Pain on ejaculation after radiotherapy

User

Posted 13 Mar 2020 at 15:15

Hi All,

I've been on hormones since May 19, chemo 4.5 months and now just finishing 37 fractions of radiotherapy next week. I went to ED clinic early and I'm using Cialis daily with 20mg for action + using a pump every other day + regular sex at least twice a week so my old fella is getting lots of 'exercise'. The problem is over the last few months I can get hard but really struggle to ejaculate through penetrative sex, when I masturbate I have to really really focus on the job in hand to ejaculate ( excuse the pun!) Over the last week though when I ejaculate I get the usual dry orgasm feeling then straight after a pain which I've never had before. It feels like something wants to come out then blocked!? only way to explain it! Pain goes away within seconds.

Has anyone else had this problem?

User

Posted 13 Mar 2020 at 23:03

Your prostate, seminal vesicles, and other muscles in the area will be inflamed by the radiotherapy. It's probably not surprising if they hurt when contracting, although this didn't happen to me during RT - orgasms still felt the same. Ask your radiographers if you can speak with a urologist (they can often get you same day access to consultants), but you might simply have to put up with the pain for a few weeks after RT.

The difficulty to orgasm is caused by reduction in libido due to hormone therapy. You could try some things to increase your arousal, such as sex toys, particularly vibrating cock rings. Some erotica or soft porn might help too, BUT you must both be completely happy with its use or you risk damaging your relationship. Also, make sure all possible distractions are removed - as libido reduces, it becomes more difficult to concentrate on the task at hand, and unrelated things can easily distract you.

By the way, excellent that you've got daily and event dose tadalafil and a pump - you have a good GP.

User

Posted 13 Mar 2020 at 23:43

Stalwart, do you mean difficulty in ejaculating or do you mean difficulty in reaching orgasm?

RT damages the prostate and eventually leads to dry orgasms (little or no ejaculatory fluid). If this is only just beginning to show itself, you may be experiencing retrograde ejaculation (what fluid is there is going into the bladder rather than coming out of your penis) - this can be painful but will usually improve as you stop producing ejaculatory fluid completely.

HT can cause loss of libido and make orgasm difficult.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 14 Mar 2020 at 10:33

To be fair the GP was useless, she couldn't understand why I was getting ED whilst on hormones!! No joke. I asked for ED referral and they were brilliant, offered everything I wanted and more if needed. I do need porn to orgasm though as it helps focus, my partner has no problem and is very supportive.

Lynn - Yes your right I have dry orgasms not ejaculation but on occasion get sort of pre cum come out (very small amount)

User

Posted 15 Mar 2020 at 15:29

Stalwart, can I ask .. you say you're on hormone treatment, and having regular sex did you lose your sex drive?...

I have posted previously on other threads that we expected that my partner would have to go on HT and we both knew that loss of libido was more than likely going to happen. The first week of treatment it seemed there was no real difference but the last 2 weeks there has been a definite loss of sex drive and interest which has taken us both by surprise.

Some days you just have to create your own sunshine......

User

Posted 15 Mar 2020 at 15:55

Hi Annie,

Obviously everyone is individual but my body/personality seems to be fighting the hormones. I still have the desire to please sexualy and show affection to my partner, kissing, stroking etc but I can only get an erection by using cialis and sometimes the help of a cock ring. I still feel like I want to rip her clothes off when we meet. However I used to watch porn but have no interest now and find it really really hard to orgasm, I also have to focus on sex, if I lose focus my erection is gone and I have to start again.

Incidentally I'm 53,fit have a very positive outlook and had a very good sex life before hormones.

User

Posted 15 Mar 2020 at 16:45

Thanks for your reply Stalwart. I should say it's not the loss of libido that's taken us by surprise because we had done quite a lot of reading etc so expected that its the speed of it that has shocked us.

Its also quite early I suppose in the HT journey and getting our heads around the news that his cancer is advanced so hardly surprising as I have said elsewhere on the forum that I think he is feeling some depression hence the disturbed sleep.

I did suggest to my partner last week after what felt like a really clinical afternoon trip to the bedroom, that we just accept that it is what it is and he has no choice he has to have the HT so we just accept that our sex life is over and focus on all the other good things about our relationship, we are and always have been very affectionate and tactile with each other and I was feeling like if I initiated sex that I was pressurising him and that was something I didn't want to do, as Lynn said in her brilliant post a woman knows when her man is just going through the motions which is what prompted me to again broach the subject this morning we do just accept things.

I guess I'm wondering for his sake as well as mine if there is any light at the end of the tunnel, because whilst we both agreed that it may be for the best we are both devastated as I'm sure many other couples on here faced with this scenario are at the prospect that we have lost such an important part of our relationship.

Some days you just have to create your own sunshine......

User

Posted 15 Mar 2020 at 17:37

I think sometimes it's not just the hormones that sap the libido but the shock, feeling low and dark place some men go to after being diagnosed especially advanced PC. I am a very positive person and decided early on that this awful disease wasn't going to define me as a person and that I would make a concerted effort to lead a normal life work wise and relationship wise. Sex and intimacy is a big part for me therefore I make a big effort to counteract any side effects, if I get distracted and lose my erection we just carry on and do other stuff I'm under no pressure to perform.

User

Posted 15 Mar 2020 at 18:03

Im sure your right about the shock. My partner is usually quite positive and determined. I think for me its just one of those tough days today 🙂

Some days you just have to create your own sunshine......

User

Posted 15 Mar 2020 at 18:54

Sorry to jump in , but it’s posts like these that have made me resist any future treatment until it gets urgent. Five years post op and refused anything further. My psa is over 300 and im only 53 in June. I’m simply not prepared to lose all function and desire again. It was bad enough first time round. I feel fit and healthy and am working. Zero symptoms. I’m not gonna be a monk !

User

Posted 15 Mar 2020 at 19:04

Sorry Chris J..having read your posts I know where you are in your journey.
My day went from being quietly stoic this morning to feeling upset and selfish this afternoon. Tomorrow is another day 🙂

Some days you just have to create your own sunshine......

User

Posted 15 Mar 2020 at 23:43

Oh Annie, I feel for you. On the up side, at least you know the HT is working its magic!

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 15 Mar 2020 at 23:53

Absolutely Lyn, thats what I told him the other day. It is early days on our HT journey which is going to take some getting used to and I have no doubts there will be a lot more bumps in the road, but I think all things considered he is actually quite amazing. 🙂

Some days you just have to create your own sunshine......

User

Posted 20 Mar 2020 at 07:54

I’ve only just found this forum, wish I’d found it earlier. I was diagnosed with advanced PC Dec 2014 at the age of 51. I went from a normal (maybe high) libido to almost zero with the hormone therapy.
I was (still am) in a failing marriage.
The hormone therapy had a huge effect on me. I had almost no symptoms from the PC, but the therapy wiped me out. Emotionally and physically. My wife didn’t want sex anyway but I couldn’t have had if I wanted. i think I was depressed but am pulling through with the support of a few friends and a new outlook on life.

i have (embarrassing moment) experimented on my own since ending hormone therapy and I can get an erection now. It’s different and I have to concentrate more. I definitely think about it more but haven’t tried viagra. No need at the moment.

User

Posted 20 Mar 2020 at 11:03

Have you been on HT constantly all this time then Jimmyz? or had any breaks etc? We have no idea whether my partner will have to stay on it constantly until it stops working then transfers to something else or if he will get a break if PSA drops. The oncologist at The Christie was very brusque with us when he told us there were 20 lymph nodes involved, more or less just said... this is what it is, this is what we are doing come back in 6 months. No explanations really or discussions on whether chemo could help... nothing he wasn't even offered support of an advanced cancer nurse.

The more I thought about it the angrier I got and after visiting our local support group we spoke to the Mcmillan nurse who encouraged us to think about transferring to the oncologist closer to home. I also have an oncologist who I see for monitoring every two years which is why I was dismayed at the way my partners spoke to us and the lack of discussion.

My partner is definitely depressed and whilst I don't tend to get depressed I have certainly felt very sad at times particularly at the start of the week, but we are very close and talk things through and things have certainly gotten a little easier as the week as gone on helped by the lovely sunshine which has meant he has been able to get out and do some things in the garden and bits of DIY which have all helped to lift his mood a little so we will see. His first PSA test is due 31st March.

Some days you just have to create your own sunshine......

User

Posted 20 Mar 2020 at 12:20

I am so sorry that you have had so little information or warmth from the specialist.

I think as he is now incurable, the intention will be for him to have HT for the rest of his life. The good news (!!!) is that we have had men who lived for 10, 15+ years on HT and there is something called IHT or 'hormone holidays' for men whose PSA stays low and stable for two years or more who would like to have a break sometimes. If they were intending to offer him chemo, the COVID situation has probably put paid to that. Chemo isn't critical to his long term outcomes right now - more important to get his PSA under control.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 20 Mar 2020 at 13:28

I was on HT for 3 years, finished 2 years ago. The Marsden was great but it so busy so not much of a personal touch. I don’t have much interaction with my oncologist now and I think unless you push you don’t get much.

Its important to try to stay positive, and sex can help but can be awkward if there are difficulties. It’s important to concentrate on the intimacy more than the sex.
But there does seem to be a lot of help out there regarding ED that I wasn’t aware of.

User

Posted 21 Mar 2020 at 11:33

Thanks Lyn, I think for now we are just waiting for his first PSA test since starting the HT and as you say the Covid19 has put lots of things on hold so it may be that we just get the test done and then sit tight until his next hospital appointment then see what's what.

Some days you just have to create your own sunshine......

User

Posted 21 Mar 2020 at 11:45

Thank you for your reply Jimmyz, We have a fabulous ED nurse who we saw three weeks before starting the hormone treatment and were given a new "friend" as I call it ( pump ). As you can see from my earlier posts the weekend and early week was one of us both feeling very sad and led to lots of talking and tears. I think the shock of the advance cancer diagnosis was finally hitting us both. However, the week ended on a much happier note for us both with a little help from our friend :) I'm sure we will have many more bumps in the road, many more tears but for now its a day at a time.

Some days you just have to create your own sunshine......

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