common search on google that gets to prostate diaries…”sex drive after prostatectomy.”

orators become dumb… when beauty speaketh-shakesphere

Okay…one more time. 

  • sex drive is called libido and is dependent on testosterone
  • testosterone is not affected by removing the prostate
  • testosterone is produced by the testicles and gets into the body through the blood stream independent of the prostate
  • potency is the ability to get an erection
  • an erection after prostatectomy is a function of sparing the nerves
  • a prostatectomy does not affect the testicles or the level of the males hormones or testosterone
  • it is possible to have a very high libido and not have the ability of having an erection (which can happen after any treatment of prostate cancer)
  • fertility is the ability to have children which is unrelated to potency or libido…but will go away with a prostatectomy but may not with radiation of the prostate

So…In answer to the search question…Sex drive or libido which is hormonally driven… will not change after a prostatectomy. Now…a prostatectomy or any treatment of the prostate had an emotional hit or consequence…that too can affect libido or drive……it’s complicated……

When a man has a vasectomy or a prostatectomy his sex drive or libido, which is dependent on the male hormone testosterone, does not change. Testosterone is produced by the testicles and released into the blood stream and subsequently not affected, or its blood level diminished, by either procedure.

What is wrong with the terminology in the following urology joke? 

One of the oldest Urology jokes around involves a man coming to the Urology clinic for a vasectomy all dressed up in a tuxedo. When asked,” Why the formal attire?” he responds,” If I am going to be impotent, I’m going to look impotent.”

The answer and the  problem with this joke, as explained in the bullets above, is that a vasectomy makes you sterile (no sperm), it has no affect on potency. Potency refers to erectile function which is independent of fertility (which is what a vasectomy affects). I mention this because it is misconceptions like these which abound within the male population, and contribute to the “perfect storm” of delayed diagnosis alluded to earlier in this book. It is still a cute joke however.


5 Replies to “common search on google that gets to prostate diaries…”sex drive after prostatectomy.””

  1. Hi Dr. M, Your Decision book has been very valuable to me this year. I am 50 and will be having a robotic radical prostatectomy in a couple of days. One glimmer of hope I have for future pleasure is that a climax may still be possible without an erection (although dry) if certain nerves are left undamaged (I breathed a sigh of relief when I read this in the book).
    Thank you for sharing your story with the web site and your book!

    Paul C, Decatur, GA


  2. You are wrong. There is some yet to be determined change after prostatectomy affecting libido. Possibly to do with dihydrotestosterone loss which the prostate is the major source of.
    There has to be a reason dht is produced.


  3. Love the joke. Thanks for the advice. I’ve noticed a reduction in libido since my surgery 1 1/2 years ago, and wondered if its psychological, age related or what (or all the above). Ejaculating urine is a real downer/off switch for wanting to have sex (or having anyone wanting it with me), but that is another story… This being said, it was definitely worth it, whether its in my head or not. I never had sex every day, but I go to the bathroom many times a day, and my growing prostate was pinching off my flow severely. Now, I can best any 15 year old boy with my bubbles!


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