Robert Ginyard struggled with the indignity of impotence after radical prostate cancer surgery in August 2010, then a course of radiation and finally hormone treatment this year.
"After hormone therapy, I lived the life of a woman," said the 49-year-old entrepreneur from Baltimore. "I had hot flashes, tender nipples and lost some hair. I even lost my ability to even think about sex. It just took away my libido."
"I have a beautiful wife, but she could be in the best-looking bikini," he said. "But because of the medicine, nothing could happen."
Despite improved therapies for men diagnosed with prostate cancer, most men face erection dysfunction because of nerve damage or blood flow problems. Many also lose their desire for sex and have difficulties reaching an orgasm.
Now, a new study published online in Cancer, a peer-reviewed journal of the American Cancer Society, suggests that counseling can enhance the effectiveness of erectile dysfunction medications to help improve couples' sex lives.
Both Internet-based counseling and face-to-face therapy sessions improved the sex lives of prostate cancer survivors and their spouses, according to the study led by Leslie Schover, a psychologist and professor at the University of Texas MD Anderson Cancer Center in Houston.
"When men get these problems, they see their sexual function as how hard is my erection, and women get ignored and turned off," she said. "And so men get distressed emotionally and feel like they are a failure."
Such was the case with Ginyard who said his wife "didn't know exactly what to say or how to hold me. She felt like an outsider."
Eventually, Ginyard was able to restore his sexual function.
In the study, Internet-based and face-to-face counseling focused on both partners' enjoyment when they "encountered more intimacy and less performance," said Schover.
Other than skin cancer, prostate cancer is the most common cancer in American men and the second-leading cause of death, according to the American Cancer Society. One in six men is at risk for prostate cancer in his lifetime. Each year, more than 240,000 men are diagnosed with the disease and nearly 34,000 die.
And African American males like Ginyard have a 60 percent higher risk for prostate cancer than white males.
The University of Texas study involved 115 couples. In each case, the man's prostate cancer treatment had taken place no more than two years prior to the study. Half of the couples sought no help for three months. The other half had three face-to-face counseling sessions or worked with an online counselor who gave feedback on the Internet.
A third group of 71 couples who lived too far to participate in face-to-face counseling was part of the Internet group.
Couples were also educated about treatment options for impotence: drugs like Viagra that increase blood flow, shots in the penis, vacuum pumps and surgical penile implants.
Each partner looked over the information on these medical interventions and rated them. The computer generated their top three choices.
Couples compared notes then agreed on a treatment option as a first step. They were also monitored by counselors to see how well it worked and to "troubleshoot," according to Schover.
She said treatments can be a "hassle," especially if both partners are "not motivated to really take the time and put a priority on making sex intimate and fun and communicate about what feels good."
"Just having a hard erection doesn't fix things," said Schover.