Recovery from one ADT shot?

Older men’s testosterone recovery can lag significantly—and in some older individuals, can unfortunately become permanent.

> See a Urologic Oncologist who will evaluate if you are in a durable remission and if it’s safe to consider interventions to fix your low testosterone.

> See an Endocrinologist (the experts in dealing with hormones), who (if it’s safe) can evaluate options such as Testosterone Replacement Therapy.

Before that Eligard injection, did your medical team recommend that you engage in load-bearing exercise (for as long as your testosterone was being suppressed) in order to minimize most of those side-effects you mentioned?

All the symptoms you mentioned are from low testosterone. Should also get a bone density scan since bone loss is one you did not mention. Most take calcium supplements. For the 4-month dose you took another 4-8 months to recover is not unusual. 13 months with no recovery probably means that you will never recover to a level where it will even be low normal (300). As mentioned now is the time to see doctors about TRT (risks vs benefit of getting rid of side effects). It is unlikely to improve with waiting another year or two. Since TRT causes testes to shrink that is one side effect that will not reverse with TRT.

To ken1969

I had the same issues after 4 months of Lupron. I had every side effect in the book and thought I would die or kill myself. Fortunately, my urologist read the recent reports that document that testosterone does not feed cancer, so he put me on TRT at 100 ml/2 week to raise my testosterone after 15 months of almost no recovery (111 and falling). Within a week my side effects were gone but still no firm erections. I see him again in 3 weeks and hope he will raise my testosterone more to enable erections. He diagnosed me at age 84 as hypogonadal.

@pesquallie Do you know where I can find any of the recent reports on testosterone not feeding cancer? I have heard that there are two schools of thought on that, but so far the Dr's I have talked to are stuck on what they learned in the past and resistant to any new information. Mostly I am told to be patient or shrugged off as collateral damage and "you should be grateful to be rid of the cancer, but you are an your own now" Than you for the reply, it gives me some hope!

@brianjarvis I have always been active and "load bearing exercise" is just part of my life. I jokingly call it "country cross fit", but as this low "T" situation goes on the hills are getting steeper. I am seeing an endocrinologist, but getting anywhere has been slowed by some lab screw-ups and time between appointments. Thank you for your reply, it helps!

@ken1969 Your ADT therapy has effectively been for 18 months and will probably be for the rest of your life unless you take action. That would be okay for an advanced metastatic case but is over kill for prostate confined disease. Might be time to discuss an ADT vacation with your current or new doctors. Normally, this is a stop of ADT drugs but for you it is starting TRT. Both PSA and testosterone need to be closely monitored. It is normal to have a bounce once testosterone is restored. PSA of .5 or less is probably ok. If PSA continues to increase it means the cancer is still active and more treatment (PSMA PET scan to look for metastasis) is required.
>> Gynecomastia stops and may shrink but is unlikely to go back to normal.
>> Unless doing penile rehab getting erections back may not happen. Fibrosis of blood vessels occurs and the longer it has been the more damage is done. Can still use trimix injections, etc. since libido will return with testosterone even if ability does not.

@jim18 One shot May 9th of 2025 is the only ADT I had. My PSA is 0.10 so I'm good there. You and the rest have given me much to try and persuade doctors with. Thanks

@ken1969

There are many institutions that now say that testosterone does not feed cancer. Baylor, Duke, and Johns Hopkins are among the research centers that are questioning the current use of ADT. Here are some web sites.
https://www.bing.com/videos/riverview/relatedvideo
https://www.bing.com/videos/riverview/relatedvideo
https://www.bing.com/videos/riverview/relatedvideo

@ken1969 The purpose of ADT is to reduce testosterone to castrate levels defined as below 50. In the old days this was done by surgery and was permanent. With the shots it is to make castration reversable. Your prescription was for 4 months, and your doctors expected you to regain testosterone within 6-8 months. It has already been twice as long, and you are still at castrate levels. Permanently losing the ability to produce enough testosterone to eliminate the negative effects of ADT is a known side effect with the probability getting higher with age. If you want the doctors to listen to you do not mention that testosterone does not feed cancer. Mention that you have already had twice as much ADT as prescribed and the side effects are ruining your life.

With radiation the cancer cells take 1-2 years to die off. The only way to check if the radiation treatment worked is to recover testosterone to a level that eliminates the side effects (300-400) and see if PSA remains low (<.5). It does not look like that will happen for you without TRT. If PSA increases TRT can always be stopped.

I am 67. Two years after radical prostatectomy, my PSA increased from <.01 to .71. After a PSMA PET scan, I was diagnosed with lymph node metastasis. I had two three-month Lupron injections before deciding to stop because of the symptoms you described. The last injection was 18 months ago. The lowest my T level got while I was on Lupron was 139. It took about 17 months for my T levels to get into the 200s after I stopped. The lowest my PSA got was .05. Now my PSA is up from .07 three months ago to .21. I made a personal choice for quality of life. I do feel much better, but it took a long time for my T levels to increase. My T levels before Lupron were in the mid-600s. Wishing you the very best.