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Inability to have an orgasm (Anorgasmia) comments

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Posted 1/3/2015 5:23 AM (GMT 0)
I personally suspect that all of the above about either no orgasm or orgasms that are a mere hint of what used to be before surgery is because the prostate itself has it's role to play, and contribution to add, to sexual pleasure and sensations. Then again, there are a few who report orgasms that are better than before surgery, so maybe not.

Post Edited (BillyBob@388) : 1/4/2015 9:18:39 PM (GMT-7)

Posted 1/3/2015 3:31 PM (GMT 0)
This is a timely thread. After open RP, my orgasm response was horrible. Up to about 1 year post RP, they were very painful with spasms and were unpleasant. At that point, they started to improve and the spams gradually went away. I am now almost at 3 years post RP, and orgasms are "passably good" but nowhere near what they were prior to RP. Of course, my uro told me everything would be fine with orgasms-I was not told of these kind of possible problems.
Still no natural erections, but trimix or max strength Cialis work ok.
Posted 1/5/2015 2:22 AM (GMT 0)
JimO.

I'm not on any of these drugs, but I've noticed that PDE5i (Viagra etc) may delay orgasm. Trimix makes my dick cold to the touch and I last much much longer, to the point that I wish for an orgasm.

Having a dry orgasm is indeed novel, its enjoyable and it lasts much longer. Orgasms are intermittent nowadays.

Orgasms are like my testicles: some days they hang loose; other days they clump together in a thick leather pouch.

Just enjoy them.
Posted 1/5/2015 4:17 AM (GMT 0)
Trimix= cold to the touch? First I've heard of that except with a pump and rings. It makes mine quite warm and pink. Not all that hard, the very reason I inject, but warm!
Posted 1/5/2015 3:48 PM (GMT 0)

RamonV said...
Of course, my uro told me everything would be fine with orgasms-I was not told of these kind of possible problems.

Still no natural erections, but trimix or max strength Cialis work ok.

Ramon:

That seems to be the usual problem with a lot of doctors. Perhaps they are told in med school that to detail all the side effects will scare you off treatment. However, IMHO I have seen many guys with low level disease rushed into surgery that might have opted for active surveillance had their uro mentioned it.

Seems to me, it is extremely poor practice for a doctor not to advise patients of ALL options that apply, but it seems to be a common complaint!

Consider yourself lucky that Trimix and Cialis work for you. Many guys are in much worse shape in that regard.

Jim
Posted 1/5/2015 4:47 PM (GMT 0)
I have to wonder what the difference is between men who report high (if not higher) quality orgasms post-RP, and those who report low or lower quality orgasms.

My wife and I are off to see a doctor later today. She has had a rough few months, with 2 surgeries for melanoma, 4 weeks or radiation scheduled to start Wednesday (to reduce the likelihood of a localized recurrence), and a possible hysterectomy in the very near term. If that happens, radiation and the surgery need to be coordinated. But, even in her case, no one has been honest with her about the sexual changes she may see if she needs the surgery. For some women, contractions of the uterus are a big part of orgasm, and if that is removed, the orgasm will suffer. I can find this online, but no doctor has been willing to even discuss it. In some ways, I think women have it even worse than men. Our docs want to rip out our prostates and not tell us all of the side effects. For a woman past child-bearing years, the docs want to rip out the entire plumbing system if just one part has a problem. And, they basically assume that a sex life for a menopausal woman isn't that big a deal.

The past 18 months have taught me over and over that the only way to get the care you want is to fight for it every single step of the way. Otherwise, the system will just run you over in a rush to collect money for expensive procedures.
Posted 1/5/2015 5:32 PM (GMT 0)

dmlvt said...
I have to wonder what the difference is between men who report high (if not higher) quality orgasms post-RP, and those who report low or lower quality orgasms.

dmlvt, I would propose that this, using my own personal experiences, may be at least a part of the differences you have wondered about.  I am now 5+ years post RP, so my perspective on this may be considered a bit more long-term than others, or even different from my own perspective at much less post-RP time.

As I previously mentioned in this tread, pre-RP I was more prone to premature ejaculation.  After RP when I first started experiencing difficulty achieving orgasm, a part of my thoughts were along the lines of "Hey, this is a plus!  I'm like the Everready Bunny!  I can go, and go, and go!"  Perhaps I, too, initially mistook this as "higher quality."

As time went by, it became apparent that this was not a plus. 

 

Posted 1/5/2015 5:34 PM (GMT 0)

PSA3DOT7 said...
JimO.

I'm not on any of these drugs, but I've noticed that PDE5i (Viagra etc) may delay orgasm. Trimix makes my dick cold to the touch and I last much much longer, to the point that I wish for an orgasm.

Hi PSA -- I've never heard of Trimix making you cold either. It's mode of operation is to increase blood circulation into the penis and restrict outflow -- the same way the the PGE1 produced by a normal man's body on arousal, so I would think it would make you nice and warm.

I've seen a few anecdotal reports of PDE5 inhibitors delaying or inhibiting orgasm. Seems to be relatively rare but I may be wrong.

Jim
Posted 1/5/2015 6:53 PM (GMT 0)
JimO,

It seem reasonable that for men whose erections are very prolonged with Trimix they could experience a cool whangdoodler with injections. Trimix acts by reducing the tone of the smooth muscles surrounding the blood chambers in the erectile tissues. This allows more blood to enter, initially, leading to the erection, but once the erection is established the blood flow is limited by the amount that is allowed to leave. For men with much-above-average veinocclusion very little blood is allowed to leave and, Mr Happy, waving in the cool breeze, will tend to cool off with Trimix just like wearing a ring after using a VED and for the same reason.
Posted 1/6/2015 3:06 AM (GMT 0)
I'm a bit scared of Trimix, I use it very very sparingly. It takes a long time before I orgasm, even if I use .08cc.

It works and that’s what counts...and the misses is "happy"!
.
Posted 1/7/2015 9:42 PM (GMT 0)
This is a really fascinating topic for me, as I have wondered about this stuff a lot, but never seen any discussions of it anywhere.

My case is this: Dx was approx 5/1/14. Have not taken any drugs or treatment to date. I can orgasm, but it is weird. It feels good building up to it, almost normal. Feels like I am going to shoot a giant amount, like before I ever had any problems, but then when it comes, it is usually just a little dribble of clear fluid, much the same as pre-ejaculate, only a little more, maybe a 1/4 or 1/2 tsp. No pop at all there. Just doesn't feel anything like it used to. It's very disappointing and frustrating. There is still a little satisfaction, but nothing like before. And there is still a little bit of that relaxed after-glow, but only maybe 10% of what it used to be, 'cause it used to be awesome.

As to being able to orgasm, I can when I *********. With a condom, it is very difficult. But I am not married, and the experience varies quite a bit. If the woman is small with a tight vagina, it is impossible to orgasm using a condom, there is really no point in trying, as it is just too frustrating. If she has broad hips, and a bit of a behind on her, then sometimes it is not a problem, but I have to take the first opportunity to come, as if I delay it, then it is likely not going to happen.

Post Edited (Jaybee_007) : 1/7/2015 2:52:31 PM (GMT-7)

Posted 1/7/2015 9:59 PM (GMT 0)
Hey guys

When I started this thread, I didn't expect to get many responses. But, it seems like this is a massive problem that virtually nobody (except you guys) are willing to talk about.

Anyway, I'm sure happy to be getting lots of input on this. I feel like summarizing it in a book titled "What Your Doc Won't Tell You about PC Treatment Side Effects" for those guys that might manage their disease with active surveillance!
:-)

Jim

Post Edited (*JimO*) : 1/7/2015 3:02:47 PM (GMT-7)

Posted 1/9/2015 3:29 AM (GMT 0)
Good idea, JimO.
Posted 1/12/2015 4:07 PM (GMT 0)
Hey JayBee

Actually, there probably is not enough info for a book, and the reader base is relatively limited. However, I do intend to write an article on this subject that I will publish in my newsletter or on another prostate specific site.

If you (or anyone else) would like to be on the distribution list, shoot me a private email.

JimO
Posted 1/12/2015 4:25 PM (GMT 0)
Jim O,

It was interesting for me to learn that SSRIs are noted in two different topics of men's sexual health.

First, as has already been discussed here, SSRIs have been linked to anorgasmia.

Second, not yet discussed here, I have learned that SSRIs are a common medication prescribed to treat premature ejaculation.  (reference Dr Mulhall's book Men's Sexual Health and Fertility: A Clinician's Guide)

What do you think of this?  There seems to be a sexual health balance of benefits/harms brought about by SSRIs.

Posted 1/12/2015 5:36 PM (GMT 0)

NKinney said...
Jim O,

It was interesting for me to learn that SSRIs are noted in two different topics of men's sexual health. -- anorgasmia and premature ejaculation.

The chemistry of this is pretty complicated and not always clear. However, IMHO, the hormone prolactin plays a big role in this. After an orgasm, prolactin levels soar, which appears to be the main reason for inability to be aroused or get another erection shortly afterward. Several studies note that SSRI's (and some other drugs) have the effect of increasing prolactin.

The high prolactin level is, IMHO one cause of anorgasmia. On the other hand, a person suffering from premature ejaculation may have a low prolactin level and increasing it with the use of an SSRI might help. So, while the SSRI's cause a problem with one condition, they may solve it on another.

Anecdotal -- I have had a problem with anorgasmia on and off for a long time. After some recent research, I started measuring my prolactin level regularly and found it elevated. After about two months of intense herbal and amino acid supplementation, I halved my prolactin level and the issue is much improved. This is an ongoing research issue for me. So far, it looks promising, but I've been here before and been disappointed.

Edited to add this abstract --
http://www.ncbi.nlm.nih.gov/pubmed/20345874

Jim

Post Edited (*JimO*) : 1/12/2015 10:44:35 AM (GMT-7)

Posted 1/12/2015 6:12 PM (GMT 0)
Jim O, a questions and a comment.

First, how did you measure your prolactin level?

Second, I read the abstract you linked to.  Please note FYI what I've read elsewhere (interesting read; check it out)that "...anejactualtion [discussed in your link] and anorgasmia are often mistakenly used interchangeably.  Anejaculation specifically refers to the lack of ejaculation that may or may not be coupled with an orgasm. Anorgasmia is simply the lack of orgasm that is not necessarily a coupled response with ejaculation."

Orgasm and ejaculation basically come from different parts of the anatomy.  Both are "down there," but different parts of "down there."

Posted 1/12/2015 7:40 PM (GMT 0)
Hi NKinney:

Prolactin is measured in blood. Your doc can order the test for you. I can't post it here, but if you send me a private email, I'll tell you how to get the test yourself.

I took a quick look at the post you referred to, and don't have the time right now to read it thoroughly but I will later today or tonight.

I don't know what criteria is used to discriminate between orgasm and ejaculation. My belief is that orgasm is the period of intense sensation that (in most cases) precedes the heavy contractions of ejaculation and expulsion of seman. In most cases the two events occur in sequence, but I have heard of some folks having an ejaculation without an orgasm and visa versa.

This is an interesting topic without a hell of a lot of research on it. If you have seen a detailed description or study on this, I would love to read more about it.

Jim
Posted 1/12/2015 8:16 PM (GMT 0)
Jim O, this is an interesting topic.   Dr Mulhall describes (in the book I previously mentioned) the orgasm and ejaculation as “ integrated but incompletely interdependent processes .”     The orgasm may occur in the absence of ejaculation (as in the cases after surgical removal of the prostate and seminal vesicles), but not visa versa (per Mulhall’s book).   There is an interesting, detailed descript ion of each step in the process in his book.   Ejaculation, for example, consists of two distinct phases:   emission and expulsion (with a paragraph descript ion on each, including the prostate and SV role in emission), and orgasm is “ a distinct supraspinal, higher-order cognative event ” that occurs after a threshold level of arousal is attained.  The book goes on to explain how a neural circuit called the central pattern generator (CPG) precisely coordinates the two processes from different parts of the body together into essentially one event.     BTW, I saw online sites which offer prolactin testing.   What I also learned from that site is that marijuana use can cause moderate increases in prolactin…so that explains why dope smoking and sex don’t go together very well.
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