The orgasm conspiracy

2025 June 28th

So it’s twelve days since my last Martian Death Ray Treatment and how am I doing? I finished the treatment stressed and tired, with joint aches - mainly for no obvious reason in my hands, left knee, and the right side of my jaw, some discomfort when starting to pee, and a lack of energy. I’d been warned about the cumulative effects of radiotherapy and that it could continue to build up to around two weeks after the treatment had finished, and broadly that’s what happened. Around day 9 that all started to subside, and it is still subsiding. Yesterday I managed a slow but satisfying four mile run, and that clearly helped too, as have a couple of aspirin most mornings and the other limited exercise I’ve felt up to taking over the last two weeks: rather less than I’ve usually been able to do, but more than none. In a bid to take care of this, Mrs.G (who may not have the physical effects but is every bit as stressed and tired as I am) and I have taken some time off. Work devices are locked away and we’re doing what we can to decompress, which is some serious relaxing. Early nights, late mornings, fresh air and exercise, good healthy food. Early days, but it’s happening, and it’s helping. We’re both looking forward to another week of this before we reengage with the world, hopefully in a much better state to deal with it.

In the meantime, some symptoms in myself have caused me to go looking up some information about sexual function post radiotherapy. This is the point where if you’re of a tender disposition you might want to stop reading and wait for my next blog.

If you’re still with me then… if you read the websites of organisations like the NHS, Prostate Cancer UK, or Cancer Research UK, the advice on long term effects of external beam radiotherapy or EBRT they do warn you that a proportion of men can suffer from erectile dysfunction, then direct you to advice on treatments for that. They also suggest that if you’re still hoping to father children you should consider sperm banking as the radiation can effect the health of your sperm. That’s honest enough, and so far as I can tell the advice offered is sound.

However some of my own different symptoms caused me to start having a deep dive into the scientific literature on the long term effects after EBRT (MDRT to you!) which amongst others brought me to a paper: the snappily titled "Ejaculatory performance after radiotherapy for prostate cancer: a systematic review and meta-analysis”, by a team of mainly Californian medical researchers who summarised seventeen studies covering over two thousand patients. Their conclusions are stark and rather painful…

- 85% of men who have had EBRT have suffered a reduction in the amount they ejaculate

- 18% of men who have had EBRT suffer a complete end of ejaculation.

- An unquantified but large proportion of men who have had EBRT also suffer a changed or reduce sensation of orgasm during sex.

The authors conclude their paper with a very straightforward statement: “Patients receiving radiation treatment may experience significant changes in their ejaculation, such as the absence of ejaculation, reduced ejaculatory volume, and ejaculatory discomfort. It is important to counsel them about these potential side effects.”

(Here it is if you have the appetite to read the whole thing: https://pubmed.ncbi.nlm.nih.gov/39277705/ )

This is probably the most recent paper I can find on this but I found others with similar conclusions going back ten years or so, so this isn’t new knowledge.

Was I counselled on this? - not one tiny bit. Worse than that, it appears that none of the usual UK trusted sources of advice for cancer patients mention anorgasmia or anejaculation at-all.

Our friends across the Atlantic seem to be very ahead of us Brits on this, this page from the American Cancer Society is a lot more up-front about the risks, saying pretty much what I summarised above:-

https://www.cancer.org/cancer/managing-cancer/side-effects/sexual-side-effects/ejaculation-and-treatment.html

Needless to say, I only recently found that, and not before my treatment started.

So where does this leave me, or anybody like me? Frankly quite angry and upset. Without going into too much personal detail, there are issues here that we’ve only just found out about, which Mrs.G and I need to process and handle, probably for the rest of our lives. That would have been a whole lot easier as an emotional task if we were warned up front. The obvious question here is just why did this happen - why did not a single person amongst the many who have treated me, or who have authored documents and websites supporting prostate cancer patients in the UK think that this massive issue wasn’t worth mentioning?

I’m going to go out on a limb here and guess. I think that the British medical establishment just don’t think it’s good for us to know. They’re aware that a lot of men are so embarrassed or uncomfortable about the idea of any interference with their nether regions that they simply won’t have even the simple digital test, let alone beyond that. So information is withheld from us, for our own good, to make sure we don’t back down from the treatment that’ll hopefully cure us of cancer. And then afterwards, so many of us probably think it’s “just me”, and because it’s so personal, just don’t talk about it.

I find that arrogant and annoying. If you want us to do the right thing, appeal to our rationality, appeal to our masculine sense of doing what’s right irrespective of the consequences, explain the full realities - or if you’re busy, and you probably are, point us at full and truthful sources we can digest in our own time. Don’t lie to us, and don’t withhold information - because the next time a physician recommends to me what the right treatment should be for me I’m likely to be a lot less trusting, and use a lot more of their time up understanding what I’m really up against. Frankly, you should be too.