Inability to have an orgasm (Anorgasmia) comments

Hi guys:

I'm doing some research on this subject, and am interested in any personal or other info you may have to contribute.

Most of the studies I've looked at are either dealing with women or they consider this to be a psych problem only. However, I've been contacted by many guys that experience this on a regular basis, and while a few of them may have some psychological issues, I don't think this is the norm.

One known cause of Anorgasmia is a high level of the prolactin hormone, which can be helped herbally or with the drug Cabergoline. But the drug has some very nasty side effects.

Another cause is a documented side effect of the drugs pregabalin and gabapentin, -- both used to calm nerves and pain for conditions like Fibromyalgia and chronic fatigue syndrome.

No holds barred. I'm interested in anything you may have to contribute, and I will share anything I find out publicly or via private email if you like.

This is a serious problem for many guys. Puts them in the position of not being able to finish the sex act, and leads to a very high degree of frustration and/or depression.

Jim

I was going to mention fluoxetine, too. That stuff (Prozac) sure did it for me. I think most (possibly all) of the SSRI antidepressants have anorgasmia as a frequent side effect.

Well, in my experience the SSRI effect is complete and quite continuous. The problem began quite soon after starting it. Not intermittent for me whatsoever.

My experience with Prozac was pretty much like RedWing described. It totally shut me down for the duration. But to be fair to the drug, my entire experience with Prozac was spent on ADT with a T level in the single digits. Still, even with the ADT I was capable of orgasm before and after the Prozac but not during.

Here's a posting I made about the problem shortly after I started the Prozac. Prozac Giveth and Prozac Taketh Away.

Is this a problem for women also? Especially the drug induced problems?

BillyBob@388 said...
Is this a problem for women also? Especially the drug induced problems?

SSRI's produce exactly the same problem for women as men - SSRI's can be brilliant at relieving depression but are amazingly effective at removing the ability to achieve orgasm in either sex!

JimO - that is interesting, I don't have any knowledge of Trazodone but see that it belongs to a different group of anti-depressants to the SSRI's.

It appears to have an occasional issue of causing priapism in men as well which I don't think any SSRI has ever been accused of!!!!

Prevail

Yeah! Also reported was unanticipated erections in men. But, before anyone gets too excited about this, sexual effects of Trazodone seem to wear off within a couple weeks of starting use. Strange, it's a similar class to th SSRIs, but has wildly different side effects.

My personal observation -- my wife became a sexual dynamo when she was put on Trazodone -- burned me out! Two weeks or so later, it wore off and she was back to normal.

Jim

Jim-
I sent you an email.
-Gedman

Jim, Regarding your first question, I have never had any SSRIs (anti-depressants).   Second question, I have mild hypertension for which I take a low-level channel blocker (diltiazem) and receptor blocker (irbesartan).   I also take a baby (81 mg) aspirin, and fish oil. Thirdly, there surely appear to be multiple causes of anorgasmia, but the problem CERTAINLY IS A SIDE EFFECT OF PROSTATE CANCER SURGERY—radical prostatectomy—for some men.   I would refer you or anyone else interested in these articles: ·          In The “New” Prostate Cancer Infolink, from May 25, 2012, the article titled:   “ The management of anorganmia after radical prostatectomy:   a role for cabergoline ?”   If you look, you will also find HW-PC postings from men who have used cabergoline after RP to combat anorgasmia. ·          This Wikipedia article helps frame the big-picture of anorgansmia, and positions RP as a cause of “secondary anorgasmia:”   http://en.wikipedia.org/wiki/Anorgasmia ·          This PubMed abstract reports that nearly 40% of men experience anorgasmia following RP:   Erectile dysfunction and sexual health after radical prostatectomy ·          On the other hand, this PubMed abstract reported that the prevalence was only around 5% following RP:   Prevalence and predicting factors for commonly neglected sexual side effects to radical prostatectomies   While these articles all talk about the “what,” they are short on discussion about the “why.”   In Dr John Mulhall’s book however, Saving Your Sex Life:   A Guide for Men with Prostate Cancer , he very specifically calls out a list of antidepressants which may cause anorgasmia:   Zoloft, Prozac, Paxil, Celexa, Luvox, Zyprexa, Lexapro and Effexor, in specific.   But for those of us NOT on antidpepressants, he highlights that while the nerves for erections, which lie alongside the prostate, are traumatized during RP, the sensation nerves are nowhere near the prostate.   So, he surmises that men with the inability to obtain orgasm after RP have psychogenic anorgasmia…ie., anxiety related caused by treatment. Anorgasmia is just one of the very long list of side effects which is INADEQUATELY DISCUSSED with men who get rushed into PC treatment, and even for many men who feel they have done their "due diligance."  (Ask Pratoman, for example, if he's familar with the fact that somewhere between 5-40% of men have anorgasmia following RP, and I'd bet he says "Huh?")  This is part of today's sad, very sad, PC overtreatment environment.  Very sad.

This is a very much under-discussed aspect of PCa and treatments.

I felt lucky to retain good erection capability through radiation, HT, and to this day. However, the ADT has whacked my libido so I'm just not interested anymore (very weird). And, SSRI or something has stopped any ability to orgasm. So, penetrative sex might as well be done with a finger for all the pleasure it provides.

Intimacy is still important, but just doesn't happen very often. It feels nice, but so does a decent massage. There's not much more to it than that anymore.

It would be great to experience those explosive moments again, but it's not likely until some time after getting off of HT, if ever again.

As a guy, it's a huge loss. Beyond words. And it's just not something that we ever talk about, that no one would want to hear, and no one can really help with. Breast cancer victims have visible losses through mastectomy, and get lots of sympathy and support. Guys who can't complete the sex act anymore? Who cares, probably for the better since guys are just oversexed maniacs anyway as depicted in the culture.

dmlvt said...
The third article above could describe me very well, particularly the 38% with a "less satisfying orgasm". Having gone back on TRT six months ago, my libido is through the roof. My wife is a willing accomplice as well. But, it seems that things build up to that point of no return, and then it's just over. There's no real orgasm there at all. It's like I get right to the edge, and then my body says it's done, but the best part just doesn't happen.

Because of this, I am at a point where I feel I could have some sort of sexual activity 10 times per day and I'd never really get any relief. Ten minutes after any activity, my brain says it still wants to go again, and I think it's because I never really had an orgasm.

I never imagined I could be in a place like this. At this point in time, I just want to go back to the start and refuse all treatment. I almost feel like I'd rather take my chances with the cancer rather than dealing with these side effects I've been dealt. I know that's a very unfair thing to say, when so many others here are looking at a very different prognosis. I've told my wife recently that if I had a million dollars, or even a billion dollars, I'd pay it all for one decent orgasm with her again. That's where I am right now - so desperate that I'd give up just about anything for a brief glimpse into how things were a year ago.

DMLVT, I can pretty much relate exactly to what you said. I also have plenty of libido, which functions as a sort of torment. But, on those rare occasions when I am willing to go to the trouble to get a mediocre erection (maybe 5/10 with injections if I remain standing. Much better- plenty hard- with a pump/rings but an unpleasant overall experience), though I can have an orgasm, it just doesn't yet feel worth a dang. Not yet at 11 months anyway. And it doesn't feel good building up to it, especially with rings. It seems to bear no relationship to what it was before, and at least sometimes- with the aid of Cialis, it was occasionally once again feeling at least as good as I could ever remember it having felt as a young man. Not always, but always pretty good and occasionally spectacular. So it all seems all of the bizarre crap that must be gone through to get that erection really has a very low payoff. Now you may be thinking how much you would give for one of those orgasms I'm having, but trust me: it ain't much, and it is not satisfying. Nothing that I ever think about and think how much I would like that again right now. Now, some of the orgasms I had a year ago: heck yeah, bring it on!

But if I was in a survey, I would give them one more who could be added to the "orgasm fairly soon after surgery" group. But on the 0-10 feel good scale compared to past good orgasms I'd put it at between 1 and 2 or so. Still, I guess that must be better than nothing so maybe you would trade places with me in that area. And you are also about 15 years younger than me, so that probably makes it seem even worse. But dealing with the SEs of surgery can really make me debate about some of the things you mentioned re: if you could revisit those earlier decisions.

I didn't know it had a name...But I have trouble with orgasm but not with erection. (well it is takes more stimulation to get an erection and the blue pill helps that but not the orgasm since I had robotic surgery in July of 2011.) I rarely speak of it because most people would kill to get an erection so I feel bad complaining. When I can get to what I think is close to an orgasm it feels like a "ghost" of what it used to feel like or an oops back in the good ole days lol...

I hoped time would help but it didn't. The ability for me to "hold" the feeling so it can build up is just not there. It makes be almost dread trying now but it is still better than no erection at all. We do manage once per week usually but its more for her than me now but that is ok...

My meds are basically the same now as before I had the surgery so while it is related to that I don't know what it is...and you know its better than the alternative...(most of the time) To me it is like the poor thing isn't as sensitive as it was before....even though it will get within 80% as rigid as before (my guess)



edit for I have taken a few clonazepam for anxiety but that didn't start until a couple years after and I rarely take them...less than 10 a year...(but they work good for the anxiety))

Post Edited (hawkgfr) : 1/2/2015 9:51:44 PM (GMT-7)