Depression and hormone therapy

I'm sorry to hear that. Body dysphoria (including not being able to respond sexually the way you think you should for your gender and sexual identity) is a tough challenge.

Just remember that at the core, the spark that makes you YOU is still burning bright, and that the people who care about you love you unconditionally, not because of what you can or can't do.

The depression and mood issues people have from ADT and just PC can be helped a lot by doing exercise, getting out and running or walking and doing weight exercise. I know a lot of people that have said that that really made a difference for them. You really should try to do this first it can make a big difference.

Other people have said that their only solution was pharmaceuticals. I’ve heard of different people taking these following drugs and having great results having them lift their life view about everything.

Common drugs for depression and anxiety
Wellbutrin, Zoloft, Effexor, Buspirone, Cymbalta, Lexipro,

You’ve gotta speak to a doctor about this, Someone who can prescribe these drugs. Hopefully, you can find that exercise can lift your mood.

@northoftheborder
Thank you.
As an athlete, my self worth depended on my performance. Having an injury which takes me out of the game is especially hard on my ego. She’s okay with it but I am not.

@madisonman0326 It sounds like a challenge that all athletes face sooner or later — in many pro sports, retirement can happen as soon as 30.

There must be many good resources to help athletes who've spent their whole lives training hours/day, narrowly focussed on one goal, adjust to life afterwards, learning to define themselves in new ways, and perhaps some of those could help you in your current situation aa well.

@northoftheborder
Thank you. Actually, I was lost in the woods when my partner - let’s call her Ann - found me. My wife of 22 years had left me the previous year, I was obese and working an office job I detested. I met Ann in a singles group for middle aged people and I was smitten. She was an athlete, a cyclist, tall, blonde and fit. She wanted nothing to do with me because I had too many issues but she later found out through the rumor mill that I had once been an athlete so she pulled me off the rejection pile and decided she would make me her project. She had me join Weight Watchers and monitored my progress. I lost 63 pounds in two years. She then encouraged me to hire a coach - toward the end of my athletic career, I had been a short track speed skater - and I found one who was a retired marine DI. By age 58, I was back on the circuit and winning in the masters division and I owe all this to Ann, who believed in me when I didn’t.

Well before starting hormone therapy (Eligard for a localized 4+3=7), my medical oncologist and I discussed the likely side effects and how to minimize/avoid them.

I had 28 sessions of proton therapy (during April-May 2021 @ 65y), SpaceOAR Vue, and 6 months of Eligard.

An athlete my entire life, I understand the importance of focusing on the task at hand.

Physical side effects of ADT were minimal due to engaging in resistance training exercises (which my MO had highly recommended).
> https://m.youtube.com/watch

Emotional/mental health side effects of ADT were also minimized/avoided, again through exercise.
> https://m.youtube.com/watch

As for libido, my MO told me that the key is to continue “doing it,” despite the “want to” not being there. I was told that it’s a “use it or lose it” scenario. And despite having no libido while on Eligard, everything still worked.

(Though I have no data to support this - only my MO’s advice that it would work; and I think it did - my experience not having ED while on ADT might also be related to me ramping up my resistance-training and cardio programs to minimize the side-effects of hormone therapy; that might(?) also have the side-benefit of keeping the blood flowing “down there” as well; It’s all about hydraulics so, keeping the blood flowing would seem to be important. Libido eventually returned to normal when testosterone returned to normal.)

So, I never worried about those things you mentioned (even though my wife had been married before as well). Those (jealous) thoughts you mentioned never even crossed my mind.

Though I do understand the chemistry behind it, the thought of “chemically castrated” never seriously crossed my mind either. Besides not being productive thoughts for me to think, as a retired computer scientist my thoughts were focused on getting my testosterone level below 50 ng/dL (mine went to 3.0 ng/dL) and my PSA to undetectable (mine went to < 0.008 ng/mL). It was important for my mental (and physical) health to focus on what was important. That’s how I got through all this while maintaining my sanity.

My wife later told me that if she hadn’t known I was undergoing radiation treatments, she wouldn’t have realized it from any change in me. And as for the zero libido, though I did mention it to her once in a while, I went through the motions anyway, for her sake as well as mine (in order to keep our relationship as normal as possible).

That was 4-1/2 years ago; seems like a distant memory. And life goes on…….

You’ll get through this.

@jeffmarc
Thanks for the advice and I will reconsider talking to a therapist.
I actually do exercise - I lift weights every weekday, I am a member of a spin class and I still train with an ice skating coach with the objective of racing again.
I also watch my diet because I never want to be obese again and I have lost much of the “Lupron belly.”
My malaise is only partially due to performance issues due to hormone therapy but is also related to my waning sex appeal as I approach seventy. When I shave, I am seeing an old man looking back at me and, I suspect, PC may have accelerated the aging process.

@madisonman0326 Hey buddy, While I am not qualified to diagnose your depression - or lack of it - I think what you are feeling is totally normal and relatable to many of us on the forum.
You were an athlete, went to seed, came roaring back like Rocky Balboa and then had the rug pulled out…how can you NOT feel less than elated??
Not being able to please your partner sexually is a BIG, BIG issue for all of us and there’s no easy answer; and no therapist (Although essential in true cases of depression) is gonna magically help you either. You can have an erection or you can’t; plenty of other ways to satisfy your partner while on ADT but your lower libido is not going to make you feel like going there most times.
The best thing IMO is to vocalize your emotions and fears directly to your partner - I did this with my wife and it really cleared the air about many things left unsaid.
As men, I think we are afraid to open up and ‘put things in her mind’ like having a boyfriend or leaving you for greener pastures…but it’s total nonsense - they are WAAAAAY ahead of us in the thought process and are far more perceptive than any ten of us combined!! Best,
Phil

I suffered bad depression while on hormone therapy and spoke to a therapist and also took Wellbutrin. It's an activating antidepressant which also helps with brain fog, and is one of a few antidepressants without sexual side effects. It was very helpful and I've since been weaned off it and am doing OK now a full year past ADT.

While on ADT I was still able to get functional erections using 100 mg of Viagra. I think a lot of doctors put it into our heads that sex on ADT is impossible so we just believe it. My therapist talked to me about something called "responsive desire." It's basically normal libido being gone--no random sexy thoughts, no visual stimulation being a turn on, etc. BUT having gentle touch and slow foreplay from partner being enough to overcome this. It did work for me, except I had anorgasmia which I couldn't overcome so it was more like a journey without an end.

What @brianjarvis said about using it or losing it is true but it is also possible, with the right stimulation and mindset (and I KNOW the mindset part is difficult), to WANT to do it.

@heavyphil
Thanks. Actually, in full honesty, I can still perform sexually and I believe being an athlete and maintaining a training schedule is a big factor in that area but I worry about losing that ability because my radiation oncologist, a man, told me, flat out. that, post radiation I won't be able to get an erection because the process destroyed the nerves necessary for that function. He offered to prescribe Viagra because my regular oncologist is a pretty young woman and I might be shy about asking her for a drug to enhance my sexual performance.
"Ann" has been very supportive in this journey and recently we had some frank discussions about our relationship, some of which were a surprise to me. We had friends in common when we met, which can be wonderful and which can be alarming. One mutual friend, Gaila, warned"Ann" that, although I may give off the choir boy vibe (which, admittedly, I do) I had actually "Played the field" and I was hardly innocent. Until now, I didn't know she knew - I thought she thought I had gone straight from marriage to a relationship with her!
Ann did know, however, that I was just about to lock down a relationship with another woman, "Brittany" - a fair -skinned Irish beauty who, at fifty, retained the good looks of her youth - before she, Ann, ran an interference play and I dated both of them for a while - although I was only intimate with Ann. Ann traveled frequently and, when she wasn't available, I would hit the clubs with Brittany...which was really unfair to both women. Brittany should have dropped me and pursued an available man and Ann should have given me given me the classic ultimatum: Me or her. But, really, it was up to me to make the decision and I didn't. I believe in equal rights for women but, if the shoe was on the other foot - if Ann went clubbing with another man while I was out of town - I would have gone ballistic. I like women but I'll never understand them