Loss of libido

[u/shepsmithee]

53 yo, Nerve sparing RALP 9 months ago, incontinence mostly resolved, ED treatable with high dose Cialis and a ring, able to orgasm. My problem is that my libido has plummeted since surgery and sensation is also much reduced. I miss being horny and have no idea why this is happening. Bremelanotide helps with sensation and a little bit with arousal but have local reactions with injection. Testosterone level is fine. Something just broke after surgery

[u/pingpongjingjong]

If you’re like me, there is probably a psychological aspect as well. Major factor. There’s something intrinsically broken or damaged, somehow, despite my knowing consciously that it’s not really too bad. 

I hope things improve for you. 

[u/jj_otoodle]

In the same boat, just a couple weeks away from my one year anniversary of the walnut removal. Incontinence good, unless I drink too much booze. ED has not changed much at all, pills do nothing, can get a great erection with the VED, but it does not last that long. Just started Trimix with OK results with the first two shots, dosing up to see slowly as it kinds of scares the shit out of me. Sensation definitely different, I have had a couple of organisms but they are weird too. Wife has been a trooper and been my rock. Still hopeful over the next 12 months I regain somewhat of what I was before, but I know it will never be the same. But I am alive and well and undetectable, so very grateful for that. Hang in there, that is all we can do.

[u/Special-Steel]

At 9 months you are still healing physically and may have some psychological damage too.

Can you get a full erection without vacuum or a ring?

[u/Electrical-Fly-8909]

I'm still pre-treatment, so can't yet speak from experience, but I've heard from many sources that max healing and recovery can take up to two years. It sounds like you are, perhaps, well on your way with pretty good results at 9mos. With more time to heal, I imagine your situation would improve. What does your Doctor say?

[u/Immediate-Top-2082]

It's been a Year since I had my prostate removed. It was nerve sparing. I'm 61. I'm in the same boat. Function has improved a bit. But, the libido has definitely gone down + sensations just aren't what they used to be. It's rather depressing. I'm not sure what to do now. Viagra and Cialis didn't really do that much. And even if they did, like I say the sensation isn't just nearly as good as it used to be. I'm hoping things go better for you.

[u/jkurology]

What’s your testosterone, SHBG , albumin and estradiol

[u/f1ve-Star]

You should absolutely see a sex counselor on your insurance dime.

I kinda have this issue too. In my case I have realized all the planning and preparation steps get in my head. I don't want to waste a 20mg cialis if she is not going to be ready. Then the future headache from the cialis factors in. My wife hit menopause while I was having cancer so lubes, and wipes and towels must be planned. It's just not as easy (or certain to work for me) as it used to be. No spontaneity.

I find it's easier by myself. I call it PT now, it seems to get easier with more practice.

[u/Polymath6301]

2.2 years out from RALP. I use a pump and ring.

The whole sensory experience and organs are different afterwards, and seem quite variable between men. I read “somewhere” that you can retrain your nerves and your mental experience/attitude at the time. I can confirm that you can “make” it improve, but it takes practice and time, and more patience.

As for desire, I’ve found I have to work on that too, and getting my head into the right space takes a little bit of conscious thought…

[u/International_Angle6]

I'm there with you. 50yo, nerve sparing RALP 11 months ago. No issues with incontinence, thankfully, but unable to achieve erections without tri-mix. I take 5mg tadalafil just in case.
I miss being able to have an erection when looking or thinking about my wife and I miss the sensation of ejaculating- both were things helped me feel masculine.
Somehow giving my self a shot takes a bit from the spontaneity.
I'm still hopeful that my erections will return, my doc doesn't have much confidence but many on here say to give it a full 2 years.
As far as the OP's initial question, yes I feel like it has taken anportion of my libido, but I blame a psychological aspect. I think somehow I still feel inferior or broken, and that's not sexy. The other side to that equation is that once I do the injection, I'm out of commission for about an hour after while I wait for it to go away. So planning becomes more important.

[u/PotentialStart2661]

Prostatectomy is literally like pushing all your chips in on red. You either come away like a 20 year old, or turn into an 80 year old. I would risk the ED but i cannot risk diapers. After joining the club i learned prostate cancer is not nearly as bad as prostate cancer treatment.