Am posting because I've seen various posts and questions about anal sex after radiotherapy (and prostatectomy), some of which were positive experiences, others not. I think it's an important issue to relay experiences about.
I had LDR brachytherapy four days into the new year, and wrote all about it here. Had no ADT, just the one-and-done LDR treatment.
I'm happy to report that anal sex has been as pleasurable as it's always been, with no difference at all. I waited a few months after my procedure, as I was advised, and then plunged right in (or, I guess, it was the other way around.)
Same intensity and sensation. I've had no erectile issues. Ejaculate has diminished but intense orgasm still happens, and sometimes I pre-cum during the activity.
I had no short-term urinary frequency or retention after LDR, which is usually something others have experienced for a few months or even a year. So I've been lucky in that regard. And I've had no bowel issues.
Can't say I wasn't anxious months ago about how things would turn out, as anal sex is important to me. But I have no complaints, and am glad to be doing something I like to do.
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Took quite a while for me to "get back in the saddle," so to speak. ADT killed desire. Nowhere near the frequency now vs pre-treatment. Some concern about bowel (apparently zapped a bit during IMRT) but, "with notice" and prep, can btm again. Woo-hoo.
Thank you so much for sharing your story. I am about to start the process for Cyberknife. I am having markers implanted tomorrow and I’m sure you are aware of the steps that follow.
I too was so worried about losing my erections and ejaculate but more than anything else, I love receiving anal sex. The thought of not enjoying it anymore was destroying me.
I am so happy to learn of your positive experience and I am sure this will be the case for me too and I will be back in the saddle in no time. I do have a few questions, hope you don’t mind. How long did you wait? How long did it take for erections to get back to normal? How long did it take before you lost your ejaculate and do you feel it’s made a big difference not having the big finish.
Glad you decided against surgery, and read Tall Allen's informative piece about that regarding gay men.
Happy to answer your questions . Just understand everyone's a bit different and people have individual experiences. Also, while LDR brachy and CyberKnife are both radiation treatments, there are differences.
I waited a little over three months before having receptive anal sex. With LDR--seed implants--they're putting radioactive seeds right in your prostate. So you need to give it time for all that to set and heal. With Cyberknife it's external radiation so you don't have to wait as long. But I still believe two to three months is what's advised. Check with your doctor on this. (My RO was more liberal, telling me I could begin sooner; my urologist was a bit more conservative and urged three to four months.)
I personally had no issue with erections from the start and actually found them better after treatment--quicker and stronger. This is because they put you on low-dose Cialis as a prophylactic therapy to keep all the vessels open down there and help prevent ED, beginning a few days before your treatment, and I just stayed on it indefinitely (though you could come off it after three months post treatment.) I've not noticed any change at all, at least at this point, almost two years out.
I actually lost ALL ejaculate days before treatment because of taking tamsulosin--which prevents frequent urination and other urinary side effects--which they put me on just before treatment began. Loss of ejaculate is a temporary side effect some people have re: Tamsulosin. With LDR, urinary urgency and irritation is a big short-term side effect, lasting a few months (it is a side effect with other treatments, but less so.)
I didn't have the urinary issues at all though after treatment, so a week or two after treatment I went off of it. And am happy to report ejaculate returned -- though it was very different and diminished in quantity. This is where I think a lot of people are different. Some people only have a drop or two over time, or nothing at all--others not. No matter what, the sensation is NO different--still very intense and if you weren't looking you wouldn't know.
In my case, now almost two years out, it didn't diminish further from those early days after treatment and is well more than a drop or two (though it can be if I have a quickie and cum quick). In fact, if I have a long sexual session, or have a few over a few days without ejaculating, there's much more, as it seems to build up. It's a different consistency--not white and creamy. Mostly clear/slightly cloudy and thinner. But it can squirt a bit and make a bit of mess. So I'm happy about that, ha. (But I don't think it would matter much to me, as the sensation is as intense as ever.) From what I've read here others have very different experiences-- it just depends. But most say the sensation is no different.
A couple of other things:
I had periodic hemorrhoid issues for years; I rarely let them get in the way, and just powered through with my sex (that's just me) and used over the counter creams etc. After treatment, for the first six months or more, hemorrhoid issues were a lot more intense when they'd arise. I used ointments--I found Dr. Butler's to be the best--and pushed through, and of course made sure to take fiber supplements, as I had been (Pure for Men). Didn't let it get too much in the way of my sex. (Sometimes people who didn't have hemorrhoid issues before will get them after treatment, but it might just be temporary.)
Glad to say they subsided greatly. And now, it's almost like they're gone. I haven't had them for many months, which is longer than prior to treatment. So, go figure!
Also, bowel urgency, short-term side effect, is sometimes reported post radiation--it's less an issue with LDR but some with SBRT or CyberKnife report it. (I had no real issue.) So this may or may not be an issue re: being ready and prepped, but it should only be temporary if it happens at all, just a few months.
Glad everything is better than hoped for. When I had my prostate removed March 2020 my wife of over 20 years and I didn't make sex a top priority at the time. But we adjusted to foreplay for her and anal play for me, at over 65 yo I couldn't be happier with the fun we are experiencing and not relying on orgasms as the ultimate goal, just smiles, moaning and pleasing each other with no expectations... AWESOME is how it's been for the last two years, getting better every day. Good luck, JHT!
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