Bowel problems and sex after radiotherapy for prostate cancer

Radiotherapy uses radiation to kill cancer cells. It is a common treatment for prostate cancer.

Radiotherapy to the prostate gland can affect your sex life in several ways. For example, daily treatments for several weeks can make you very tired. You might not feel like having sex. Other side effects can affect you when having anal sex. Side effects include:

• loose poo or diarrhoea
• irritation and pain around the back passage and anus
• leaking poo

How diarrhoea affects your sex life

You might get diarrhoea during radiotherapy and for some time afterwards. This can be unpleasant and tiring. It may put you off wanting to have sex. Your doctor can arrange for you to have some anti diarrhoeal medicine.

It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But your doctor might suggest changing your diet if diarrhoea is a long term problem. Radiotherapy damage to the bowel might mean that you can't cope with as much fibre as you used to. So you could try:

• low fibre cereals
• white bread instead of brown
• tinned fruit instead of fresh fruit

Ask your doctor for advice or speak with your dietitian.  

Irritation and pain around the anus

The skin around the outside of the anus might become sore because of the radiotherapy itself or diarrhoea. The anal area may become generally more sensitive and prone to irritation. If you are used to having anal sex and you are the receiving partner, this can be painful. You might want to avoid anal play or sex until this side effect improves. Things usually improve a few weeks after treatment has finished. But it could take longer.

It might help to think of other ways to enjoy sex and be close to your partner.

When you decide to try anal sex again, it might help if your partner uses extra lubrication. You could try water soluble lubricants or silicone based. Ask your pharmacist about the different products. Don’t use oil based lubricants because these could irritate the area further. It might be more comfortable if your partner wears a condom.

Proctitis

Some men might have more long term problems with anal irritation and discomfort. This is due to the radiotherapy causing inflammation around the back passage (rectum). It’s called proctitis.

You can have a feeling of wanting to strain whether or not you actually need to pass a bowel movement. You might have a slimy mucus discharge or bleeding from your back passage. 

Talk to your cancer specialist if you have proctitis. Treatments such as anti inflammatory cream may help to reduce the inflammation. 

Leaking poo

You might leak some poo. This usually settles down a few weeks after radiotherapy finishes. But it can be a long term side effect for some people. This can be very embarrassing and put you off any kind of sexual contact.

If this problem continues, talk to your GP or specialist. They might refer you to a doctor who specialises in the long term side effects of radiotherapy to the pelvic area.

Talking to healthcare professionals

You might feel uncomfortable speaking about your bowels and sexual life. But it's important to remember that your doctor and specialist nurse are used to talking about these kinds of things. 

You should always let them know about any problems you're having. Explain the impact that these side effects might be having on your life, such as your sex life. They can help you to manage any problems you might have,