By Ralph Blum

Although I don’t subscribe to the idea that we men are exclusively the products of our hormones, our sex life—or lack of it—following cancer treatment is a matter of serious concern to almost all of us.  

My own adjustment to being in an unfamiliar, hormonally uncharged space for the first time since puberty has been an education in intimacy, and in what it really means to be a man.

When my PSA began to rise after 14 years of “active surveillance,” I decided on testosterone inactivating pharmaceuticals (TIP), the treatment that blocks the male hormone testosterone. The rule of thumb is: no testosterone, probably no erections; but for damn sure, no libido.

A loss of sex drive is different from impotence. But without sexual drive that translates as “desire,” the vast majority of men lose all interest in the very idea of potency. For many of us, no libido means that our manhood is severely damaged. The actual cost of being without a libido, therefore, is both physical and emotional.

Once you begin TIP, your testosterone level descends rapidly; it really tanks, gets down almost to castrate level. I could hardly believe it, but after only a few weeks my sexual desire was history. I found the female form about as stimulating as covered furniture.

It turns out that through the wonders of modern pharmacology a number of determined men on TIP have managed to maintain an active sex life despite their reduced libido. One man told me, “Hey, I’ve been taking Viagra regularly during TIP, and I get it up like a Trojan!” However, a lot of guys—myself included—couldn’t dredge up enough desire to want sex.  I’m sure you’ve seen the commercial pitch for Cialis: “When the moment is right…” Well, for me, there was no such thing as a “right moment.”

Here’s what I wrote before in my blog, “Positive Side Effects of Prostate Cancer:” 

A fate worse than death, right? Wrong. To my surprise, I didn’t feel defeated or “less of a man.” I realized it was not the end of the world. In fact, if not getting my libido back is my fate, well and good. Been there, done that. Being without a libido permits a freedom I had not experienced during over half a century of full-blown sexual drive, and a much richer emotional life with my partner—a new kind of intimacy.

However, if against all odds, you’re still “hot to trot,” you’ll find support out there. In fact, there's an ad in a current AARP Bulletin (Page 35) promising “50% off 4 Better Sex Videos" showing couples how to overcome sexual problems including erectile dysfunction, and claiming "100% satisfaction guaranteed!" The website is video, as watched from the Libido Free Zone, elicits a yawn—reduced from jaw stretching to trivial.

Point: Even if you’re not thrilled to find yourself in the libido-free zone, there is your partner to consider. And not being able to “get it up like a Trojan” doesn’t mean that you have to give up sexual pleasures altogether. 

So what is this, a postgraduate course in sex education? Hardly. Still, I have to confess that being less self-involved—relieved of the burden of more than half a century of goal-oriented behavior—has actually improved our intimate life. I feel less rushed, less driven. I feel more tenderness for my Jeanne. I believe that I have become more sensitive to her needs, her pleasure. I believe that I have discovered a new kind of satisfaction and a new feeling of emotional commitment—both of which are unexpected and encouraging surprises during the Seventh Inning Stretch.


 Article originally posted on November 8, 2011, on Prostate Snatchers: The Blog, by Ralph Blum

About Ralph Blum (1932-2016):


Ralph H. Blum was a cultural anthropologist and author, graduated Phi Beta Kappa from Harvard University with a degree in Russian Studies. His reporting from the Soviet Union, the first of its kind for The New Yorker (1961—1965), included two three-part series on Russian cultural life. He wrote for various magazines, among them Reader’s Digest, Cosmopolitan, and Vogue. Blum has published three novels and five nonfiction books. He lived with prostate cancer, without radical intervention, for twenty years.