Reviewed by Lorraine Grove. Specialist Nurse. (23/0/2026)
Author. : CLare Delmar The Focal Therpay Clinic
At a Glance
Prostate cancer treatment can significantly affect sexual function, intimacy, and emotional wellbeing — but with the right support, men and their partners can rebuild confidence and connection. Psychosexual specialist Lorraine Grover explains that early, open conversations about sexuality are essential. At The Focal Therapy Clinic, focal therapy preserves sexual function in 90%+ of men (FTC audit, n=265), offering an alternative that prioritises both cancer control and quality of life.
Key takeaways:
- Sexual side effects are common — radical prostatectomy and radiotherapy frequently cause erectile dysfunction, altered orgasm, and reduced libido
- Early conversation matters — psychosexual support should begin before treatment, not after problems arise
- Partners need support too — emotional distance can grow when intimacy issues are avoided; couples therapy can help
- Focal therapy preserves function — 90%+ of men maintain sexual function after HIFU or NanoKnife at The Focal Therapy Clinic
- Recovery is possible — with psychosexual therapy, adapted intimacy practices, and personalised care, men can regain confidence
Sexuality and intimacy are among the most important concerns for men facing prostate cancer treatment — yet they are often the last topics discussed by clinical teams. At The Focal Therapy Clinic, we believe sexual wellbeing deserves early, open attention. Our outcome data shows that focal therapy preserves sexual function in 90%+ of men with normal pre-treatment function (FTC audit, n=265), offering a genuinely different path to men who want cancer control without sacrificing intimacy.
In this article, Psychosexual Nurse Specialist Lorraine Grover explains how prostate cancer treatment affects sexual function and relationships, why these conversations must start before treatment begins, and how psychosexual support can help men and their partners rebuild confidence and connection.
How Prostate Cancer Can Affect Sexual Function
Prostate cancer treatment frequently affects sexual function, but the extent depends heavily on the type of treatment chosen. Radical prostatectomy carries the highest risk, with published literature showing 30–70% of men experiencing lasting erectile dysfunction. By contrast, focal therapy at The Focal Therapy Clinic preserves sexual function in 90%+ of men with normal pre-treatment erections (FTC audit, n=265).
The main sexual side effects of prostate cancer treatment include:
- Erectile dysfunction — difficulty achieving or maintaining erections, most common after surgery and radiotherapy
- Reduced libido — especially with hormone therapy (androgen deprivation therapy)
- Altered orgasm — dry orgasm or reduced sensation, particularly after prostatectomy
- Changes to ejaculation — absent or reduced ejaculate following surgery or radiation
The impact goes far beyond the physical. It can shift how a man sees himself, affecting confidence and feelings of masculinity. Without open communication and the right support, emotional distance can grow between partners. That is why early, honest conversations about sexuality should be part of every treatment pathway.
What Happens to Sexual Function After Prostatectomy or Radiotherapy?
Radical prostatectomy removes the entire prostate gland, inevitably affecting the nerves and structures essential for erections and ejaculation. Even with nerve-sparing surgical techniques, published data shows 30–70% of men experience lasting erectile dysfunction, and most will have dry orgasms permanently. Radiotherapy to the whole gland can also damage nerves and blood vessels over time, leading to progressive ED.
| Outcome | Radical Prostatectomy | Radiotherapy | Focal Therapy (FTC data) |
|---|---|---|---|
| Sexual function preserved | 30–70% | Variable (declines over time) | 90%+ (FTC audit, n=265) |
| Urinary continence | 80–95% | 85–95% | 97% (FTC audit, n=265) |
| Recovery time | 4–6 weeks | Gradual (weeks to months) | 1–2 weeks |
| Ejaculation | Absent (dry orgasm) | Often reduced | Usually preserved |
Source: FTC one-year outcome audit (n=265) and published literature. Explore focal therapy success rates for detailed outcomes.
Being informed about these potential outcomes before treatment is vital for setting realistic expectations and reducing anxiety. Psychosexual specialist Lorraine Grover observes that discussions around radical treatments have historically prioritised cancer cure and continence, with sexual function addressed later — if at all. This gap can leave men and their partners unprepared for the significant psychological and relational impact of altered sexual function.
How Does Erectile Dysfunction Affect Relationships and Emotional Wellbeing?
Changes to sexual function after prostate cancer treatment affect both men and their partners emotionally, not just physically. At The Focal Therapy Clinic, we see couples navigating feelings of loss, anxiety, and uncertainty — and we know that addressing these concerns early leads to better outcomes for relationships as well as recovery.
Lorraine Grover, Psychosexual Nurse Specialist, notes that partners are frequently the ones seeking information and support first. Their concerns often extend beyond the physical:
- Emotional distance — when sexual difficulties are avoided rather than discussed, couples can drift apart
- Loss of identity — men may feel their masculinity is diminished; partners may feel rejected or helpless
- Guilt and uncertainty — both partners may struggle to initiate conversations about changed intimacy
- Relationship strain — particularly if intimacy was not discussed openly before diagnosis
Rebuilding intimacy requires more than addressing physical side effects. Through honest, compassionate conversation, many couples discover new ways to feel close — focusing on touch, sensuality, and emotional connection rather than solely on intercourse. Couples who face these challenges together often report developing deeper emotional intimacy than they had before treatment.
This is one reason why choosing a treatment that preserves sexual function matters so much. Focal therapy’s 90%+ sexual function preservation rate (FTC audit, n=265) means many couples can maintain their physical relationship while also benefiting from the emotional growth that comes with navigating a cancer diagnosis together.
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How Can Psychosexual Therapy Help After Prostate Treatment?
Psychosexual therapy is a specialist form of counselling that addresses the emotional, psychological, and physical aspects of sexual difficulties following prostate cancer treatment. Lorraine Grover, Psychosexual Nurse Specialist, explains that these sessions go beyond physical challenges — helping men and their partners navigate how prostate cancer treatment intersects with identity, relationships, and self-worth.
Support options available to men after prostate cancer treatment include:
- One-to-one psychosexual therapy — individual sessions exploring body image, confidence, and adapted sexual practices
- Couples counselling — helping partners communicate openly about changed intimacy and rebuild connection
- Group support sessions — normalising the conversation and learning from other men’s experiences
- Medical interventions — PDE5 inhibitors (such as sildenafil), vacuum devices, or penile injections for erectile dysfunction
- Educational resources — information from Prostate Cancer UK and Macmillan Cancer Support
Taking the first step to seek help can feel daunting, but it opens the door to meaningful recovery. The goal is not just to restore sexual function but to rebuild intimacy and connection with confidence. At The Focal Therapy Clinic, we ensure patients have access to holistic support alongside their treatment.
What Do Patients and Partners Say About Psychosexual Support?
Lorraine Grover, Psychosexual Nurse Specialist, shares that simply giving patients and their partners permission and space to talk openly about sexuality can be transformative. Many men at The Focal Therapy Clinic express wishing the topic had been raised earlier in their treatment pathway. Being invited into the conversation eases anxiety and empowers them to seek help.
“Sexuality is deeply intertwined with emotional wellbeing, communication, and connection. When we give men and their partners space to talk, many discover they can rebuild intimacy in ways they hadn’t imagined — sometimes finding a deeper connection than before treatment.”
Some couples report finding a different, sometimes deeper, form of intimacy after treatment. This comes not from a full return of previous sexual function, but from learning to communicate better, adapt their practices, and explore different ways of being close. For men who choose focal therapy, the high rate of sexual function preservation — 90%+ at The Focal Therapy Clinic (FTC audit, n=265) — means this emotional growth often builds on a strong physical foundation as well.
How Does Focal Therapy Preserve Sexual Function?
For men with localised prostate cancer, focal therapy preserves sexual function in 90%+ of men with normal pre-treatment erections (FTC audit, n=265). Unlike radical prostatectomy, which removes the entire prostate, focal treatments target only the cancerous tissue — leaving the nerves, blood vessels, and structures essential for erections and ejaculation largely intact.
The two main focal therapy options at The Focal Therapy Clinic are:
- HIFU (High-Intensity Focused Ultrasound) — NICE-approved under IPG424, uses focused ultrasound energy to destroy cancerous tissue with precision
- NanoKnife IRE (Irreversible Electroporation) — NICE-approved under IPG768, uses electrical pulses that destroy cancer cells while preserving surrounding structures
In our clinic’s experience with over 2,000 procedures across seven UK locations, men who choose focal therapy consistently report high satisfaction with both cancer control and quality of life. Our outcome data shows 90% remain cancer-free at one year, with 97% maintaining full urinary continence (FTC audit, n=265). Each patient receives a personalised treatment plan tailored to their cancer location, grade, and personal priorities.
“If you had completely normal erections before treatment, most men find that their erections return within a few months after focal therapy. By one year, most men find their erections are normal or close to normal.”
Not every patient is suitable for focal therapy — suitability depends on the cancer’s location, size, and grade. Our consultants assess every referral carefully with mpMRI and targeted biopsy before recommending treatment. For men who are suitable, focal therapy offers more than a clinical solution: it provides reassurance that cancer control and intimate wellbeing can go hand in hand.
What Should You Do Next?
If you are facing a prostate cancer diagnosis and sexual wellbeing is important to you, there are clear steps you can take:
- Ask about focal therapy — if you have localised prostate cancer, focal therapy preserves sexual function in 90%+ of suitable patients (FTC audit, n=265)
- Request psychosexual support early — do not wait until after treatment to address sexual concerns; ask your clinical team or seek a specialist like Lorraine Grover
- Involve your partner — couples who communicate openly about changed intimacy report better emotional and physical outcomes
- Book a consultation — at The Focal Therapy Clinic, our consultant urological surgeons assess suitability through detailed MRI review and discuss all treatment options including their impact on sexual function
Your sexual wellbeing deserves to be part of the conversation from the very start. Contact The Focal Therapy Clinic to discuss your options with our specialist team.
References
Prostate Cancer UK. (n.d.). Sex and relationships. Retrieved from https://prostatecanceruk.org/prostate-information/living-with-prostate-cancer/sex-and-relationships
Macmillan Cancer Support. (n.d.). Sex and cancer. Retrieved from https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/sex-and-cancer
Grover, L. (n.d.). Psychosexual Therapy Services. Retrieved from https://lorrainegrover.com/
