Post treatment sexuality-a contrary view

Guys (and ladies who are here as well), I'd like to pose a slightly different view on the subject of sexual function after RP:

First and foremost, I do absolutely (I am one of the guys, after all) get in my gut the reality for us men about the connection between sexual ability and our view of ourselves as whole men. And how devastating it can be to lose that ability. I'm one of the fortunate ones with no significant issues. But, pre-surgery, I was preparing myself for the possibility that the roll of the dice was going to go against me--and my wife and I had many conversations about that possibility.

That being said, I want to start an honest discussion about reality: How many of us, now that we are in our 60's or more, have spouses who are post-menopause, and who really aren't all that interested? Who have a completely different level of both interest and responsiveness than they had before? I'd suggest that we (guys) need to lighten up a bit on this subject. WE may think we're still the young studs we (thought?) we were back in the day--or maybe should still be that guy--but we aren't. I, at least, stopped being that guy a long time before PCa showed up. It's darned sure our wives aren't the women they were even a few years ago, before their bodies and brains went through the change.

Sometimes I feel like saying to myself--ok, I've got this woody, what the heck am I going to do with it? (which I suspect would have been the truth even without PCa and RP)

Complex subject and good you brought it up. Regardless of our own self-views, I think to wonder about most post-menopausal women as having lost interest is not only inaccurate but demeaning. Sure, we all read in comedic fiction about women who are continually trying to shoo the old goat away. But that's made up stuff by writers trying to poke fun (ouch!) at the grand subject of human sexuality.

Anecdotally I know of two men in their 70s whose female partners of a similar age can't get enough sex. Without betraying intimacies, my own wife and I enjoy a mutually-fulfilling sexual relationship which is of course not the fire station it used to be, but is definitely still burning.

I'll be interested to read of others' comments!

The timing of PCa occurrence, hormonal and other treatments, and our partners passing through menopause can lead to complete disruption of sex in our marriage. It's a devastating aspect of this disease that is little discussed, really.

One can arrive, post treatment, at a situation with a limited sexual ability and interest, with a completely disinterested partner. All generalizations are risky, but this definitely does happen. At this point in life, physical sex may be just history, and what ability we men may have regained may just be a frustration with no helpful outlet. For some, it may be preferable to not have any sexual interest or ability.

This is a difficult one to discuss in a public forum like this. Appreciating the reality of this, the depth, may not be possible unless one has been on extended ADT. It is an experience that really must be lived to have any understanding of it. Words simply cannot convey the reality.

In a positive vein, even without the physical sexual relationship we can still deeply love our life partner, nourish our relationship, and enjoy whatever physical closeness that's comfortable for both without any pressure.

After 3 years on ADT, I know what zero libido felt like. Post menopause, without their estrogen to drive it, our wives may find themselves in the same place, with zero libido. Hormone replacement therapy to replace their estrogen has risks that may not be worth taking just to accommodate their husband's renewed physical demands.

Is there perhaps a way to gain testosterone's help with fatigue, hot flashes, and lost bone density but not fuel a futile sex drive? Before experiencing this disease and its treatment's aftermath, such a thought would have seemed seriously unhinged to me. Not any more...

well ok. I see a big difference between having sex and being able to spontaneously get an erection. I take Cialis every day because it just feels more natural and that's important to me.

After surgery I experienced complete ED. I tried the usual ED drugs and none of them had any impact, except that one gave me a horribly stuffy nose. I can still self-pleasure with the help of a lubricant, despite no erection. I think my wife is largely relieved that I can't do it anymore. She has not initiated sex for a long time and usually had to be talked into it, and declined my advances 90% of the time. I don't think I feel "less of a man." It's just a regrettable outcome, like the dribbling that happens sometimes int he evening. Far more important, however, is that I'm now 18 months post-SRT with a still undetectable PSA.

My wife has been an obliging but, let’s say, much less interested, partner, over the last 10 years or so, due to health issues of her own. We are both 68.

Since I’ve been on Lupron, I’ve lost my interest (and it seems, ability, although not sure that’s the Lupron).
I remarked to a friend just last night, that on some level, not having interest is a relief. I’m sure many here can understand that.

What’s interesting, I really do NOT feel any less of a man because of it. Thinking on a logical level, I don’t understand why it would make sense to feel otherwise. I still can provide for and care for my family. What’s more manly than that? I have a great marriage, despite the sexual issues. We are best friends. And I’m the husband not the wife (or at least she lets me think so 😂) So why feel less like a man just because of a physical issue.

There’s lots more to being a man than traditional thought allows. Being caring, loving a woman, protective of loved ones. Ignoring an ****** making snide remarks, or trying to start a fight. Being confident, driven. Lots more.

Over 40 years, I seem to recall my wife on more than one occasion asking "Can't we just cuddle without it always leading to sex?" So we do more cuddling now and she seems to like it. Happy wife, happy life. Not a big deal for us so far.

My wife lost interest when she hit menopause hard. Now, she has almost no drive and her female parts don't function like they used to. (Lack of testosterone is also responsible for females loss of libido) She will 'accommodate' me if I persist, it is fun though much different than it used to be.

That said, I have a dead testicle (thanks, Lupron!) so my testosterone hovers around 200 (no libido here). We have a 27 year old son who is about to be married so the underlying biological drive has been satisfied. The balance of our relationship is top - notch and 29 years deep. We are looking forward to our son's wedding, mountain climbing, camping on the North shore of Lake Superior etc.

I am still working as is she, I have the loveliest lady Labrador in the world and a long list of things to accomplish. I have a monster waiting for me up ahead somewhere and I know it, so I try to keep things in perspective. I value, appreciate and cherish what I have, try not to dwell on what I don't.

This has been an amazing and revealing thread! It seems many of us are in about the same situation. A fascinating aspect of this might be how it could affect treatment decisions. I might not have chafed as much about a 3rd year on Lupron if I would have realized that there was no sex life waiting after it ended anyway!

Since we're sharing different perspectives here, and since I seem to be a but of an outlier, here is my slant on the issue:

Before I started treatment I promised myself that I would do whatever it took to claw my way back to being a functional sexual creature. It took over five years but I made it. During my surgery my doctor took all of the nerves on my right side and some of the nerves on my left side. It wouldn't have been that amazing if I had recovered some natural erections -- but it was even less amazing that I did not. When my post-op pathology came back somewhat alarming, I was also treated to radiation and two years of androgen deprivation therapy. I call the combination of treatments a three scoop shit sandwich and I consider the ADT far and away the most flavorful ingredient. After the ADT ended my testosterone only recovered to about 25%of its pre-treatment baseline level so I had that to deal with, too.

Along the way to recovery I tried pretty much everything and in more-or-less the recommended order -- trying the subtler alternatives first and graduating to the more brute-force solutions only after I had given subtlety a shot. I tried pills first, of course, but gave up on them pretty quickly once the ADT started since a) they weren't working, and b) the ADT would interfere. I did three years of trimix three times a week and a vacuum device the other four days. I finally decided that my venous leak was simply too serious for trimix to ever work satisfactorily. I opted for an implant and in the months leading up to the implantation I tried a penile traction device in hopes it would let my surgeon use a slightly-larger device. For my lingering hypergonadism after ADT I tried cabergoline pills and hCG injections separately and in combination while waiting for enough zero PSA readings for my medical oncologist to be willing to hook me up with T supplementation.

So, at the end of the process I have an implant that gives me slightly odd but definitely usable erections on demand and I use a T cream to supplement my testosterone back to my normal levels. While I was doing all this, of course, the menopause fairy visited out house and I sometimes find myself just a bit "all dressed up with no place to go" but that's OK, I'm fine. The wife and I have a tolerable amount of physical intimacy. She likes to think of it as "cuddling" and I as "heavy petting" but we both get something out of it. I expect she wishes I was a bit less handsy and I wouldn't mind if the things that used to get her going still worked, but we get by. Having been on ADT for several years I understand what she is dealing with. I try to be considerate and when the old, comfortable madness gets problematical I deal with it myself.

You might think that once you get an implant the whole penile rehab thing would be over but actually it's not. If you don't pump the thing up every now and then the tissues shrink and it hurts the next few times you inflate it. I mostly pump mine up in the shower a few time a week and revisit my teenage years.

Since my implant gets very little use for its first and best purpose it might be tempting to think that my whole rehabilitation effort didn't pay off. But it did. Most guys my age with post-menopausal wives wouldn't mind getting a bit more than they do. That's life. That's being a living man. Actually, most men of any age wouldn't mind a bit more than the get. I'm back and it feels good.

I have several friends on the forum (and at least one on this thread) who are into shooting sports. They have concealed carry permits and occasionally carry a pistol for defense. They spend hours at the range practicing with those guns because they want to be proficient with them should the need arise and because shooting at targets is fun. I'm fairly sure they never shot anyone and it is hightly unlikely they ever will. But being a gun owner is part of who they want to be.

I'm kind of like that with my implant. I am quite happy with it. I spend a bit of time at the practice range -- just to keep my hand in, so to speak -- and it keeps me who I need to be.

OK. I'm wading in to this deep subject from a wife's point of view. ( I have Randy's OK to post this.) Randy and I have been married for 35 years. I was 17 when we started dating and 19 when we married, so I guess you could say I've been married to him for my whole life. I was 50 and he was 55 when Randy was diagnosed. We were first told that they were (almost) sure the cancer was contained. Post op pathology and persistent PSA told a very different story. Nerves were spared, but there were no erections. Cialis didn't help. ADT and radiation followed closely behind surgery, so we'll never know if the nerves would have worked again. The fact is...they never did. We tried a pump and injections, but everything was such a chore for him, and he had absolutely no desire.

At age 50, I wasn't ready to give up on our intimate life together. But every time we tried, I could feel his frustration and his embarrassment (?) for lack of a better word. He really wanted things to be as they were before, but that just wasn't possible. As time passed, I stopped asking. I truly understand that his lack of interest has nothing to do with me and everything to do with ADT. As mother nature has since abandoned me, my want-to has waned some, but I still miss it. I would love to have that relationship that we once had. But I don't want to pressure Randy or make him feel any worse, so I just don't bring it up. After 35 years of marriage, I still love him with my whole heart. I know he sees himself as less a man, but I don't. The fact that he does breaks my heart. We don't have a sex-life anymore, but we do have a life, and for that I'm grateful.

Donna.

Post Edited (RandyJoe) : 4/8/2019 11:27:45 AM (GMT-6)

Boy, this thread has been an education for me. First and foremost: my heart goes out to all you guys who are going through what I never have and hope never to have to... but of course can't be at all sure of. Having gone a round with cancer already, I know nothing is certain with this crap.

I also realize how lucky I've been to have a wife with whom I'm on the same sexual wavelength. She's looking at menopause through the fairly-distant rearview mirror, and for both of us it's more and more difficult to summon the energy. But the will and desire are there as well, and for that I'm grateful.

Sexual compatibility over the long term. Books have been written, more will be. But the older I get the more I realize how critical it is to sustaining a marriage or any kind of long relationship. Sure, it's not the #1 thing. But it's definitely up there. And when I hear stories (from either sex) about differences of opinion in this matter that lead to unhappiness, it makes me sad.

Now maybe I'm going against the rules here, and the mods can smite me if they choose, but for those of you living in the right places who have never tried cannabis I'd suggest considering it. Even in an edible form should you choose not to inhale, it can do wonders for the pure physical sensation. Of anything really, but, as I learned years ago, it can be a huge boost to sex.

Just a thought.

Thanks to all of you for contributing to this vital train of thought.

that's funny. I smoked lots of pot (4-finger lids) before using hard drugs and I found it was a huge boost to my appetite. never saw it as an aphrodesiac