Total inability to have an orgasm post radiation

First of all, thank you for taking the time to post a response. As you’ve likely learned, treatment for cancer, is it not a one size fits all proposition And I’m glad that you’ve had good results with proton therapy.

When I was first diagnosed in 2020 I absolutely did not want surgery. I was afraid of incontinence issues and sexual dysfunction, and I was unwilling to compromise even in the short term. My two top choices for treatment were proton radiation therapy and low dose radiation brachytherapy. I had private insurance at the time and my carrier Aetna wouldn’t even discuss paying for proton therapy. They also wouldn’t pay for any biopsy other than a 12 core random transrectal biopsy.

I opted for LDR brachytherapy and everything was great for three years until cancer returned with a vengeance in summer of 2023. Gleason 9 Stage 3. My prostate was removed in the salvage operation in January 2024 and I underwent seven weeks of salvage radiation that finished July 18 2024. I will be on ORGOVYX and generic Zytiga until April 2026 and my care team is optimistic that we can knock this into remission for several years and hopefully the rest of my life.

We are both blessed to live in an age where the treatment is largely so successful that we have the luxury of being concerned about sexual function.

Good luck on your journey!

I have heard of this situation in my support group. The guy that had it , said it resolved itself in time. Body needs time to heal and such . Radiation. , generally, takes soem time to work too and drive down PSA number . Give it some time and walk / hike alot and keep active ! Keeping active and sauna's helped me recover - I do believe !

Thanks. I walk my dog 3-5 miles every day and then cycle about 15. I always feel better while doing it, especially cycling which forces me to pay attention to something besides the negative thoughts that try to fill my head. Also do weights 3 days a week and yoga 1. Haven't thought about the sauna--may give that a try.

100% , you are doing the right thing for sure . Yes those negative thoughts are normal, so deal with them the best you can and divert your attention. Also , when you start going to the sun , bring in plenty of water and small micro sessions first ....then longer . I
The Sauna has many Bio-benefits. Read up on what "protein shock " therapies do , ridding your body of extra urea, salts and heavy metals , etc . I usually crave pickles after a Sauna ( common) to get my eltrolytes . BUT my point here is work your sweat glands in the sauna , but start slowly and work up to 15 minutes at 3 exposures per vision ! 🙂 . Also read up on the benefits of Sauna . Got use to it when I was working out of Budapest - very common . Looks of "Eye Candy " in those saunas in Budapest as well. Lovely gals ! 🙂

I did a small bit of counseling and a cancer center and a surprising number of older men, past 65, had no sexual function at all. I personally haven’t had any since 2010. It’s what my life is and I have adapted to that. I’m not married and don’t have a steady girlfriend at the moment. Again, it’s something you have to adapt to because your body simply doesn’t respond that way anymore. It doesn’t stop closeness in a relationship, but you do have to find a woman who can look past sex as love .

after my robotic surgery erection was not possible I tried MUSE and then trimix and trimix does work My orgams now are much more intense for some reasons, and because trimix stays active for over an hour, repeat performances are now the norm. my orgams are dry and have no ejaculate
the trimix takes some advanced planning so spur of the moment events are not possible

That’s awesome! Good for you! I am meeting with a urologist that specializes in ED and going to investigate that. Wish me luck!

Fellow warriors, you might this study report on the subject interesting.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735091/

Thanks for that. At least I know now I'm not insane. I have my 3 month post-radiation PSA test in two weeks and am seriously considering stopping ADT after that so I can hopefully be "me" again by the end of the year.

Thanks for sharing that! Here's the money quote:

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The role for hormonal treatment initially was restricted to men with metastatic and inoperable, locally advanced disease. Now it has been extended to neoadjuvant or adjuvant therapy for surgery and radiotherapy, for biochemical relapse after surgery or radiation, and even as primary therapy for non-metastatic disease.
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So the article seems to be focusing on whether proactive ADT always makes sense for early-stage (non-metastatic) prostate cancer; it's not questioning it for advanced stages.

There's a similar debate over proactive chemotherapy for advanced cancer that's still responding to ADT (castrate-sensitive).

In both cases, the question is whether it's better to hit it hard right at the start, or to avoid interventions that affect quality of life until we're sure they're needed. I suspect the answer to both is "well, it depends…" 😕