Sex, Marriage and Prostate Cancer


Michael Russer explains that impotence does not have to mean a loss of sexual intimacy. In fact, impotence can lead to greater sexual intimacy.

Recently, I had a woman reach out to me to see if I could help her fiancé of two years deal with his impotence. When he discovered that he could no longer have traditional sex (intercourse) he told her to “…find another man” because he was “broken.” He was feeling so much shame and had shut down so completely that he couldn’t even bring himself to talk to someone who had gone through this successfully (me). She told me that since losing his erectile function, he no longer even interacts with her. He’d come home from work, lie down on the couch and stare at the television, refusing to connect with her. His way of coping was total and complete disconnection.

This was especially sad to me because I knew she was suffering too, and needed his loving support as much as he needed hers. Most women know, intellectually, that they are not the cause of their man’s ability to become erect. However, many cannot help but feel that their man may no longer find them attractive. If they show that insecurity, it can cause their male partner to feel even greater shame and shutdown, leading to a downward spiral that eventually crashes and destroys the relationship.


This year, over 233,000 men will be diagnosed with prostate cancer. This is a serious disease that kills approximately 29,500 men a year. Yet, for many men, the biggest concern is the impact the treatment will have on their sex lives. Most men with prostate cancer are married, and prostate cancer-induced impotence can be devastating, and often leads to marital breakdown.

It doesn’t have to be this way. Impotence does not have to mean a loss of sexual intimacy. In fact, impotence can lead to greater sexual intimacy. I know this sounds about as counterintuitive as a statement can sound, and I’ll explain. First, let’s examine why impotence due to prostate cancer can have such a profound negative impact.

Impotence does not have to mean a loss of sexual intimacy. In fact, impotence can lead to greater sexual intimacy.

Most men equate impotence with a loss of their manhood, of their essential masculinity. This belief that a hard erection is a necessary hallmark of manhood comes from deeply entrenched cultural and biological wiring. It’s something we learn from our culture: if we can’t perform sexually according to more traditional, procreative dictates, we feel broken. We feel unworthy of our mates’ affections.

Of course, losing one’s ability to have an erection is enormously difficult – a significant loss that must be grieved by both the man and his partner. Everyone who experiences this goes through three or more of the traditional four stages of loss: disbelief, anger, depression and acceptance. Because of the importance our culture places on normal erectile function, and the lack of conversation about what else is possible (aside from pharmaceutical and surgical interventions designed to restore lost function), many men get stuck in anger and/or depression. In so doing, they create an environment that no relationship is likely to survive. This unfortunate and totally unnecessary scenario is being played out with millions of couples all the time.

The key to preserving these relationships – and, potentially, experiencing even greater intimacy than before – starts with acceptance, the last stage of the loss process. Once a man accepts the “isness” of his impotence (i.e. no longer fighting or resisting the reality of it), both he and his partner are on the doorstep to incredible healing and intimate possibilities. This means no longer chasing the possibility of regaining erectile function through medical means. I’m not saying that these possibilities are off limits (that’s your doctor’s job, if it is truly the case); I’m saying that letting go of them for a while is key to discovering what my partner and I did: that there are so many other ways to be intimate than standard erectile-function-dependent intercourse.


Once I accepted my ED, my partner and I became open to exploring other ways of being intimate. And what came out of that exploration is nothing short of extraordinary. My partner and I now make love for two to four hours at a time. I receive incredible satisfaction seeing her climax a minimum of five to seven times every time we make love. And my own climaxes are far more powerful and longer lasting than they were when I actually had a prostate and could get an erection. (Yes, a man can climax without ejaculating or having an erection.)

As men, we can choose to believe the cultural imprinting that our ability to “perform” is what makes us a man. Or, we can choose to define who we are as men by how deeply we connect with and are able to please our partner.

We are not alone in our experience. Research has shown that about 15% of couples affected by ED also enjoy far greater and more fulfilling sex lives than they did when everything was working properly.

How is this possible? It’s quite simple, actually.

Not being able to get hard means I no longer have that overwhelming urge to “use it” that normally functioning men encounter during an erection. This allows me to slow down significantly for my partner, and more closely match her sexual response profile.  As a result, my partner is able to have a much more powerful sexual experience. Being the source of that experience, I have a deeper level of fulfillment and satisfaction than ever before.

The key to turning the tragedy of prostate cancer-induced ED into a blessing boils down to a choice. As men, we can choose to believe the cultural imprinting that our ability to “perform” is what makes us a man. Or, we can choose to define who we are as men by how deeply we connect with and are able to please our partner. This choice is available to every man affected by prostate cancer or ED, regardless of the cause.

Relationships don’t have to self-destruct because of prostate cancer. It can create an opportunity to rekindle and substantially deepen emotional and physical connection between couples, and may even  become the doorway to far great sexual satisfaction and fulfillment than they ever thought possible.

Photo: Flickr/Pedro Ribeiro Simões

About Michael J. Russer

Michael is a prostate cancer survivor who was left completely impotent as a result of his treatments. Yet, it was because of his impotence that he and his partner discovered an entirely new approach to emotional, physical and spiritual intimacy that far exceeds anything either experienced prior to when things were working "correctly." His mission is to help men, women and couples everywhere to achieve extraordinary intimacy on all levels.

He is an international speaker, author and thought leader on the issues of human connection and intimacy. He also speaks pro-bono to Cancer Support Centers and Gilda’s Clubs around the U.S. for cancer survivors and their partners about regaining intimacy in the face of cancer. Go to to explore the possibility of having Michael speak at your next event.

Michael is also a champion of the nonprofit men's work being done by the ManKind Project ( He completed the New Warrior Training Adventure in 2012.

iTunes: Creating Extraordinary Intimacy in a Disconnected World
TEDx Talk:


  1. Merv Kaufman says:

    One problem that Michael Musser doesn’t probe involves physicians—doctors who prescribe prostatectomy for cancer victims and other quasi-surgical procedures to correct prostate enlargement without clearly defining the possible consequences. Namely, ED. Which means that, during the post-op healing process a great many men are shocked by the realization that they are suddenly, and permanently, impotent. Frankly, it would be hard enough dealing with the reality of prostate cancer…then to be suddenly hit with the fact of impotence just has to be a shock. Yes, of course, patients should ask questions—a lot of them—except that a lot of men are so fearful of having any kind of surgery that they fail to pose any serious questions. I think doctors should anticipate this—and put all possible issues on the table. Better yet, convene a conference with the patient and his wife, so both can be informed at the same time of the possible consequences of whatever procedure has been posed. If the procedure is unavoidable—and there are no alternatives—isn’t it better for the patient to know in advance a possible outcome than to be hit in the gut with it later on?

  2. Loved this article. Thank you so much for sharing your experience.
    We have such a limited view of what constitutes sex and intimacy and articles like this help people to look at the whole question from a deeper perspective.
    It saddens me to read the responses from married couples who are still struggling to develop atruly intimate relationship – where nothing is held back, nothing is taboo and everything can be talked about openly, honestly and with vulnerability on both sides. This is truy the measure of a good relationship.

  3. This should be required reading for any man with prostate cancer.

  4. Jennifer G. says:

    Dear Michael Russer:

    Am glad that you put pen to paper (more or less) and stated what I’ve been attempting to tell
    my guy, that he does not need to be that erect to satisfy me sexually.

    Yours truly,

    Jenn G.

  5. Anonymous says:

    I’m a man who has ED who is on the verge on telling my partner to move on, and find a ‘whole’ man. My intellect understands there are are other ways to share pleasure and intimacy besides PIV sex. In fact, that was fine, until intercourse was not an option.
    I feel like the sexual aspect of my masculinity is broken and that is a terrible feeling. Deep, deep shame. On one occasion, my partner chastised my being upset over my inability to achieve an erection..
    If I thought I couldn’t feel worse about the ED, I was wrong.
    I know she meant well, but the sexual part of our relationship has never recovered. I was so ashamed I couldn’t look at her for days.

    • Jennifer G. says:

      Dear Anonymous:

      First, you are with the wrong woman. Second, you are so with a Wrong Kind of Gal. A female who cherishes you would never even think that you were “broken”, much less taunt you over a physical impairment – and impotency can be treated successfully – and she would not only keep her lips zipped, she might quietly seek out a physician who has some understanding of male anatomy.

      “I know she meant well, but the sexual part of our relationship has never recovered.” No. She struck out at you in a most vicious way and the sexual part of your togetherness is probably gone, as it ought to be. “I was so ashamed I couldn’t look at her for days.” In my opinion, the wrong person was feeling shame.

      Time to trade up for a more loving and understanding mate.

      Yours truly,

      Jenn G.

  6. This is a great article if you’re already in a committed relationship. I’ve dealt with prostate cancer as a single man and being able to start a relationship has been impossible because of my impotence. Acceptance would be easier if I wasn’t reminded daily that sex is valued far more than I am as a person and what I could off in a relationship.

    • Johnny, I can see it being a difficult conversation to have in a new relationship. But there are also many women who have little desire for penetration for one reason or another who would love to have an intimate relationship. As a victim of sexual assault, I would love to share intimacy and pleasure with a man without that particular sexual act that frequently causes me to freeze up and feel frightened. Women get the same reminders of our sexual value, although I realize that we don’t have the same performance pressures.

    • For what it is worth Johnny, I met my life partner *after* being struck impotent. I had a very candid conversation with her when it appeared that we were going to be more than just friends. I simply asked her “Sweetie, this isn’t happening (pointing to my crotch) and it may never happen. Are you willing to explore other ways of being intimate with me?”

      Being the wonderful woman she is, she of course said “yes!” And it is out of that inquiry and sense of mutual discovery that we experience (and continue to do so) truly extraordinary emotional and physical intimacy.

      I think you might be surprised at how many women will eagerly embrace you as a man with all that you can offer. Sex after impotence isn’t over, it’s just getting started my friend.

      • Thanks for sharing this. My biggest fear has been being rejected because I cannot get a erection after my prostate cancer surgery. So I purposely would not even think about trying to date again but the desire to be in a relationship again is stronger than ever. Your revelation of meeting your partner after being struck impotent really gave some encouragement and hope. Thanks.

    • Women are still ignorant as we’ve all been programmed to engage in a style of sexuality which does not truly enhance intimacy. There is a wonderful website called with a community of folks from all ages and backgrounds, who are learning a new style of love-making. Known by various names — tantra, karezza, “cool” sex — the practitioners mostly practicing non-orgasmic sex, and as you describe here, having other experiences of sexual intimacy which they never had when practicing the traditional, “mating” style of sex.

Speak Your Mind