection. Seeking psychological support to better understand and break out of this cycle can be beneficial
  • Engaging in mindfulness-based activities can be helpful before sex, as when you are entering a sexual encounter anxious or thinking about your ability to gain an erection this can impact on your arousal level. For information on mindfulness activities you can go to: Mindfulness – NHS
  • If you feel less masculine due to difficulties with your erection, it can be helpful to think about other ways in which you are or can be or feel masculine (e.g., through your actions).

More general tips and advice about sex and intimacy after a cancer diagnosis can also be helpful and can be found here sex and intimacy.

More information

This is just an introduction to difficulties with erections. For more information visit:

Who can help

Speak to your cancer team or GP for support or an onward referral to a specialist erectile function clinic or pelvic Health Physiotherapy if needed.

You can ask your cancer team for a referral to the Macmillan Cancer Psychological Support Team (CaPS) at St George’s Hospital if you are a patient under their care and would like to consider psychological therapy. You can find information about the CaPS team at: