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Should I try using TRIMIX while on ADT?
ATTN MODERATOR: I’m aware that there is another post here related to TRIMIX. I’ve gone through it and could not find an answer that applies to my situation. In light of that I hope you don’t mind me starting a new thread on this.
Here’s my situation: I’m 69 years old now and in arguably good health except for PCa. Was diagnosed with Gleason 6 prostate cancer in 2020. Opted for focal Brachytherapy. For mix of reasons unimportant for this discussion treatment failed and PCa came roaring back last year. Was diagnosed with stage three prostate cancer with lymph node involvement in December 2023. Had salvage robotic prostatectomy in January 2024 at Northwestern medicine in Chicago. Dr. Ashley Ross. Dr. Ross was able to remove the known cancerous lymph node but was unable to safely remove a cancerous obturator lymph node. Started Orgovyx and Zytiga April 2024. PSA is undetectable now. My medical team wants me to be on both of these for 24 months. I am currently undergoing 33 sessions of IMRT to the lymph node basin.
I’ve been reading that permanent penile atrophy can be a real problem while on ADT. I recently watched a YouTube video presentation by Dr. Mark Scholz of the prostate cancer research Institute that addresses this issue. He was just discussing the viability of Trimix injections to keep penile tissue healthy, even if there is no libido. The idea is that when ADT ends, libido may return and it may be impossible to regain function if too much atrophy has taken place. Speaking frankly, I have zero libido, but have found that with stimulation a 60% erection is possible. I don’t think anything is going on nocturnally though.
Before I reached out to my urologist or oncologist, I thought I’d propose it to the forum and see what opinions others with more experience have. Thank you for reading this and I wish you all well on your journey with PCa!
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I think the easiest, cheapest way to keep the muscles functioning (avoiding atrophy) is a vacuum device (VED). They are quite cheap as a sex toy and often include a rechargeable motor, which I think makes the process easier. I also use trimix, but only for sexual interaction, not for muscle atrophy apart from that. When I use trimix, I figure that takes the place of (boring) exercises with a VED.
Thanks for your comment. I tried a VED and found it to be somewhat effective but uncomfortable bordering on painful. Maybe a better VED unit is the answer.
Are you currently on ADT?
I am not on ADT. I found some helpful discussions from Australia which discussed technique. Basically I do subsequent rounds of vacuum and release, beginning with lower vacuum, increasing vacuum incrementally with pauses, and repeating cycles as the penis adjusts for a period of 10-15 minutes. Each cycle takes 1-2 minutes, longer as the penis adjusts (and becomes more engorged). One of the protocols is to never enter the painful. Instead any pain at all is a trigger to immediately release pressure. As you know from other cycles of engorgement, the penis responds differently in slack vs engorged conditions.
I am a 71 year old who underwent a RP in 2021 with subsequent triple therapy (including ADT for a year) as well as pelvic radiation. With the combination of age, radiation and RP most men our age experience some degree of ED. I have complete ED and have experienced penile shrinkage. I have intermittently used the medical grade vacuum device which I believe ( with expensive reading) is the best method to keep penile tissue healthy. I used Trimix while on ADT. It was/is effective. The only concern is frequent repeated use can cause some scarring of the penile tissue ( you are instructed to vary side and injection sites).
Maybe frequent (daily?) use of the vacuum device (not to the point of pain) coupled with occasional Trimix could be a good compromise.
Some urologists suggest 5mg daily Cialis to theoretically increase penile blood supply as an adjunct. Probably doesn't hurt.
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2 ReactionsExcellent comment! Thanks!
I'm on ADT and I use Trimix once every 1-2 weeks to keep the relationship going with my wife. I also use the vacuum pump 2X a week for 20 minutes each time to keep things healthily. It is not uncomfortable. I sip coffee early in the morning and watch the news. I keep it filled for 5 minutes, release, and fill with air again. Hoping to be off ADT soon and my urologist that specializes in sexual issues says to be doing something 2X a week, either Trimix, vacuum or both.
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4 ReactionsThank you for your thoughtful comment. I genuinely appreciate it. While I have lost all interest due to ADT and know that I’ll be on it for another 21 months I think that I either need to start “using it” or accept “losing it” permanently. Could you please share what brand/model has worked for you? I previously tried a non-medical device that used an electric motor to create suction and was far too aggressive with far too little control.
Thanks again and best wishes for a successful journey with PCa.
I definitely recommend using versus losing! I purchased the device from Augusta medical systems in Georgia. 1 800 827-8382. I bought the lifetime warranty for $100, which I have used a couple times over the years when it lost pressure. I still have the invoice. It says item number 200–900, but I think it’s the only one they sell.
Best of luck to you as well!