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Advice on safety of gay sex after prostate cancer

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User
Posted 08 Sep 2020 at 15:31

I've been asked a few times about resuming gay sex (or more strictly, MSM) after prostate cancer treatments, an issue on which there has been a dearth of information. I also tried to respond here to a similar inquiry from a straight couple who engage in prostate massage, for which some of the same considerations apply (and I can't find that thread now, of course). Information on this had been very elusive and isn't in any of the leaflets from PCUK, Macmillan, etc, because it hadn't even been discussed by clinicians. However, a year or so back, a group of clinicians did merge their thoughts on this and come up with some recommendations. The BBC posted a health article based on this work, so I thought I'd plant a pointer to it here for reference:

Advice on safety of gay sex after prostate cancer

User
Posted 08 Sep 2020 at 15:31

I've been asked a few times about resuming gay sex (or more strictly, MSM) after prostate cancer treatments, an issue on which there has been a dearth of information. I also tried to respond here to a similar inquiry from a straight couple who engage in prostate massage, for which some of the same considerations apply (and I can't find that thread now, of course). Information on this had been very elusive and isn't in any of the leaflets from PCUK, Macmillan, etc, because it hadn't even been discussed by clinicians. However, a year or so back, a group of clinicians did merge their thoughts on this and come up with some recommendations. The BBC posted a health article based on this work, so I thought I'd plant a pointer to it here for reference:

Advice on safety of gay sex after prostate cancer

User
Posted 08 Sep 2020 at 17:52

We also have quite a lot of info on this in the older posts on this GBMSM thread including some useful posts from researcher Sean, I think.

Edited by member 08 Sep 2020 at 23:35  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Sep 2020 at 10:30

I don't see how it can have any effect after a RP, unless you still have a lot of prostate cells left behind in the posterior of the prostate bed (perhaps over-ambitious nerve sparing?).

Note this is the time to avoid receiving anal sex, not the time to avoid ejaculating, which the panel did not discuss. Also there was some disagreement as some panel members suggested a longer period - the average was 1.6 weeks, but 1 week was the consensus (most common answer).

Also, this is not based on research (as the article suggests), but the views of a set of clinicians with a special interest in treating gay/bi men with prostate cancer.

Edited by member 09 Sep 2020 at 10:37  | Reason: Not specified

User
Posted 09 Sep 2020 at 10:42
I think for a bottom, the PSA wouldn't be affected if you don't have a prostate anymore. Plus, if you have had lots of post-op monitoring PSA tests without knowing this and wouldn't be able to say for sure that you have never received anal within a week of the test, it is better to carry on as you are.

There is lots of anxiety about things like orgasm, cycling, anal stimulation affecting PSA but most of the data is about the possible impact of prostate stimulation - if there is no prostate, what is there to stimulate? It seems to me that the most important thing is to try to be consistent before tests - behave the way you normally would. Perhaps the day before a PSA test is not the best time to buy a bike and go out on a 30km bike ride, have anal sex for the first time ever, etc.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Sep 2020 at 10:46
Aside of all that, I suspect the whole anal stimulation thing is a bit of a red herring as some poos are as large as or larger than a penis or butt plug - why would something going in affect the PSA and not something coming out?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Sep 2020 at 10:54

Originally Posted by: Online Community Member
why would something going in affect the PSA and not something coming out?

That's not really a side-by-side comparison...

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User
Posted 08 Sep 2020 at 17:52

We also have quite a lot of info on this in the older posts on this GBMSM thread including some useful posts from researcher Sean, I think.

Edited by member 08 Sep 2020 at 23:35  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 08 Sep 2020 at 21:06
Ah, prostate massage, the male ‘G-spot’.

Those were the days...😉

Cheers, John.

User
Posted 09 Sep 2020 at 10:10

Thanks for posting this.

It came to me as a doubt after reading the recommendations ...

"Before a PSA blood test—1 week (may lead to an inaccurate result) "

Is this valid both before and after RP? How do you interpret this?

 

 

User
Posted 09 Sep 2020 at 10:30

I don't see how it can have any effect after a RP, unless you still have a lot of prostate cells left behind in the posterior of the prostate bed (perhaps over-ambitious nerve sparing?).

Note this is the time to avoid receiving anal sex, not the time to avoid ejaculating, which the panel did not discuss. Also there was some disagreement as some panel members suggested a longer period - the average was 1.6 weeks, but 1 week was the consensus (most common answer).

Also, this is not based on research (as the article suggests), but the views of a set of clinicians with a special interest in treating gay/bi men with prostate cancer.

Edited by member 09 Sep 2020 at 10:37  | Reason: Not specified

User
Posted 09 Sep 2020 at 10:42
I think for a bottom, the PSA wouldn't be affected if you don't have a prostate anymore. Plus, if you have had lots of post-op monitoring PSA tests without knowing this and wouldn't be able to say for sure that you have never received anal within a week of the test, it is better to carry on as you are.

There is lots of anxiety about things like orgasm, cycling, anal stimulation affecting PSA but most of the data is about the possible impact of prostate stimulation - if there is no prostate, what is there to stimulate? It seems to me that the most important thing is to try to be consistent before tests - behave the way you normally would. Perhaps the day before a PSA test is not the best time to buy a bike and go out on a 30km bike ride, have anal sex for the first time ever, etc.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Sep 2020 at 10:46
Aside of all that, I suspect the whole anal stimulation thing is a bit of a red herring as some poos are as large as or larger than a penis or butt plug - why would something going in affect the PSA and not something coming out?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Sep 2020 at 10:54

Originally Posted by: Online Community Member
why would something going in affect the PSA and not something coming out?

That's not really a side-by-side comparison...

User
Posted 09 Sep 2020 at 12:03

Thank you both, Lyn and Andy, for your answers. Clear then.

True that I cannot say when I had sex or not before my past PSA tests ... 

Well, in fact anxiety is getting bigger with the tests, particularly now since April this year as PSA has slowly going up.

I had RP on April 2018 and the PSA marks have been quite stable around 0.03 for 2 years (I must say anyway that for the first 9 months the machine could not read below 0.04 … so I never knew what was in fact). On April 2020 the test came 0.05. 3 months later 0.06 and last Monday (further 2 months apart from last time) 0.08. I have a doctor appointment for next week.

I fear I am in need of further treatment and this post gave me some hope about staying well untreated for longer J

 

User
Posted 09 Sep 2020 at 12:47

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member
why would something going in affect the PSA and not something coming out?

That's not really a side-by-side comparison...

 

You say that but in the 10 years that I have been reading, researching and learning, I have never seen anything that would explain the difference. 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 07 Dec 2021 at 14:50

You might want to read Sean's published medical paper that the BBC based their article on

It can be found on the resources tab of our website outwithprostatecancer.org.uk.  You'll need to scroll down to the bottom of the page to get to the research papers.

Sean is a founder member of the Out With Prostate Cancer group.

Edited by moderator 07 Dec 2022 at 10:04  | Reason: Not specified

User
Posted 07 Dec 2021 at 14:57

Before RP then prostate massage (riding a bike, anal sex, prostate massage) should be avoided as it's known to raise PSA.  After RP, there is no prostate to massage so it will not impact PSA.

User
Posted 07 Dec 2021 at 14:59

Because, unless you are spending ages passing that "large stool" or keep putting it back in and passing it again it's not the same as anal sex or riding a bike in terms of prostate massage.

User
Posted 07 Dec 2022 at 11:24

.... and just to be clear, there is nothing that links prostate massage or anal sex to higher risk of prostate cancer. Just that prostate/anal play the day before a PSA test might falsely elevate your PSA reading.

 
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