Testosterone Replacement Therapy after 12months of Orgovyx and Radiati

Following. I’m in the same spot as you. Last Lupron shot a year ago and testosterone 54.

I was in a similar situation, having been on TRT for 14+ years before my diagnosis. My T level was 700+ when I was informed (late 2022). I stopped the injections immediately, and my T level dropped to 55. I started out getting Proton radiation treatments, followed by six months of Orgovyx (2023). My T level dropped to a resounding 15. The side effects of Orgovyx and low T caused significant issues, both physical and mental.

After what felt like an eternity, I was (grudgingly) given the approval to restart TRT, but agreed to a lower dosage and regular PSA tests. My first lowered dose was on 4/11/24, and almost immediately, I started to feel better. My new dose is .5ml, injected every 14-days (previously was 1ml), and my T level is in the 500's and most importantly, my PSA has remained low, most recently 0.25.

I would add that my Urologist made a similar comment about rising T levels, whether it occurs naturally or via TRT,

Following as well. It's been 15 months since my last Orgovyx pill and my T has only reached the low 200s. I feel slightly better, but not much, and am developing serious osteoporosis because my Estradiol level is only 4. Sexual health doctor says he's treated thousands of prostate cancer patients for low T and the recurrence rate isn't any higher than the not treated, but GP and oncology nurse are dead set against T supplementation, while oncologist isn't taking a side one way or the other.

@round5
What does your medical team say about TRT? What was your Total Testosterone before treatment? Mine was 328 and I was 88 then. My oncologist is very supportive of TRT. He simply says if there is a cancer recurrence we will treat it! I am contemplating if I should take that chance.

@ava11
150’s but that was after stopping ADT a previous time with salvage radiation. My PSA had become detectable, and I had some spots requiring chemotherapy. I had six Docetaxels with six Carboplatins over 18 weeks followed by 6 Pluvictos over 36 weeks all completed April 2024. I’ve been doing Nubeqa monotherapy for the past year. The Doctor Who did my chemotherapy and Nubeqa prescriber said he would do replacement if I didn’t come up on my own. Another doctor I see appears to be opposed. I see both of these doctors in a couple weeks after I have my scans so will be addressing that then. My scans have been OK so far so we’ll see what happens in a couple weeks.

@scottbeammeup
What was your T before ADT? Mine was 328, now it is 65. I think I will feel lot better if mine reaches 200.
It appears deciding to undergo TRT to feel better is an experiment that each individual has to decide without knowing precise risk vs benefit analysis that applies to every person of every age.
My oncologist very supportive of TRT. He is a bit aggressive.
I am going to get a second opinion from another oncologist. I will also check with my cardiologist.

Before ADT it was close to 600. It was 8-9 during Orgovyx treatment. Three months after stopping Orgovyx it briefly went up to 350 which was encouraging but then, every three months since, it's been dropping. I had my pituitary tested and my FSH levels are off the charts high so my brain is screaming to my body to make T but it just isn't doing it.

@scottbeammeup
What about your LH levels? If I am not mistaken it is LH that tells testicles to produce T.
Did your doctor say you have to increase the dosage of TRT? If I go on TRT, my goal will be to bring my T level up to 350 and no more!

@ava11 My LH and FSH levels are as high as the lab can measure them, i.e. off the chart. My brain is doing all the proper signaling to start making T again but my body isn't listening. My urologist said it may be "testicular failure." This is something that was NEVER even mentioned as a possibility so I am quite angry about it. I was woefully kept in the dark about ADT side effects when I was in cancer panic mode and seeking treatment. Knowing what I know now, I would have skipped it and done radiation alone as I feel ADT has done me more harm than good. Even the name "hormone therapy" is benign sounding for what it actually is.

@ava11

7 months after radiation I still feel awful but my urologist will not even discuss TRT.