This article is based solely on discussions among gay and bisexual men in Malecare’s public online forum about prostate cancer. It highlights what real patients have shared – their challenges, solutions, and perspectives. Each section below covers a key theme that came up repeatedly, with direct quotes from the men themselves (with sources) to amplify their voices. The focus is on your concerns and experiences as a gay or bi man dealing with prostate cancer.

Emotional and Social Challenges

Feeling Isolated or “Out of Place”: Many gay men with prostate cancer feel a unique isolation. Prostate cancer typically affects older men, and some note a disconnect with gay social norms that prize youth. One member bluntly described this age-related challenge:

  • “Also prostate cancer often affects men over 55 years old and the gay community is looking at younger men, so we get a double whammy.”​
    pmc.ncbi.nlm.nih.gov

This “double whammy” of being older and managing cancer can make you feel invisible in the community. It’s a reminder that your feelings of isolation are shared by others.

Emotional Ups and Downs: Patients often discuss the emotional toll of treatment side effects. For example, hormone therapy (androgen deprivation therapy) can deeply affect mood, body, and self-image. One gay man on long-term hormone treatment expressed frustration with how it changed his body and sex life:

  • “I really dislike the side effects of it. Loss of muscle, loss of erection, almost dry climaxes. I haven’t had sex w/ anyone for yrs.”​

Reading this, you realize you’re not alone if you’ve experienced a loss of libido or confidence. Such emotional lows are voiced openly in the forum. Men share these feelings to vent and to find understanding from those who get it. In response, others often encourage patience and self-compassion, noting that these side effects do not have to mean the end of your intimacy or fitness (many later discuss ways to manage or improve these issues – see below).

Dating and Relationships After Treatment

Starting or continuing relationships after prostate cancer is a common concern. Gay and bi men in the forum have very frank discussions about dating post-surgery or during treatment. Two different approaches emerge: jumping back into dating versus waiting longer, but honesty is key in both.

  • Being Open with Partners: One man shared his experience of going on a date a couple months after surgery and choosing to be upfront about his medical situation. He wrote, “It was good I was open and honest with my medical issues.”​

    He found that honesty early on made the experience easier. This suggests that being candid about your prostate cancer and side effects (when you’re comfortable) can lead to understanding rather than rejection.

  • When to Resume Dating: There is no single “right” timeline. The forum members’ experiences vary:

    • Soon after recovery: The man above didn’t wait long once he felt physically healed enough to socialize. He asked others, “My question to those that are single, how long after your surgery did you wait before getting back in the dating game?”​Many replied with their own timelines.
    • Waiting longer: One member answered, “4 months for dating…6 months for sex.”​In his case, he took a few extra months to rebuild confidence and adjust to post-surgery changes before pursuing sex.

Both approaches are valid. You might feel ready to date as soon as your catheter is out and you have energy, or you might prefer to focus on recovery for several months. The common advice was: go at your own pace and don’t compare yourself to others.

New Relationships vs. Existing Partners: If you’re single, starting new relationships can be daunting without a roadmap, but these stories show others have navigated it. If you have a long-term partner, discussions highlight the importance of communication and patience. (For example, forum members talk about involving their partners in doctor visits and finding new ways to be intimate if intercourse is difficult – see next section on sexual function.) The overarching message is that open communication – whether with a new date or a spouse – helps set expectations and reduces anxiety for both of you.

Sexual Function and Intimacy

Nearly every gay or bi man in the forum eventually talks about sex after prostate cancer. This includes erection issues, ejaculation changes, and adapting sexual practices. Below are patient perspectives on these topics, and what you can do or expect.

Erection Difficulties and Solutions

Erectile dysfunction (ED) is a major concern post-treatment. Men discuss how it affects both tops and bottoms in gay sex. The good news is that forum members have found several solutions that can help you regain a usable erection:

  • Injection Therapy (Trimix): Penile injections are often brought up as a reliable way to produce an erection, even when nerves are damaged. As one member explained, “Trimix creates an erection regardless of whether your brain is into it or not – it causes blood to pool in the penis.”​

    In other words, even if your natural arousal signals aren’t enough, the medication will physically produce an erection. This can be a relief if you’re a top worried about penetrative sex – it means you can get hard enough with medical help. (Some guys noted downsides like the injection process itself, but many in the forum use Trimix successfully.)

     

  • Vacuum Pumps and Pills: Others share success with vacuum erection devices and PDE5 inhibitor pills (like Viagra or Cialis). One man described participating in a program specifically for gay men that “provided the pump, a very helpful website (complete with frank discussion and videos), and sildenafil pills.”​

     

    This combination of a pump plus ED meds and education helped him recover sexual function. Pumps help by improving blood flow and can be used solo or with a partner as part of foreplay. Daily low-dose Cialis was also mentioned in discussions as a way some men promote blood flow during nerve recovery (even if it doesn’t lead to full erections immediately).

     

  • Pelvic Floor Exercises: A few men credit Kegel exercises (pelvic floor training) not only for improving continence (see next section) but also for helping erections to some degree. Strengthening those muscles can boost rigidity and control. One member said “I’ve been doing the kegels…” as part of his routine to improve urinary control​, and other users noted this can’t hurt on the ED front either.

     

Takeaway: Regaining erections takes time and often medical assistance. Forum members encourage trying these solutions and sharing results. In their experience, you may not get spontaneous erections for a while, but tools like injections, pumps, and pills can give you back an active sex life. As one might put it: don’t give up on sex – many men report finding what works through trial and error and support from their doctors and peers.

Changes in Orgasm and Ejaculation

Because prostate cancer treatments can remove or damage the prostate and seminal vesicles, ejaculation is usually changed or absent after treatment. This can be an adjustment for gay men, some of whom valued the act of ejaculating in their sexual lives. Men in the forum openly talk about dry orgasms:

  • The member on hormone therapy mentioned “almost dry climaxes”​as one of his side effects. After surgery or radiation, dry orgasms (no semen) are the new normal. Patients describe the sensation as different but still pleasurable. In fact, some have noted that the orgasm can feel just as intense even without fluid – the pleasure isn’t lost, only the mess. Others say it takes getting used to and can be psychologically odd at first (“nothing came out!”).  

     

  • Loss of ejaculate play.  First described in 1997 by oncology social worker and LGBTQ research pioneer Darryl Mitteldorf, LCSW, some men who enjoy sex with men enjoy the feel of seman after ejaculation.  Sometimes there is play using fingers, tongue, or one skin surfaces.   The loss of ejaculate incites a deeper loss of identity, as well as a concrete loss of intimate pleasure.

  • Loss of the “prostate orgasm”: If you enjoyed prostate stimulation during sex (for example, being penetrated and feeling that deep orgasmic push from the prostate), there is fear of losing that. Forum members who are bottomsvoice this concern strongly. The consensus from those further out is that while the sensation changes, you can still experience sexual pleasure. Orgasms now originate from remaining nerves (some in the penis, some in other pelvic areas). One man reported that even after his prostate was removed, “the orgasms can even be more intense than before” (a sentiment echoed in related communities)​. Your mileage may vary, but the important point is that orgasm doesn’t disappear after prostate cancer, it just changes.

  • Communication with partners: Because you won’t ejaculate, you might want to let your partner know what to expect. This is less of an issue in gay relationships than the ED itself, but it’s something guys talk about educating their partners on (e.g., “Don’t expect me to cum like before”). Most partners adapt quickly and are just happy that you’re alive and still able to be intimate.

Resuming Anal Sex After Treatment

One topic unique to gay and bisexual men is anal sex after prostate cancer treatment. If you’re used to being the receptive partner (“bottom”), you likely have questions about safety, timing, and how it will feel. This issue came up frequently on the forum, with men sharing personal guidelines.

Lack of Medical Guidance: A common refrain is that doctors don’t always give advice about anal intercourse. As one patient posted:

  • “My doctor didn’t talk about when I could start having anal sex again post prostatectomy. Any guidelines guys know about?”​
     

Many men were left to figure it out on their own or ask peers. From the collective experiences, a few clear recommendations emerged:

  • Wait at Least 2–3 Months After Surgery: Most members agree on roughly a three-month waiting period after a radical prostatectomy before attempting receptive anal sex. One user said his urologist “recommends at least 3 months”​of no receptive sex. This gives your internal wounds time to heal and scar tissue to strengthen. Trying too early risks tearing sutures or causing pain. Listen to your body – even after 3 months, start gently. As that user added, “if you feel any pain at all, stop what you’re doing.”​

    Patience is crucial for safety.

  • Radiation (Brachytherapy) Requires Healing Time: For those who had LDR brachytherapy (seed implants), the timeline was similar or a bit longer. One man shared, “I waited a little over three months before having receptive anal sex.”​

    He explained why: “With LDR–seed implants–they’re putting radioactive seeds right in your prostate. So you need to give it time for all that to set and heal…”​. The radiation seeds can irritate tissue, and there’s a slight risk of exposing a partner to radiation if you engage too soon. Waiting ensures the radioactivity levels drop and your prostate area recovers. (Doctors often recommend using condoms for a period after brachytherapy if you do have sex, to catch any expelling seeds – forum members mention this kind of tip as well.)

     

  • After TURP or Other Procedures: Even men who had a TURP (transurethral resection of the prostate, often for BPH) came to the gay forum for advice about anal sex. The guidance they received was similar: make sure you’re fully healed. The size of tissue removed was large in one TURP patient’s case (1.5 times a golf ball)​, so replies urged caution and likely a couple of months’ rest. The principle is the same: any invasive prostate procedure means internal healing is happening – give it time.

     

To summarize the community’s input, here’s a quick reference table on when to resume bottoming:

Treatment Patient-Shared Wait Time Notes
Radical Prostatectomy ~3 months post-surgery​ “At least 3 months”; go slow and stop if it hurts​
Seed Brachytherapy >3 months post-implants​ Wait until prostate area heals; seeds need to settle​.
TURP (prostate resection) ~2–3 months (varies) Ensure full healing of resected tissue (similar precautions).

Even after waiting, the first time back might be nerve-wracking. Men suggest using extra lubrication, communicating with your partner, and perhaps choosing comfortable positions. One guy mentioned his first time post-surgery “was good, no pain and it was pleasurable as before.” (This kind of success story is encouraging – it can feel normal again with time​.) The bottom line 😉: almost everyone gets back to enjoying anal sex, but don’t rush it.

 

Urinary Changes and Incontinence

Urinary incontinence – leakage of urine – is a side effect that many prostate cancer patients face after surgery (and sometimes after radiation). For gay and bi men, this is not so much a unique issue as a universal one, but it’s heavily discussed in the forum because it affects day-to-day quality of life and confidence in social/sexual situations. Members share candid accounts and practical tips for managing incontinence:

  • “Flood Gates” in the Beginning: Right after a prostatectomy, it’s common to have little to no bladder control. One member vividly described his early post-op days: “My incontinence in the beginning was like the flood gates of my penis opened up… I wore the Depends and was changing them quite a bit during the day.”​

    In other words, urine was pouring out whenever he stood or moved, and he needed full adult diapers, changing many times a day. This level of leakage is normal initially, though the severity varies person to person. It can be distressing, but as his story and others show, it improves over time.

     

  • Adapting and Improving: That same man then shared what he did to regain control. “I learned to limit my intake of water and stopped drinking my green tea.”​

    By cutting down bladder irritants and not overfilling his bladder, he reduced accidents. After some weeks, he said, “I’ve since been able to switch to the pads during the day and at night wear the Depends to bed.”​– a big improvement from 24/7 diapers. Using lighter pads (or guards) in the daytime meant his leakage was much less. He still wore a brief at night just in case. This kind of progress – from heavy leakage to moderate leakage – often happens in the first couple of months.

     

  • Ongoing Leaks (Dribbles): Even later on, minor incontinence can persist. “I am able to pee normally and then there are times I’m just a dribbler and I dribble in my pants. So thank goodness for the pads…” he wrote​. Many guys echo this: they might be mostly continent but still have small drips especially with exertion, laughing, or when the bladder is very full. Pads or liners become an everyday safety net. This is manageable, as he implies – pads catch the drips and life goes on. Importantly, doing pelvic floor exercises (Kegels) was mentioned: “I’ve been doing the kegels….”​as part of his recovery. Others in the forum strongly encourage starting Kegels before surgery and continuing after, to speed up continence return.

  • Severe Long-Term Cases: A few men had more serious, long-lasting incontinence. In rare cases, when continence doesn’t adequately return, doctors might recommend additional procedures. One member who was 5 years post-surgery and still struggling posted, “Five (5) years with incontinence following RP, a new oncologist has recommended AUS placement, again.”​ pmc.ncbi.nlm.nih.gov

    (An AUS, or Artificial Urinary Sphincter, is an implanted device that helps close off the urethra to prevent leaks.) This is typically for the small minority with severe permanent incontinence. The fact that he says “again” implies he’d been hesitant before – and indeed, forum replies often explore pros and cons of advanced solutions like AUS or male slings. They’ll ask if anyone has done it and share any second-hand knowledge. If you are in this situation, it helps to read those threads; you’ll find that you’re not alone even in extreme cases.

     

Practical Tips Shared by Patients: Throughout the discussions on incontinence, gay/bi men swap very down-to-earth advice:

  • Try different brands of pads/guards (some prefer Depend, others find supermarket brands or male guards that fit in regular underwear).
  • Watch your diet and fluids: alcohol and caffeine can worsen leakage for some, so can acidic juices.
  • Time your outings and empty your bladder right before any sexual activity or date, to minimize accidents.
  • Don’t be embarrassed to bring an extra pad when going out – “it’s like having a spare, just in case,” one person hinted.

The tone is often humor mixed with frustration, but ultimately determination. These men want you to know that while incontinence is annoying and even embarrassing, it usually gets a lot better with time. And even if it doesn’t fully go away, there are ways to live with it (or medical fixes if needed). You are still you, and you can still date, work, and have sex – maybe with a pad in your briefs, but that’s a small price for being cancer-free.

Hormone Therapy and Advanced Disease Challenges

Not all discussions are about surgery or localized treatment. Some gay men in the forum have advanced prostate cancer and share what it’s like on long-term treatments like hormone therapy (androgen deprivation). We touched on one man’s experience with side effects earlier (loss of muscle, erection, etc.​). To expand a bit:

 

  • Body and Mood Changes: Hormone therapy (e.g., Lupron, Zoladex, etc.) is known to cause weight gain, muscle loss, hot flashes, and emotional swings. The quote above shows how it affected that patient’s self-image and libido (he hadn’t had sex in years because of it). Members often discuss strategies to counteract these effects: exercise (to rebuild muscle and stamina), diet (some try plant-based or supplements to combat fatigue), and mental health support. It’s common for men on ADT to report depression or feeling “flat.” Seeing others admit this can validate your own feelings and encourage you to seek support or counseling. You don’t have to “tough it out” alone.

  • Maintaining Intimacy on ADT: A unique challenge for gay men on ADT is maintaining a sense of sexual intimacy when your libido is near zero. Some couples adapt by focusing on non-sexual affection, or finding different ways to please each other that don’t rely on erection or orgasm. One forum member mentioned that even though he has ED from treatment, “my partner and I have learnt to deal with it… with support of medicine, pumps… we get there.”​. This indicates creativity and teamwork in a relationship can overcome the physical limitations. The forums serve as a space to share these coping methods, whether it’s using adult toys, exploring other erogenous zones, or scheduling intimacy when one feels most up to it (ADT fatigue can be worse at certain times of day).

     

  • Sharing Long-Term Hope: Some long-term survivors on the forum offer hope by example. For instance, one man posted about being 13 years post-diagnosis with stage IV cancer, having been through many treatments and now trying new medications​. His story and others illustrate that prostate cancer can often be managed as a chronic condition. Hearing from someone who has lived with it for over a decade can be encouraging if you’re newly diagnosed with advanced disease. They talk about cycles of treatments, remissions, and keeping a positive mindset (without using flowery language – just genuine hope and occasional humor).

     

Note: While the Malecare  focuses on patient experiences, a few users also share news of clinical trials or studies specifically relevant to gay men or trials about new medications). If you have advanced prostate cancer, you might learn about these opportunities from fellow patients who post about “Hey, check out this study”. Always discuss with your doctor, but it’s good to know the community is looking out for cutting-edge options that might benefit you.

 

Final Thoughts

The voices from the Malecare “Prostate Cancer and Gay Men” community show that your experiences are valid and shared by many others. From navigating dating to finding new ways to have sex, from managing incontinence to staying upbeat on hormone therapy, gay and bi men are supporting each other through it. In this guide, you’ve seen just a sampling of their advice and stories:

  • You’re not alone in worrying about sex and relationships post-treatment – real people have been there, and many are finding happiness in new forms.
  • Practical fixes (like pumps for ED or pads for leaks) and patience go a long way. As one member’s journey showed, things that seem dire right after surgery (diapers, no erections) can improve significantly with time and rehab.
  • Don’t hesitate to reach out in such communities. The men discuss everything frankly – from the technical (PSA levels, Gleason scores) to the personal (self-esteem, dating apps, bedroom techniques). Sometimes just hearing “me too” from another gay man with prostate cancer can relieve a burden.

This article organized key themes to make it easier to digest, but every individual’s path is different. Use these insights as you will: maybe you’ll try an injection because someone said it worked, or maybe you’ll simply feel comforted that others have gone through the same post-cancer adjustments you’re going through.

In the end, the overarching message from the patient community is one of resilience and adaptability. As a gay or bisexual man, you might face specific challenges with prostate cancer, but by sharing our stories and solutions, we all get stronger. Your sexuality is an important part of who you are, and prostate cancer doesn’t change that – it just means learning and fighting in new ways, together with your peers.