Ask Joan: Sex and ED

Every month in Sex at Our Age, award-winning senior sexpert Joan Price answers your questions about everything from loss of desire to solo sex and partner issues. Nothing is out of bounds! To send your questions directly to Joan, email sexpert@seniorplanet.org.

A member writes:

I’m 62, three years divorced, fit for a man my age, and a prostate cancer survivor. I am pleased that things went well with the surgery and cancer removal, but I am left with ED, as is often the case after prostate cancer surgery. Partial erection and orgasm are possible, but I do not know if full function will ever return. Spontaneous erection occurs during sleep, but never from visual or mental stimulation.

Because of this limitation, I have avoided pursuit of another relationship. I am intensely lonely, and I miss the companionship of a partner. I do not know how I would deal with the shame and awkwardness of revealing my lack of erections to someone special. Sexual intercourse is an important part of intimacy for most partnerships. That said, I am certainly open to other options for pleasing a partner.

What would you suggest for men who are unable to have penetrative intimacy with a partner? When and how should that be revealed in a way is fair and appropriate? Is this a deal breaker for most women?

If there is any possibility of finding joy again in companionship, I would like to explore that potential. I’m just not sure how best to move forward.

— No Erection, No Partner?

Joan replies: 

You present two important concerns: (1) You do not have full erectile function and you don’t know whether you’ll ever be able to have penetrative sex with a partner; (2) You are ashamed and reluctant to seek a partner because you’re sure your ED will be a deal breaker. Let’s take these separately.

First, let’s rejoice that you’re a cancer survivor. Yes, prostate surgery commonly affects erectile function, sometimes temporarily and sometimes permanently. You didn’t say how long ago you had surgery. It can take two years before you regain full function or know what permanent limitation you might have. It’s a good sign that you have spontaneous erections during sleep. I hope your urologist has discussed this issue with you—if not, please open the conversation. Ask about your options, including whether you might be helped by medications, injections, or a vacuum pump.

Even if full function does not return, you will still be able to enjoy sexual pleasure, become aroused, and reach orgasm—with or without an erection. Many men, as well as their partners, are not aware that the right stimulation from your own hand, a partner’s hand or mouth, or a sex toy like the Pulse from Hot Octopuss or the Manta from Fun Factory can produce strong and satisfying orgasms even without erections. If your prostate was removed, that doesn’t affect your ability to have “dry” orgasms—without ejaculate, but with the full sensation of orgasm.

Now about your reluctance to seek a partner: Some women will find it a deal breaker, yes, but many will not. Only 25 percent of women orgasm through intercourse alone—the rest require clitoral stimulation. There are so many ways to satisfy your partner (and yourself) without intercourse. See the resources at the end to get you started.

If your partner likes the feeling of a full vagina during sex, you can give her that with your fingers or a dildo (penetrative sex toy). You might enjoy wearing a harness that lets you penetrate her with a dildo attached to you, so your thrusting does the action. Visit your local, progressive sex-toy shop to see how this might work. Don’t be shy about asking questions—there’s nothing that they don’t hear on a regular basis.

I hope this helps you see that there’s no reason to be ashamed or to avoid dating. You don’t have to reveal your erectile issues on a first coffee date, but once you see the chemistry is there, and maybe after you’ve shared a first soulful kiss, it’s a good idea to disclose. Try your version of this:

1. I’m a prostate cancer survivor.
2. Due to the surgery that saved my life, I can’t have penetrative intercourse, at least for now.
3. I’m enthusiastic about pleasing my partner in any way she desires and showing her what pleases me.
4. If this is a deal breaker, it would be a kindness to tell me before we take this further.

You’ll find that women your age have their own issues, and some will be very happy to enjoy a relationship filled with orgasm-filled, non-penetrative sex. If some reject you, move on. We all get rejected for one thing or another, and that’s okay—it’s the screening process that gets us closer to the people who are good matches for us.

I wish you the best.

For more about prostate cancer and erections:

• “Prostate Cancer: Dealing with Erectile Dysfunction: For You and Your Partner,” UCLA Health.
• “How Cancer Treatment Can Affect Erections,” American Cancer Society.

For more about satisfying sex without intercourse:

• “A Senior’s Guide to Sex Without Intercourse,” Senior Planet.
• “Sex without Penetration: A Man’s View,” by Shamus MacDuff.
• Great Sex without Penetration webinar by Joan Price.

Send Joan your questions by emailing sexpert@seniorplanet.org. All information is confidential. Joan can only answer questions that are chosen for publication.

Joan Price is the author of several books including “The Ultimate Guide to Sex After 50” and the award-winning self-help book “Naked at Our Age.” Visit Joan’s  blog, “Naked at Our Age” and her Facebook page. For senior sex news, tips, event and webinar announcements, and special offers, join Joan’s mailing list. View Joan’s new free webinar, “Safer Sex for Seniors.”