I’m into my third month of ADT and have completely lost the ability to orgasm. I am LIVID. I was NEVER told of this side effect. In fact, I was told I’d likely have ED but orgasm would still be possible. Which is an outright lie.
Has anyone had the ability to orgasm return after discontinuing ADT or am I ruined for life? This is a whole new low for me in this experience and I’m really starting to understand why most agencies recommend against PSA testing — it sends us all into this nightmare.
Most men do not lose the ability to have an erection or an orgasm while on ADT, but without libido, it's just not worth the effort it would take. It all should come back after your testosterone returns to normal.
Not an expert here, but while I was on FloMax, I lost the ability to have an ejaculation- but still had a dry orgasm. Terms can be confusing. Can you still experience an orgasm without the ejaculation? If so, and you are taking FloMax, that might be the cause.
No, I'm completely anorgasmic. No orgasm at all. The NIH paper I read states this is a side effect for about 50% of men on ADT for three months or more. I've tried vibrators, pumps, etc. and nothing.
Funny I can still have an orgasm with a completely limp dick. You might need to try harder. And as others have said you are most likely to be back to normal when ADT is done.
I lost the feeling of an orgasm completely while on ADT (24 months). Thereafter it came back pretty fast (couple of months), even stronger than before though without ejaculation (side effect of radiation and/or Flomax?). Wish you the best,
Henk
I have just finished a 6 month course of ADT and have made a point of trying to keep everything active downstairs as much as possible whilst on the treatment. I found that after about 5 months a couple of times my orgasms were less intense and a couple of other times almost non-existent.
I am still only 3 weeks out from the end of my 6 month stint and am still in Lupron-City, with flushes and fatigue, but my orgasms are slowly returning to the levels of intensity they were before.
So as my surgeon used to say post-Op “keep doing it” it gets better.
Hope things improve for you.
Brian.
Obviously, we all have a different reaction to the effects of Lupron. For whatever it's worth: ADT, IMRT, and brachyboost. By far, Lupron was worst part of this whole experience. Fortunately, I was in a study that provided information, penis pump, ED meds, and other toys to keep parts working. A real chore at times since interest in all things sexual was nada/zip/zilch. But, glad I forced myself to use them. I think it made a difference. Oh, and there's genital shrinkage...another kick in the balls, as it were. 5 yrs later, can orgasm (no ejaculate, of course), and get a fairly stiff erection (nothing like pre treatment days...but then, I'm older now, too). As for the lack of info about this from doctors? They answered my questions but really offered nothing in the way of support regarding maintaining sexual functioning. I feel your frustration and outrage.
EdinBaltimore
Was your genital shrinkage reversible? I have noticed this after 9 months of Orgovyx. Sure hope I can get my original shape and size back.
I don't know yet. I am still in treatment and my ADT doesn't wear off until November. I hope so!
No, like the man boobs and wt, this side effect seems to be permanent. Average in size pre-treatment. Lost both length and girth but luckier than some who report dramatic change and refer to their testicles as the size of "grapes" or "raisins." I used a penis pump provided by a study I was in. Glad I did. Perhaps I would have lost more without it. No way of knowing, of course. My partner and I - to lessen my worry and anxiety about this - turned all of this into fun play; it helped.
Good luck to you,
EdinBaltimore
What absolutely kills me is the claim by urologists that there is no penile shrinkage from prostate cancer treatment. For those who had RP, they simply say "the length is the same but part of the penis is now inside the body." This may TECHNICALLY be true but, in the general sense of how most guys perceive it, it's total bullsh*t.
Yup. For whatever it's worth, my docs answered my questions but offered nada when it came to discussing side effects. It's only because of my reading, this site, the study I was in, and other online PCa organizations that I knew anything about what to expect. And, of course, that was only in the abstract...until I started experiencing what I had learned. No wonder I was depressed as hell...oh, and btw, the docs ignored THAT too. I hope that others had a much better experience with the urology and oncology world than I. "Androgen Deprivation Therapy: An Essential Guide for Prostate Cancer Patients and Their Loved Ones" provides a laymens' description of what ADT is all about, its impact (or low T's impact) upon our bodies and minds, and some suggestions for deal with the numerous side effects. I found it helpful...and, yes, it even addresses genital shrinkage.
EdinBaltimore
Yeah, I read that book and was like "holy shit, no one told me about any of this stuff." All I was told was that I might get hot flashes and be tired. I'm four months in now and have never gotten a hot flash and my energy is good. What I got instead was ED, anorgasmia and depression.
Your not alone. I had 39 treatments of EBRT + 6 mo. Lupron (ADT) for my 4+3 GL7. It took me 6 extra months to recover and a bit more to be able to orgasm again. You probably will achieve that again, but it will be more difficult and with a dry climax, it will be different. This is one of the things we have to suffer with, good luck on your journey.
Make sure you "rehab" your cock daily with a pump to keep tissues stretched and supple to avoid loss of length and girth. Remember, you're not having those 3-6 nocturnal erections which keep your cock "in shape". Every morning..... pump up, hold for a minute, release, and then repeat 2 more times. Urologists are useless when it comes to sexual function, and even less so with gay men.
It did return after I did brachytherapy then 5 days external radiation and 18 months of adt. Yes it’s great to have it back and the feelings it comes with. What I do find is it better and a lot more if I wait about 3 days between and to be honest I’m 57 three days is ok. Yes the libido goes away but will return but you have to force yourself to maintain penis health and avoid permanent shrinkage.
Btw I always had wet dreams till about 2-3 years ago and I’m sad that went away. What’s weird is I had them sometimes with woman and that’s not where my interests is.
Well, I worked on it and worked on it and worked on it and was FINALLY able to have an orgasm after two months. Sadly, it wasn't much but sure felt good to know it's still possible.
During ADT I could still orgasm with a flaccid penis but it took a lot of time and effort. Sometimes I would just give up because I could tell it wasn’t going to happen. After ADT orgasms have pretty much returned to normal, except dry of course. But they can happen fairly quickly. Using trimix for erections although sometimes I can get to about 80% without. Seriously thinking about implant. Four of my friends have had them and are very happy with the results.
It is unfortunate that surgeons do not prepare us for what happens after surgery. The one good thing about them, at least for me, is that my surgeon saved my life. Let's not forget that years ago, before psa levels were a common test, men died because they discovered the cancer after it advanced and spread to other areas. I have 11 years of a rollercoaster ride with this issue and the best advice I received was from support groups, like this one and two other online platforms and from one gay urologist. I take 5mg of Cialis every morning. I learned to satisfy myself with porn, pumps, fleshlight and my right hand. If you have a husband you can learn new ways. Unfortunately I am single. However I had wonderful sex partners in NY who shared the same experience. A few of them had the same surgeon. Many men I met who were married to women discovered it is easier to have sex with other men who have gone through the same procedure. I went on dates with men who had zero understanding of what I had gone through. It is always more satisfying to play side by side with someone who has had the same issues. I too used to be well endowed and have lost both length and width and I do miss it. Give it some time and you will find your own rhythm. Good luck and warm wishes to everyone from Fort Lauderdale.
You're going to find out a lot of things you were not told about. Like the loss in size of your penis and balls. I wasn't told it is chemical castration. I have lost 4 inches in length and have the balls of a 12 year old. I haven't looked at myself naked in the mirror since 2019.
Yeah, I suspected something was up when the parish priests started following me around 😃 😃 😃
Rich here - I've been on Lupron for 2 months now and have completely lost my libido, compared to having 1-2 daily orgasms. I just completed 25 radiation sessions. The loss of libido is the worst side effect of having PC and really wonder if it is worth it. Not sure what I can do at this point - Rich
Do you have a partner? I've found my libido is gone when looking at random guys or porn, but I can still get aroused when I'm with my partner if we have longer foreplay. With Viagra, I can still get a decent erection but orgasm is gone, or if not gone, feels almost gone. There will be very brief period when we're having sex where I suddenly feel really good but there's no intensity of feeling like a real orgasm.
No I do not have a partner. With my complete loss of libido, I haven't even tried to masturbate. Huge change for me from 2-3 times a day to nothing. Maybe I should try to see and to condition myself and keep size of penis and balls. My self-image is pretty low. thanks - Rich
I get the self-image thing. I had testicular cancer as a young adult (20) and one of “my boys” is prosthetic. It gave me serious self image problems as a young gay man and I went from being very sexually active from 16-20 to not having any sex at all until I turned 24 and then missed out on a lot because I took great pains to hide it. Then I discovered that cock rings helped hide the fact that I had a prosthesis and finally met my husband who is the first person I ever told IRL and is the only person who knows other than my parents. Now I’m going through the same self image issues even though my husband has been extremely supportive. I imagine I will eventually come to terms with this, too, but it really sucks and I feel like the universe has screwed me twice and not in the fun way.
Detached retina and orgasm 
Stopping Lupron ADT
PSMA and ADT
