“After being invisible in the prostate cancer community for 20 years, gay and bisexual men are finally being seen,” writes the AFR’s Jill Margo.
“Late in 2015, a set of four booklets was produced in Australia specifically for gay and bisexual men.
“This is thought to be a world first and the initiative was funded by the federal government via a Cancer Australia grant.
“The booklets take a frank look at the role of the prostate in gay sex.”
Margo’s article makes no bones about articulating the issues.
“Without a prostate there is no ejaculation and no semen exchange, which has an important role in the sexual play between men who have sex with men.
“Without a prostate, the receptive partner in anal sex doesn’t get the benefit of having his prostate massaged, a process that augments orgasm.
“Without a prostate, the active partner might not have an erection rigid enough for penetrative anal sex. While men might recover some erectile function after surgery, vaginal penetration is generally easier.
“Surgery can cause problems with urinary continence, which can reduce a man’s sense of being sexually desirable. It can also lead to the leaking of urine on orgasm.
“For some men orgasm becomes painful, although this generally doesn’t last.
“Apart from creating a scar, surgery can reduce length and width of the penis, further affecting body image.
“Radiation has a range of issues too, such as a slow decline in potency, reduction in ejaculate and bowel complications.
“Following radiation, the receptive partner might find anal sex makes the pain worse and damages the delicate lining of the anus and rectum.”