Whether you’re a man who has had prostate cancer surgery and you’re wondering how long it is before your sex life will return to normal, or you’re simply noticing erections are not coming as full and strong as they used to, increasingly the medical advice is “don’t just leave it to nature to take its course.”

Like many other body system functions, there’s growing agreement amongst urologists that the “use it or lose it” principle applies to sexual health as much as it does to other aspects of physical health like exercising arthritic joints.

Erectile ‘Rehab” Strategy

The basis for this is that depriving the penis of oxygenating blood may cause long term tissue damage and make the return of normal erectile function more difficult.

For men who had had a radical prostatectomy it means a strategic “erectile rehabilitation” programme with medication  to induce erections several times a week in the hopes of hastening and increasing the odds of a return of sexual potency.

Don’t Delay In Getting Erections Back

When you consider that typically Aussie men who experience erection problems leave it two years before finally deciding to seek treatment, you wonder if that delay is just going to make the return of a normal sex life less likely.

The advice seems to be “do something about it sooner rather than later.” As a LA Times report stated, Urology clinics have a saying: “Erections make erections.”

In countries like the US, where medical litigation is common, “use or it lose it” as a part of rehabilitation after radical prostatectomy is becoming a “standard of care” practice.

And that is a departure from earlier advice which was more or less not to hurry things, and “let nature take its course.

“Nature” May Not Be Best Course

For the 60 to 85 percent of men who do regain sexual function after radical prostatectomy, the average wait is about 18 months. For some men, it can take two years or longer for adequate erections to return.

But new research suggests that waiting for nature to take its course may actually make recovery of natural erectile function more difficult.

One Finnish study of 1000 men aged 55 to 75 showed having sex once a week halved men’s chances of developing erectile dysfunction, compared with a less-than-once-a-week schedule. (The study also hinted that the more often men had sex, the better they fared.)

In their analyses, the researchers made sure that other health factors — such as heart disease, diabetes, obesity and depression — did not explain the differences among men.

(Masturbation was not included, partly because the time duration of the erection seems to count, and masturbation is over quickly).

Oxygen Key to Tissue Health

Oxygen supply seems to be the key, says study lead author Dr. Juha Koskimäki, consulting urologist at Tampere University Hospital.

Oxygen-deprived tissue overproduces collagen (the main structural protein found in connective tissue). Over time, the excess collagen causes thickening and scarring of tissue within the corpora cavernosa, the two chambers in the penis that fill with blood to create an erection.

For men who’ve had surgery, the tough news is that even an expertly performed nerve-sparing radical prostatectomy causes some degree of trauma to the penile nerves that supply electrical impulses to the corpora cavernosa.

Unconscious Erections For Oxygen Supply

Doctors who favour “erection rehabilitation” believe achieving erections soon after radical prostatectomy may help prevent tissue damage and restore normal sexual function sooner.

One theory is that when the penis remains flaccid for many months, the lack of oxygen damages the spongy tissue.

Some scientists even wonder if the unconscious erections that occur during sleep might be the body’s way of making sure oxygen levels in the penis’s corpora cavernosa stay high. And perhaps that’s why even 12-week-old fetuses can have erections in the womb — because periodic oxygenation is important.

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About the author

Jenny W
First career as newspaper and magazine journalist with daily newspapers and magazines, then as an editor who successfully launched a new national Sunday newspaper and NZ House & Garden magazine. First woman editor of NZ Listener. Enjoying a second career as a business owner and entrepreneur, health products marketer, social media habitué, blogger and web marketer. Still learning and loving it.