After radical robotic removal of prostate 4 years later can't achieve orgasm.

Nele, You are probably on the right track with the medication question. I have the same problem and have for years, even before the RP. Medications reduce sensitivity. He may not make the connection, but Google the ones he's taking. Also, you don't mention if he has other health issues. I am a type 2 diabetic and that plays havoc with nerve endings. Is he on antidepressants?

Paul

[HEALTH WARNING: gross generalizations and nasty sweeping statements follow :o]

Hello Nele... I'm going to go a few places that are likely uncomfortable to perhaps help you unravel some of this...

Firstly, the BP medication is very likely your enemy here... VERY likely, time to talk to the Doc and make a change there, brand or dose. The fact that your DH was fully functional post surgery and you don't mention radiation tends to point toward this being unrelated.

Now... there's a perception, particularly among our ladies that men are to a large extent 'vending machines', you shove your quarter in the slot, punch the buttons and the goods are duly delivered. That's pretty true when we're 20 but it's a downward slope thereafter. Things change with age (and many other factors), so while I could push my girl around the carpet 5,6,7,8 times a night when I was 20, one or two now put me on the bench; or more specifically, to sleep!

In contrast to much folklore, men are also fragile cerebral creatures. If a man's mind gets screwed up we very quickly start to go wrong... it's like a snowball rolling down hill, anxiety builds on anxiety until we roll all the way down, hit a tree and break. You've got to break that cycle/downward spiral by removing and helping him remove the anxiety.

Men are kinda 80% visually stimulated and 20% is in our minds. Well that's a lie... Women think men can't multi-task right? WRONG! Men are multi-tasking all the time... at least 50% of our brain is thinking about p*ssy anyway, so the fact that we even remember to breathe is pretty remarkable; let alone answer you or analyze something! I'll work the problem like it's 100% though ;o) (Women of course are the other way around - 20% visual, 80% cerebral).

Anyway, his 20% is quite likely overriding his 80% at the moment and his 20% is in the dumpster... you gotta help him with that (and help him help himself). The first step is to take the pressure off and help him take it off himself. A therapist would have you abstain and then build it up again from zero... touching talking etc. Yeah OK... maybe. Another approach is the good old fashioned change of scenery/vacation; but here's the rub... DON'T make it romantic, that just piles the pressure back on!!!! Also, DON'T make it "just the two" of you in a log cabin on top of a mountain for a week; make it something that occupies his mind. Go do an activity - anything, dude ranch, learn to fly gliders, cooking course etc. Even going on a cruise is good (yeah you hate all the people right... wrong)... get him out of his comfort zone, stop the spiral, occupy his mind; the rest will come. Make him laugh again.

Then there's the 80%... you can give that a shot in the arm and by raising the level of excitement you'll push him further up the curve, closer to his orgasm. The way men have done that since the dawn of time is pawnography... sorry but it's just true; throw away any prudishness... you've seen this man take a sh1t after all; play his game! Remember the old adage, "men want their wife to be an angel in the kitchen and a h'oar in the bedroom...". Watch pawn TOGETHER!

Now it doesn't have to be "Lesbian Lavatory Lust" straight outta the gate... try 9 1/2 Weeks (Kim Basinger), Eyes Wide Shut (Nicole Kidman) things like that; ease into it but get his 80% working for him and even push it up to 90% for a while! I make this (perhaps uncomfortable) suggestion, because men are what they are - even though our Victorian values lead us to deny it; so play to mother nature.

EASE into it all... don't let him sense pressure to perform (he's doing that very well to himself); your job is to take the pressure off, put nature on your side and fix those meds.

I could go on but you get my drift I'm sure... turn your inner woman (I'm being polite) on and go!

Paul

Post Edited (Paul65) : 10/30/2015 10:23:38 AM (GMT-6)

I was sick this past summer with anemia that led to a major surgery. As it became obvious that I was truly sick and it wasn't something simple and transient, I lost my ability to "finish". There was just too much going on in my mind to get there.

My wife wanted more sex during this period of time, or rather, I think she thought that more sex would take my mind off of the other issue. Instead, because I couldn't finish, it ended up making things worse, as I had one more thing to worry about.

So, we just decided that it was OK if nobody finished, and we'd just have fun with it and relax. No pressure on anyone. That didn't fix it, to be honest, but it made the time together more fun.

Then, when my medical situation improved, things returned to normal. So, stress, life changes, medications or something else may all be at fault. You may simply need to find a way to accept a "new normal", even if it's temporary. But, I think both of you need to be able to accept that new normal, rather than anyone being stressed out by it. Best of luck.

Hello Nele,

Welcome to the forum. Sorry you found yourself here but glad you found us. Hope we can help.

From what you said his erectile response recovered well after the surgery and you don't mention that problem returning so I expect he's OK in that regard. But, as you probably remember, worrying about that sort of thing can put a man off his game. Since he's started a new blood pressure medicine his doctor probably wasn't happy with his pressure and high blood pressure can cause ED problems. And some blood pressure drugs can make the problem worse, or more accurately, some are more helpful than others. You should make sure he isn't worried about his erections because that is usually easier to fix. Here is a link to a writeup about which blood pressure meds cause which sexual side effects. It's a bit of a hodgepodge by it might suggests some other drugs his doctor could try.

WebMD: High Blood Pressure and Erectile Dysfunction (ED)

But, assuming you are right that his erections are OK and he isn't fretting about them then you are left with his delayed and difficult orgasms. These can be caused by a number of psychological factors including depression, worry and ennui but it can also be caused by medicines. One sort of a Catch 22 is that many antidepressants make the problem worse. Men who are depressed about their sex lives should stay away from SSRI drugs, especially Prozac, which have awful side effects on sexual function. I have personally experienced that side effect of Prozac.

I don't know if his problem in that regard is related to his blood pressure drug. I don't think they are usually related to arousal disorders but switching to a different drug might be worth trying. But if that doesn't help there are a few drugs that can treat his depression and, maybe, help with his delayed orgasm too. Bupropion (a generic antidepressant, brand name Wellbutrin) is an antidepressant that generally doesn't cause sexual side effects and seems to help with delayed and difficult orgasm. (It is often prescribed with Prozac to offset the sexual difficulties it causes.)

Here is a link to an article in the Pharmacy Times about medicines that affect libido:

www.pharmacytimes.com/publications/issue/2010/June2010/LossofLibido-0610

Unless you are a medical professional you probably won't be able to read most of it but the paragraph under the heading of "CARDIOVASCULAR" might be something he could print out and take to his doctor.

Good luck.

You might also consider having his testosterone levels checked.

It is not uncommon for guys younger than your husband to have lower testosterone levels start occurring.

I have been doing Testosterone Replacement Therapy for about three years.

Due to nerve issues in my face after sinus surgery, I cut down my injections about 25%. That precipitated difficulty with orgasm. Put the levels back up, nerver issue returned along with easier and better orgasms.

One thing that may be good to look into.

There was a thread here recently about TRT post RP.

PeterDisAbelard said...

JackH,

How, exactly, is anything you said supposed to be helpful to Nele?

I'm pleased to clarify, when needed... (sometimes bold print is not enough)


In brief, Nele, it turns out that RP causes many types of sexual dysfunction, and many of them we've never heard of. What you described sounds like what is called "male orgasmic disorder." I defined it earlier, including some of the ripple-effects, and it sounds a lot like what you described.

Regarding responses by others, BP medication and testosterone deficiency commonly cause ED but orgasmic disorder to a much lesser degree, but Nele did not describe ED (and erection problem) or libido. Depression, on the other hand, can cause male orgasmic disorder, which as I added in my earlier post can spiral around and become self-fulfilling. Some of the other replies mixed erection disorders (or libido disorders) with orgasmic disorders, but they are NOT necessarily the same thing.


I'm glad that you drew me back in, PeterDA, because I realized after posting that I spoke nothing of therapy. Male orgasmic disorder is well documented in sexual dysfunction literature, and has treatments dependent upon the root cause(s)...which as I alluded to earlier may be multifactorial (psychological, physiological). Seeking treatment, however, requires taking the first step...but at least now you have a name for the disorder as a starting point for the conversation.


Like many people when they respond to posts, PDA, I went beyond a purely clinical description and drew in my own personal perceptions, experiences, and or observations. I also hope that others who may read this thread in the future (and these threads do have legs) will be more diligent in asking about the full scope of side effects from prostate cancer treatment (and I say this without implying Nele's husband was anything less than diligent)...and this will be especially useful for those site newcomers who are newly diagnosed (the majority of newcomers to HW), and even more especially for those in the favorable-risk category who may find that the choice of an aggressive treatment is, frankly, "elective" because it will do nothing to extend their longevity.


Glad you invited me to clarify and further participate...


I, on the other hand, was wondering (at least to myself) how your (PDA) suggestion to read an article titled "How Medications Impact Libido" was going to be helpful...? Libido (sexual drive) didn't seem to be the dysfunctions she described.

Post Edited (JackH) : 10/30/2015 12:34:29 PM (GMT-6)

Yikes! Glad I stuck to smut!

Post Edited By Moderator (PeterDisAbelard.) : 10/30/2015 1:54:49 PM (GMT-6)

great posts. Thanks.

Wow, thank you all so much for your insight and suggestions, I have a lot of homework to do here. I can't tell you how much I appreciate everyone's replies. Just to know that I could put this out there and be heard and actually get solid discussion is amazing. I'm so thankful for this site. I'm one of those that always see the glass half full and now I can see it becoming fuller. Thankfully my husband and I have intense love for each other so I feel so much better after having this discussion. Thank you, thank you, thank you!!!