What % of men after radiation treatment completely lose ejaculation?

@ozelli
I brought this up on a post about a year ago. It generated a lot of posts and information. I thought I was unusual as did not remember being a topic discussed by my R/Os.

Turns out I found from other posters a common side affect from radiation. I did discuss with my R/O on next visit and was told yes common side affect as the radiation damages the seminal vessels and prostate vessels.

It can be kind of a shock as I did not expect it. I am not sure by maybe a mentor could provide how to access the past discussions on dry orgasms as there were a lot of post on it but it was some time ago.

This 2013 paper titled “Ejaculation profiles of men following radiation therapy for prostate cancer” indicated it to be 72%: https://pubmed.ncbi.nlm.nih.gov/23433425/

This 2019 paper titled “Ejaculatory and Orgasmic Dysfunction Following Prostate Cancer Therapy: Clinical Management” indicated it to be 89%: https://pmc.ncbi.nlm.nih.gov/articles/PMC6950339/

To be sure, it’s likely a smaller % than for those who undergo prostatectomy.

(Having done many years of research before making a treatment decision, I knew that this was a high probability but low impact outcome of radiation treatment.)

What are the side effects of radiation treatment for prostate cancer

18 months past treatment and I ejaculate clear fluid only which I assume is pre-cum. That only happens when I'm VERY aroused. During normal arousal nothing comes out at all. It does detract from the enjoyability of orgasm. If I had to quantify it, I'd say orgasms are 80% of what they were before.

I know this sounds cynical, but one thing I've learned about information from doctors is that when they say "some men will experience ..." they mean "almost every man will experience ..." When they say something will feel "different" they generally mean it will feel "worse."

One thing I noticed is that before surgery, I was never multi-orgasmic, but afterwards, I was. I attribute this to the fact that I (& most men) associate orgasm with ejaculation. That is, before surgery I was never able to ejaculate multiple time in a session (duh, because you've just emptied the seminal vesicles!). Once I realized after surgery that I could achieve orgasm without ejaculation, I decided to try multiple orgasms, & it worked. It's just different.

Knowing that you don't have to associate orgasm with ejaculation, frees you to try more often. After all, women don't ejaculate, & have a lifetime of orgasms without it.

@oceanview
These are the possible side effects, Definitely do not affect everyone. I had no side effects at all after 8+ weeks of salvage radiation. Five years later, I started having incontinence Issues but I also had surgery before the radiation so that is a factor.

Adjunct and salvage radiation possible side effects
Radiation proctitis
Rectal issues
Rectal bleeding
Bladder infection
Breaks in bones radiation damage to bones
Fibroses in bladder which can reduce capacity

@oceanview My RO and I spent months reviewing literature and came up with this list of short-, medium-, and long-term side-effects of external radiation and then ways to avoid/minimize each.

As for possible radiation side-effects to nearby otherwise healthy tissues and organs, as long as the radiation doesn’t hit them, they won’t be damaged. So, spend a lot of time with the radiation team coming up with a game plan as to how to not overshoot the prostate.

@scottbeammeup

5 months after 44 radiation sessions and 4 months of Lupron, I have absolutely no libido or erections but have PSA < 0.1 and testosterone < 9. I tried using a vacuum pump which helped before treatments, but it hurt and I had bleeding around my penis circumcision scars. My privates have shrunk to about half their pre-Lupron size and do not expand with vacuum. I also still have major side effects which are 24/7 soaking sweats and headaches plus sore muscles and joints. I have hot sweats, but they are nothing compared to the continuous toe to top of my head sweats that prevent me from having any cover during sleep. Maybe my next PSA/testosterone test in January will show me why I have no libido.

@pesquallie
For the hot flashes and night sweats I got an Embrlabs.com Wave 2 device. I used to wake up with a sheet totally soaked under me. The wave device stopped that.. The wave 2 Has two buttons and you can set one for Hot flashes during the day and one for night.

They normally cost $300 with this code you can get one for $200 BFCM25. They have 60 day money back guarantee.

If you get one, post on here and I can give you instructions for how to configure it the best way. They have added options to the app so that you can schedule different cooling needs. You could schedule it to automatically cool you at night instead of using the buttons.

The tissue in the penis can deteriorate a lot if it’s not used for a long time. Five months is not a long time. A lot of doctors give their patient Cialis to take daily after having treatments, That can help restore the flow of blood. You might ask your doctor about this, it could help.

You can also use injections like Trimix Which can get a good erection.

A low testosterone will give you no libido. In the next few months, yours should start to rise. Four months of Lupron is almost nothing, your testosterone should start coming back pretty quickly.

@pesquallie I started Orgovyx last Christmas Eve and had 44 radiation treatments February-April. Still taking Orgovyx, I have virtually no libido, few erections (occasionally during the night, maybe weekly) and no climaxes. I take 5 mg Cialis daily to improve blood flow. I am sorry for the severity of your soaking sweats. I have a number of hot flashes daily, but none too severe and no full body sweats. My joints were sore prior to treatment, so I'm not sure how much that is affected. My vacuum device creates an erection that lasts a couple of minutes, but I like you have experienced significant shrinkage. Body hair is mostly gone, neck and below. I tell people that this treatment is like going through puberty in reverse while adding some symptoms of menopause. All the best for your journey; we're in this together in one way or another!