I’ve been encouraged by what I read here about testosterone replacement therapy. I’ve always been lead to believe it would be akin to suicide for someone who has/is being treated for metastatic prostate cancer. My case study has a unique “situation” attached….aka divorce after 38 years of marriage. My case:

I am currently 70 yo. I was first diagnosed with localized prostate cancer in July of 2011 at age 55. My PSA rose from about 3.4 at my annual exam in the prior November to 6.6 prior to treatments beginning in Sept 2011. My Gleason score was 3+3=6 and my T was in the low 300s. I opted for 9 weeks of Proton Therapy and I was told my results were textbook. My PSA slowly declined over the next 8 years reaching a low of about .04. Over the following three years I noticed a gradual increase in my PSA but my GP didn’t seem to be concerned (perhaps because it was <4 it was “normal?). In March of 2025 it had risen to 1.1 at my annual. My GP wanted to see me again in 6 months. I checked it on my own a couple of weeks later and it was now up to 1.3. I emailed my GP and he wanted to check it in 3 months. That wasn’t good enough for me so I scheduled a visit with my Uro. He didn’t even do a blood draw or a DRE….sent me straight for a PETscan in May 2025. They discovered a moderate sized tumor on my L4 vertebrae. Surgery was not an option. So I immediately started combo therapy (Erleada daily along with Lupron injections). In conjunction, I completed 5 radiation treatments. My injections were every 90 days and I received 4. My 12-month scan was this past May and my tumor showed no brightness and is “inactive”. There were no other signs of metastasis. My blood draw at that time indicated PSA=.04 and my T was 12. I’ve been experiencing, what I consider to be, chronic hot flashes, insomnia, low energy, mood swings (but who wouldn’t given others in our situation?), 0 libido, no nocturnal erections and significant genital atrophy.

Now, if you are still reading, the “unique” circumstances. In January of 2025 (6 months prior to my diagnosis) my wife of 38 years and I separated. It wasn’t my idea but she filed for divorce a month later. A couple of months after she filed, I met a woman and we began seeing each other. The relationship was complete and physical….for about 3 months…then the Lupron kicked in. It’s been a year since I’ve had any interest is sex at all but she has remained with me. She is only 57 and her libido is at the opposite end of the spectrum to mine. I chose to discontinue my injections after my last oncologist appointment in June, with his approval.

As I mentioned, I am 70. I am concerned that I am robbing my companion of a complete relationship and hopeful I will see some return of my libido and genital shrinkage. I am 6’ tall and weigh 186. I was an active runner for years (6 marathons) but my joints can’t take it any more. I have always hit the gym religiously (4-5 workouts a week) and my Drs urged me to continue. I alternate 45-minute cardio and weight training 4x/week. While I still enjoy my Mexican food, I’ve added more salads and fruit to my diet. I’ve moderated my love of bourbon and wine, but still succumb a few times a month. My cholesterol was about 130 prior to treatment (Atorvastatin) but has shot up to 230 in the last year.
I suppose my question is: Is there someone with similar circumstances that can give me an idea of how long, or if, I might return to anywhere near “normal”? I am now divorced and don’t want to lose this relationship but feel like she deserves more than I can currently offer. I never thought I would consider TRT since my daughters and grandchildren mean more to me than anything in the world. But some of your stories give me hope. Thank you for reading and I look forward to any replies.