Prostate Cancer Destroyed My Husband’s Desire for Intimacy

“This is no reflection on her; it’s just the fact of what he’s going through,” Winston says. On top of all that, many men with prostate cancer experience a fear of mortality, and shame at not being able to perform.

Initiate a gentle conversation. Brandon, cohost of The Sex Doctors podcast, recommends discussing with your husband how the past year has been for both of you.

“Tell him you miss him and the closeness you shared,” she says.

Winston suggests that you set the stage for your husband to share his feelings. Don’t engage in finger-pointing, but ask open-ended questions like, “I’m not asking for sex; I just want a mental and emotional connection. How do you feel?”

Winston also recommends using the word “we” as much as possible. “When you say ‘you, you, you,’ it highlights his demons, and saying ‘I, I, I’ makes the problem about you. This is more of a neutral, amorphous way to tackle the problem together,” he says.

Disconnect intimacy from sexuality. When Winston talks to patients about prostate cancer survivorship, one of the first things he recommends is that couples redefine what intimacy looks like.

“A lot of folks believe intimacy means naked time,” he says. “It needs to be reframed. Remove expectations and focus on togetherness and touch.”

Brandon says to talk to your husband about taking small steps back to connection: hugging, slow dancing, holding hands or simply lying together.

“Try to build new ways of being close rather than attempting to re-create what intimacy used to look like,” she suggests.

The key is to recognize that intimacy doesn’t have to be sexual, according to Dacker. “Just be present without the pressure of being aroused,” she says.

Talk to your doctor about off-label libido enhancers. There’s no FDA-approved libido enhancer for men, but there are ones for women that can be used off-label for men, says urologist Irwin Goldstein, director of San Diego Sexual Medicine, a private practice that diagnoses and treats sexual health concerns.

This may not apply in your husband’s case, but it’s worth having the conversation. The two meds Goldstein prescribes for men are flibanserin (Addyi), an oral tablet taken daily at bedtime, and bremelanotide (Vyleesi), which is self-injected into the thigh at least every 24 hours, up to 8 times a month. Goldstein says they are safe to take if you are dealing with prostate cancer, but as always before you start something new, check with your doctor. Goldstein, who has researched sexual dysfunction since the 1970s, says insurance sometimes covers the two drugs, even when prescribed off-label. Without insurance, they cost roughly $100 a month each.

A third option Goldstein prescribes off-label to up the libido is bupropion, commonly known as Wellbutrin, which is widely used to treat anxiety and depression. “It’s been generic for years and costs pennies,” he says.

Goldstein notes that all three meds share the potential side effect of nausea. The oral drugs, Addyi and Wellbutrin, both have side effects of dizziness, insomnia and dry mouth. In the case of Wellbutrin, there is also a seizure risk. If you have a seizure history, Goldstein says to speak to your neurologist to get clearance.

Get support. Winston says many older men aren’t comfortable talking about their feelings. If your husband shuts you down, he says to consider couples therapy. There are also support groups for both prostate cancer survivors and their partners.

And if you go to each other’s doctor appointments, Winston says, “Ask your husband, ‘Hey, do you mind if we bring this up?’ He may be more open to hearing about it from an expert.”

Brandon says a sex therapist can also help the two of you find a path back to closeness that feels emotionally safe and physically comfortable.

“This is undoubtedly hard for both of you,” she says. “Start small, keep it gentle, and get support.”