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
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.
Hello to all from someone with RP, ADT, and IMRT
Detached retina and orgasm 
