Prostate Cancer: sex drive after surgery or other treatments

Posted by john57 @john57, Feb 23, 2020

hello everyone i was wondering if i could ask a group question, i had my prostate removed back in october since then i have had a lupron shot, started pt and began radiation. my question is has anyone had a decrease in sex drive? i find myself thinking about less and less. thanks in advance

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@docopp

Good Morning.
I was diagnosed with prostate cancer in July of 2022. I am 50 years old. PSA levels of 39 and Gleason scores of 4+3 in a few spots of my prostate. But luckily, no evidence of it spreading outside of my prostate. Been through internal radiation treatment, followed by external radiation for 5 weeks, and 2 of the 3 month hormone therapy injections. I have 2 months left of the last hormone injection in my system. How long, if ever, should it take to get my libido back? This last shot just flat shut it down 100%.

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I went about 6 to 8 months after the 1st injection it was to last about 6 months, only had one injection

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@docopp

Good Morning.
I was diagnosed with prostate cancer in July of 2022. I am 50 years old. PSA levels of 39 and Gleason scores of 4+3 in a few spots of my prostate. But luckily, no evidence of it spreading outside of my prostate. Been through internal radiation treatment, followed by external radiation for 5 weeks, and 2 of the 3 month hormone therapy injections. I have 2 months left of the last hormone injection in my system. How long, if ever, should it take to get my libido back? This last shot just flat shut it down 100%.

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I moved your message to this existing discussion about loss of libido so you can connect with @john57 @dmadi61 @stoney @voodoo5500 @klaken @yeno430 @ken82 and others.

You may also be interested in these related discussions:
– Shrinking penis after surgery and radiation https://connect.mayoclinic.org/discussion/shrinking-penis-after-surgery-and-radiation/
– I've lost all motivation, no sex drive, depressed. Ideas? https://connect.mayoclinic.org/discussion/new-to-group-2/

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@docopp

Good Morning.
I was diagnosed with prostate cancer in July of 2022. I am 50 years old. PSA levels of 39 and Gleason scores of 4+3 in a few spots of my prostate. But luckily, no evidence of it spreading outside of my prostate. Been through internal radiation treatment, followed by external radiation for 5 weeks, and 2 of the 3 month hormone therapy injections. I have 2 months left of the last hormone injection in my system. How long, if ever, should it take to get my libido back? This last shot just flat shut it down 100%.

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Word on the street is, however long you were on the lupron is how long you will wait to see your libido returning. I demanded testosterone level testing when I was due for PSA testing. I knew my testosterone was at 328 prior to lupron and radiation, and am now at 309 (low end of the scale). The prevailing theory of modern medicine is high testosterone levels contribute to the development of PC. That worm is slowly turning to suggest higher levels of testosterone can decrease the chances of getting PC. Ask yourself, how many 20-year-old men do you know who have PC? These young men have high testosterone levels that are through the roof, but it's the old guys with "low-T" who get the PC. I will be considering testosterone injections in the future.

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@stoney

Word on the street is, however long you were on the lupron is how long you will wait to see your libido returning. I demanded testosterone level testing when I was due for PSA testing. I knew my testosterone was at 328 prior to lupron and radiation, and am now at 309 (low end of the scale). The prevailing theory of modern medicine is high testosterone levels contribute to the development of PC. That worm is slowly turning to suggest higher levels of testosterone can decrease the chances of getting PC. Ask yourself, how many 20-year-old men do you know who have PC? These young men have high testosterone levels that are through the roof, but it's the old guys with "low-T" who get the PC. I will be considering testosterone injections in the future.

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Hello there,
I am 68 years old. Given the fact that I’ve been on successful “TRT” Testosterone Replacement Therapy for the last 11years before my recent Prostate Cancer diagnosis and was treating my Hypogonadism, I understand and feel the measurable downward effects and differences in my life and overall wellbeing when I’ve had to stop my “TRT” for various circumstances. My Total Testosterone levels were well below the lowest level considered to be within the normal range! It provides a much better, overall quality of life for me. I have been disabled for the past 32 years from very serious cases of CHRONIC FATIGUE SYNDROME, FIBROMYALGIA and CHIARI MALFORMATION. I was mostly bedridden and home confined for over 25 plus years. I still manage all the debilitating symptoms associated with those diseases. Even though there are No Cures for them, every patient manages their symptoms the best they can with whatever therapy protocols they wish to try and utilize in the hopes of recovering or improving.
The “TRT” is the only treatment that makes a measurable difference for me in reducing all of those symptoms plus treating my Hypogonadism. I still have the symptoms but enjoy a much better quality of life because The “TRT” gets me above the minimum normal range and into the middle and above ranges of normal. I had to discontinue my “TRT” when I was diagnosed with PC. When you get PC, the TRT” feeds your cancer so it obviously requires discontinuing it until you successfully treat your cancer through surgery or radiation. I chose the surgical, “RALP” protocol and had a very successful outcome in terms of getting rid of 100% of any detectable cancer and my PSA immediately following the surgery was <0.014. My Prostatectomy provided me the opportunity to immediately get all of the cancer out of my body. Thankfully, it was all located within my Prostate. I am about as close to ZERO as you can get with my PSA. I am also considered a “low risk” patient which is also quite favorable. I am ready to return to my “TRT” and the life it helps support me in. At my age and everything I’ve been through, my “quality of life” is more important than my “quantity of life.” Although “TRT” remains somewhat controversial, the latest and most current research and data more than supports the benefits of returning to “TRT” in addition to assisting PC Patients with their recovery and rehabilitation. There is NO PROOF that I will increase my chances of recurring cancer any more than patients on “ADT” Androgen Depravation Therapy in addition to radiation with anybody else’s post recovery chances. There is a 30%-40% chance that Prostate Cancer will return to any successfully treated patient within the first ir up to first 5 years after recovery. I choose to mentally and emotionally think that I will be in the 60%-70% of patients where the cancer won’t return. I prefer the odds better. Given that NO patient can completely control their future outcomes, the best they can do is monitor and treat whatever comes or does not come there way in the future. Remember, NOBODY is ever fully cured of cancer. You are either in Remission at any given time or you are not! Or as I refer to the matter, “one can be free of cancer but you are never free from cancer!” It’s a lifetime of monitoring, following up, (surveillance) and treating whatever requires your attention. THERE ARE NO GUARANTEES ABOUT ANYTHING. Lastly, the patient should ultimately have the power to choose whatever they feel is the best way(s) to move forward in their life. Everybody patient is an individual with different choices, risk attitudes and feelings about what is best for them. As much as possible, “I take full full responsibility for my life!” We can’t and don’t control everything. “However, we have 100% control in and how we manage our life with diseases and other challenges!” We consult with our trusted physicians and do the best we can. Frankly, if any physician gives tells you that their treatment protocol will 100% successfully treat your cancer for the rest of your life, you should consider walking away and finding somebody else! Whatever cancer management team I choose to use must support me and my desires. That does not mean that I don’t take or follow their advice. It does mean that I am in agreement, trust and support it! I will return to my “TRT” with or without my current physician who’s been treating it. I am ultimately responsible for whatever happens, favorable or not. However, you take those chances with anybody that treats you regardless of the treatment options they recommended.
Best wishes to all of the “Prostate Cancer Warriors” out there and I hope and pray that we will all have and keep the successful outcomes we want in our lives. Love to all of you.

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@john57

that is part of the problem colleen my wife has no desire for it and in my condition not much happens

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You love your wife, and suppose she was the one who was ill? Love, honor and cherish, in sickness and in health, till death do us part. Share.your life with her is so much more than the act of sex. Everyday is a chance.to show each other.love, say yes, when she wants to do something. Lenten book group ,couples at my church , in home gathering, talk to Jesus....

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I am glad to find this discussion. Since my RALP (prostatectomy) 1 year ago, I have had very low libido and very weak, if discernable, orgasms. This has been most challenging adjustment. The pills have not worked, the shots give erections, but not a change in libido. I read about the tensioning device about 2 mos after surgery and have used it. I think I have reaped the benefit at this point, and only use it very occasionally now. There has been slow but significant improvement in erections and significant diminishing of the trimix dosage to a very low level (5 units at the moment.) I wonder what is yet to come....
And of course I'm grateful my uPSA still remains very low (last reading .012). If I had some of the more significant complications, I wouldn't be worrying about libido!

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I found the book: "Saving Your Sex Life", by John P. Mulhall, MD to be informative on this topic.

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@spino

I am glad to find this discussion. Since my RALP (prostatectomy) 1 year ago, I have had very low libido and very weak, if discernable, orgasms. This has been most challenging adjustment. The pills have not worked, the shots give erections, but not a change in libido. I read about the tensioning device about 2 mos after surgery and have used it. I think I have reaped the benefit at this point, and only use it very occasionally now. There has been slow but significant improvement in erections and significant diminishing of the trimix dosage to a very low level (5 units at the moment.) I wonder what is yet to come....
And of course I'm grateful my uPSA still remains very low (last reading .012). If I had some of the more significant complications, I wouldn't be worrying about libido!

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If you have a PSA of .012 you defiantly have low Testorone
I had proton beam therapy and and six months of Lupron. I went to another doctor and got a testorone test and it was 148. I would wake up in the morning and barely have the energy to get out of bed. I have been on TRT feel like normal again and my PSA is.1

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@narus

If you have a PSA of .012 you defiantly have low Testorone
I had proton beam therapy and and six months of Lupron. I went to another doctor and got a testorone test and it was 148. I would wake up in the morning and barely have the energy to get out of bed. I have been on TRT feel like normal again and my PSA is.1

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That is certainly possible. Why do you think I either defiantly (or definitely) have low testosterone based on a PSA reading? I think such PSA readings are somewhat common after removing the prostate, right? [I kind of like the idea of "defiantly"--that sounds very high testosterone ;-)]

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I have prostate CA with mets to the bone and finished chemo a year ago. Getting an erection seems a thing of the past as is my sex drive. But I want to maintain intimacy with my husband because I miss it, but am fearful about what to try.

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