Living with prostate cancer: bladder, sex, hormones and feelings

What helps with leaking urine, erection changes, hormone therapy side effects and bowel changes after prostate cancer treatment, plus tips for partners and coping with PSA tests.

6 min read · last reviewed September 30, 2026

Prostate cancer treatment can change some very personal parts of life: how you pee, how your body responds sexually, and how you feel in yourself. These changes are common, and they are nothing to be embarrassed about. Your care team talks about them every day.

The most important thing to know is this: many side effects get better with time, and there is a lot that helps. Here is what to expect, and what to ask.

Bladder control

After surgery, most people leak some urine at first, especially when they cough, sneeze, lift or stand up. For many, this gets better over weeks to months. Some people have a small leak that lasts longer. Radiation is less likely to cause leaking, but it can make you need to pee more often or more urgently.

What helps:

• Pelvic floor exercises (Kegels). These strengthen the muscles that help hold in urine. Many teams suggest starting before surgery, then again once the catheter is out.
• A pelvic health physiotherapist. They can check you're doing the exercises correctly and build a plan for you. Ask for a referral.
• Pads or guards made for men. They are discreet and help you get on with your day while you recover.
• Small daily habits. Drink enough fluid, but ease off caffeine, fizzy drinks and alcohol, which can irritate the bladder. Empty your bladder before activity.
• Further help if leaking lasts. Medicines, a small sling, or a device called an artificial urinary sphincter can help if leaking doesn't improve after about a year.

Something you can do: Ask your team before treatment, "Can I see a pelvic health physiotherapist to learn pelvic floor exercises?"

Erections and sex

Surgery, radiation and hormone therapy can all affect erections. After surgery, changes often happen right away and may improve slowly over a year or two. After radiation, changes may come on slowly over time. Hormone therapy often lowers sex drive.

There are many options, and people often combine them:

• Pills that increase blood flow to the penis, such as sildenafil or tadalafil.
• Vacuum pumps, which draw blood into the penis, with a ring to keep the erection.
• Injections or a small pellet of medicine into the penis. They work well even when pills don't.
• A penile implant, placed during surgery, for lasting problems.

Some teams suggest "penile rehabilitation," using these tools early and regularly after treatment to help keep the tissues healthy. After surgery, orgasm still happens, but it's usually dry, because no semen comes out. If you might want children in the future, ask about sperm banking before treatment.

An important medicine warning: Never take erection pills if you use nitroglycerin or other nitrate medicines. The combination can cause a dangerous drop in blood pressure. Always check with your doctor first.

Something you can do: Ask, "What can I do to protect my erections, and when should I start?"

Living with hormone therapy

Hormone therapy lowers testosterone, and that can affect your whole body. Common side effects include:

• Hot flashes and sweating
• Tiredness
• Lower sex drive
• Weight gain around the belly and loss of muscle
• Thinning bones, which can raise the chance of a fracture
• Changes in mood, and sometimes memory or focus
• Breast tenderness or swelling

What helps:

• Exercise. Regular activity, including strength training, is one of the best tools. It helps with tiredness, mood, muscles, bones and weight.
• Bone care. Your team may check your bone density and suggest calcium, vitamin D, or a bone-strengthening medicine.
• Heart care. Keep up with blood pressure, cholesterol and blood sugar checks.
• Hot flash tips. Dress in layers, keep cool, and limit alcohol and spicy food. Tell your team if flashes are hard to live with.

Bowel changes after radiation

Radiation can irritate the rectum. You may have loose stools, a sense of urgency, or mild bleeding, during treatment or later. Most of this settles. Tell your team about any bleeding from your bottom or bowel changes that don't go away.

For partners

A partner may feel worried, left out, or unsure how to help. Talk openly about how you both feel. Closeness doesn't have to mean intercourse. Touch, cuddling and time together all count. Many couples find a sexual health clinic or counsellor helpful. Partners are welcome at appointments too.

Living with PSA tests

After treatment, you'll have regular PSA tests. Many people feel anxious in the days before results. This is so common it has a nickname: "PSA anxiety." Try booking your results visit soon after the test, bring a support person, and ask your team what change in PSA would actually matter.

It's normal to feel low, angry or worried. Support groups, including groups just for men with prostate cancer, can help. Tell your team if low mood or worry lasts more than two weeks.

Questions to ask your care team

• What bladder and sexual side effects should I expect from my treatment, and for how long?
• Can I see a pelvic health physiotherapist?
• What erection treatments are right for me, and when should I start?
• How will you protect my bones and heart while I'm on hormone therapy?
• What exercise is safe and helpful for me?
• Is there a support group or counsellor you'd recommend for me or my partner?

This article is general information, not medical advice. Talk with your health care team about your own situation. In an emergency, call 9-1-1 or your local emergency number.

In an emergency, call 9-1-1 or your local emergency number.

General information, not medical advice. It does not replace your own care team. If you think you or someone else is having a medical emergency, call 9-1-1 or your local emergency number. If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and the US).

Back to Prostate cancer