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Anyone have testosterone replacement therapy (TRT) after ADT?

Posted by ava11 @ava11, Aug 4, 2025

I had SBRT radiation treatment and stopped Orgovyx after 12 months.
After 2 1/2 months my T went up to 65 from a low of 8.
My oncologist says he is open to undergo TRT, but my RO says I should wait 12 months to consider TRT.
Fatigue is my main issue.

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rlpostrp | @rlpostrp | 23 hours ago

Your question poses an additional source of confusion for me that I need to research. Testosterone is the required, contributing factor to PSA production. PSA of course is produced by prostatic cells. So, if you had RP surgery, but had Extraprostatisc Extension and Surgical Margins, possibly with spread to one of both seminal vesicles, there is a high chance of your cancer returning because the urologist surgeon "didn't get all" of the cancer out of you. Thus...if you take testosterone, you are stimulating cancerous prostate cells that remain in your body, to start producing PSA, which will look like (or "is") biochemical recurrence. Then you're off to radiation therapy. So, "that" message tells me that I want "low" testosterone after RP surgery, and no testosterone therapy. But...
The other school of thought is that we "do" want to elevate our testosterone, without me having read much definitive reasoning as to "why." Then there is the confusion of each man likely needing his own testosterone level that is good/best for him...not just a target value. Up until the day of my surgery, I was quite virile and "ready for sex" at the drop of the hat, at age 70. My most recent testosterone prior to surgery had been in the mid/high 130's as I recall. Of course the normal range for testosterone really varies from about 270 - 1,070 ng/dl, averaging about 680 ng/dl. So, even with a low testosterone, I had no problems "performing". I am open to anyone's comments on their testosterone levels, how it changed their sex life (if at all) if their level was low (pre- or post-RP surgery), and how any supplemental/exogenous testosterone therapy helped them, or made things worse, especially if it caused biochemical recurrence. Thanks.

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Profile picture for Jeff Marchi
Jeff Marchi | @jeffmarc | 21 hours ago
In reply to @rlpostrp "Your question poses an additional source of confusion for me that I need to research. Testosterone..." + (show)
Profile picture for rlpostrp @rlpostrp

Your question poses an additional source of confusion for me that I need to research. Testosterone is the required, contributing factor to PSA production. PSA of course is produced by prostatic cells. So, if you had RP surgery, but had Extraprostatisc Extension and Surgical Margins, possibly with spread to one of both seminal vesicles, there is a high chance of your cancer returning because the urologist surgeon "didn't get all" of the cancer out of you. Thus...if you take testosterone, you are stimulating cancerous prostate cells that remain in your body, to start producing PSA, which will look like (or "is") biochemical recurrence. Then you're off to radiation therapy. So, "that" message tells me that I want "low" testosterone after RP surgery, and no testosterone therapy. But...
The other school of thought is that we "do" want to elevate our testosterone, without me having read much definitive reasoning as to "why." Then there is the confusion of each man likely needing his own testosterone level that is good/best for him...not just a target value. Up until the day of my surgery, I was quite virile and "ready for sex" at the drop of the hat, at age 70. My most recent testosterone prior to surgery had been in the mid/high 130's as I recall. Of course the normal range for testosterone really varies from about 270 - 1,070 ng/dl, averaging about 680 ng/dl. So, even with a low testosterone, I had no problems "performing". I am open to anyone's comments on their testosterone levels, how it changed their sex life (if at all) if their level was low (pre- or post-RP surgery), and how any supplemental/exogenous testosterone therapy helped them, or made things worse, especially if it caused biochemical recurrence. Thanks.

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@rlpostrp
Here’s a couple of articles that discuss testosterone treatments called BAT.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9313844/
https://online.flippingbook.com/view/150884930/2-3/

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