Prostate Cancer: sex drive after surgery or other treatments

Posted by john57 @john57, Feb 23, 2020

hello everyone i was wondering if i could ask a group question, i had my prostate removed back in october since then i have had a lupron shot, started pt and began radiation. my question is has anyone had a decrease in sex drive? i find myself thinking about less and less. thanks in advance

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Yes, it really has a huge effect on me. I was diagnosed almost a year ago and have been on Lupron for almost the entire time. Also sore muscles as I continue to work out.

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I had my last injection of Lupron on Jan. 30th of this year. I was on it for 2 full years. Libido is totally gone. Had trouble concentrating. Took low dose Paxil that really helped with hot flashes. Watch out for breast growth and sore nipples. Total erectile disfunction. I hope things come back when my testosterone hopefully returns. My next visit to Moffitt Cancer Center is in 2 days. I kept exercising the entire time. It helps. It is hard. Keep yourself active physically and mentally. Remember- It's better than the alternative.

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Glad you're about to abandon lupron. Easily the most powerful drug I have ever experienced -- both on the body and the mind. My experience is similar to yours. You're right; it's better than the alternative. However, I have to question the duration of the treatment in some patients. I suspect -- and two oncologists have concurred -- that some MDs err on the side of a long duration to ensure the cancer is fully eliminated. Unfortunately this is an inexact science for which we pay the consequence. Effectively it is chemical castration. One thing you may wish to explore with your MD is the possibility of a testosterone injection once off lupron to help return your sexual and physical health to normal more quickly. Again, this is a treatment that puts MDs on different sides of the table. Are you helping the patient as described or hurting them by using gasoline (testosterone) to again start the cancer fire? Ultimately you need to make this decision based on the lifestyle you wish to live. Good luck. No easy decisions with cancer as always.

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I'm stage 3 so the cancer is beyond the prostate so options are a little different. PSA very low which is good (.2) Next step looks like Chemo.

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A member sent me this article:
- Mourning the Loss of Sexual Function https://connection.asco.org/blogs/mourning-loss-sexual-function

Anne Katz, PhD, RN, FAAN, is a certified sexuality counselor who works with men with prostate cancer. She is frank and opens conversations about a topic often put off to the side. In this article she asks:
- “Have you mourned what you have lost?”
- “How about you write a letter to your penis?”

What do you think?

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Greetings,

I had successful nerve sparing surgery 7/28/20. Initially, post op incontinence was an issue, especially at night. But I'm happy to report, it's no longer an issue. Do those Kegels!

No change in libido but, ED is an issue but seems to be getting better with time. Using Viagra or Cialis and with help from my girlfriend, I'm able to get what I describe is an 80%er which means I'm getting mostly erect but not sufficient for intercourse. Now using TriMix injectable which has been somewhat frustrating learning the correct dose (50 units, yikes!) and getting the injection properly located. Ended up using a bigger needle. Get it right and it's party time!! :). I also spoke with with a gentleman that had a penile implant to deal with the ED. He is very pleased with the results. I was considering the implant but seems a bit radical and my ED is improving so I've tabled the idea. One of the ironies is that my insurance will cover a penile implant but doesn't cover the TriMix injectable!

Note on shrinkage - loss of length. At first it seemed fairly significant but I'm happy to report that I've regained most of the length lost by using a penis pump. Not a big deal plus using the pump is fun for us.

Last PSA test was undetectable!!

Thank you Mayo and Team Dr. Ferrigni! Thank you mayo for scheduling the regular check ups and physicals! Otherwise I would of not known about the cancer until.....

Cheers and be well!

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@colleenyoung

Hi @voodoo5500 and welcome to Mayo Clinic Connect. You'll notice that I moved your message to this recent discussion. I did this so you can meet other members like @klaken @ken82 @dmadi61 and @john57 talking about sexual function post treatment for prostate cancer.

You ask a good question. What can you do to reduce the risk of erectile dysfunction as you heal after surgery?

While we wait for others to weigh in, you might find this article from the Prostate Cancer Foundation useful:
- Help for ED after Prostate Surgery: The Basics https://www.pcf.org/c/help-for-ed-after-prostate-surgery-the-basics/

Jump to this post

Would like to join this group. I had radical prostectomy, 44 photon intensive radiation treatments, and two full years of Lupron injections.
I lost libido and muscle. I have confusion, depression, and hot flashes. Now, my left shoulder has quit working. Sex is only a memory. I am 74, go senior classes, and trying to write a book about my experience to keep me mentally sharp.

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@ken1946 2 years ago I had the 20 high dose radiation .. plus just 1 Lupron shot (2 months prior to the radiation) I am 83 and still subject to some of the side effects.. the sex part is particularly a problem but I live alone.. and think that I had a very good full life ... I am working on the Kegel exercises to help with those side effects.. Ken... good name..

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I am a girlfriend of a man 4 years out of a prostatectomy. We have been together for one year.
Would it be appropriate to discuss how couples can handle problems here. My man is 61, obese, very very Type A personality, very successful.
It is difficult to discuss this topic with him, he shys away from direct questions.
My problem is his constant request for oral sex which rarely results in success, but when it does the fluid is massive and repulsive. Cialis gives him allergic reactions, he does not speak of Viagra, and has the shots but has not used them.
What is this fluid?
I'd like to speak with other partners who are trying to support their mates.

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@alicataz

I am a girlfriend of a man 4 years out of a prostatectomy. We have been together for one year.
Would it be appropriate to discuss how couples can handle problems here. My man is 61, obese, very very Type A personality, very successful.
It is difficult to discuss this topic with him, he shys away from direct questions.
My problem is his constant request for oral sex which rarely results in success, but when it does the fluid is massive and repulsive. Cialis gives him allergic reactions, he does not speak of Viagra, and has the shots but has not used them.
What is this fluid?
I'd like to speak with other partners who are trying to support their mates.

Jump to this post

Good evening @alicataz. First, let me tell you how fortunate your gentleman is to have you as his partner. My life partner had a radical prostatectomy, followed by 30 days of radiation when the cancer reappeared in the prostate bed 2 years later, He is older than your gentleman at 75 and had no total performance issues until after the radiation. He chose not to use viagra except right after the surgery as part of the recovery process.

When we discussed this issue with his oncology team, he listened but did not make any commitment to take advantage of the option to try medication. This was a difficult and unfortunate end to what had been a pleasant and meaningful sexual relationship.

It is now three years later and we have just completed a year of staying home by ourselves because of COVID. We found a way of cuddling, snuggling and sharing manual manipulation. Recently, I have had a bout of kidney stones and found that my vagina and clitoris were suffering from dryness and irritation. We spoke with my clinician and she has prescribed a topical treatment that hopefully will give me some comfort.,

So, my dear, we all suffer from these aging issues. I don’t know how this will turn out, I do know that our relationship is stronger than it ever has been. What would you ask for if you could have anything you wanted? Do you talk about this issue together? Have you asked a clinician about the content of the fluid?

Have you considered working with a therapist as a couple?

May you find enjoyment in sharing your life together?
Chris

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