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ED Recovery - Helped by TRT?

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Posted 8/5/2014 2:22 PM (GMT 0)
I am 7 months past RALP. PSAs all undetectable so far, and 2 weeks ago, I resumed the use of injected testosterone. I had stopped testosterone last September after a PSA of 5, and my endocrinologist refused to give me any more until I'd had a biopsy. The positive biopsy also meant no more testosterone for a while. So, I had been off the testosterone for almost 10 months.

My urologist/surgeon said that it was possible the testosterone would help out with the ED recovery. I was skeptical, thinking it's all about the nerves and not my testosterone levels.

I was already starting to see some tumescence, as my surgeon wrote in his notes. Nothing that would work for penetration, but a definite move towards recovery.

I've been taking the testosterone for 2 weeks, and there has been significant further improvement. I am still taking 5mg of Cialis daily, and a full dose of 20mg did not provide an erection that would work for penetration. But, it was very close - way closer than at any time in the last 7 months. I have been using a 20mg dose once per month to see what happens, and otherwise using just 5mg per day. Until June, there was no response at all from the 20mg dose.

Maybe it's just a coincidence of timing. Maybe not. But, I'm hopeful right now that I am going to recover most of my function, and it hopefully won't be long until I don't need the Trimix shots. To be honest, I don't really care what the reason is. I'm just happy to see the changes.

The article here hints that testosterone might help in recovery (see page 3), but the sample size was small and the author indicates that placebo effect cannot be discounted.

http://www.medscape.com/viewarticle/750509

Has anyone else started TRT and noticed a similar effect?
Posted 8/5/2014 7:49 PM (GMT 0)
Dmlvt,
First, I want to say that this is a conversation between you, your endocrinologist and your urologist. Second is that my opinion may be highly influenced by my high Gleason score.

So, considering the relationship between T and this disease, I would tread very lightly. As one URO put it to me, "dead men don't get hard-ons." So, if it was me, my priorities would be to treat the disease and then treat the ED.
Posted 8/5/2014 8:01 PM (GMT 0)
Those cautions certainly need to be considered. But, there seems to be a lot of controversy in recent years about whether high T has any negative consequences for PC, or if it might even be helpful.

As opposed to the well established fact that with many men, going to a zero level of T can stop PC advance, at least for a while. But it may be that going from an already present T of 150 or 250 to 600 or 800( or going from 800 down to 200) does not at all have the same effect on PC as going from zero to 20 would, or the type or magnitude of effect that going from 80 or 20 down to zero would.

IOW, it seems that a very little bit goes a long ways, and whatever the harmful level might be, ten or 100 times that much MIGHT not make much difference.

Having pointed that out, my G9 was discovered after I got a PSA while seeking T therapy. I still have not sought out any T therapy since my RP.
Posted 8/5/2014 8:29 PM (GMT 0)
Turner2,

I am well aware that I am in area of unsettled science and I appreciate your concerns. I also know that it flies in the face of what many people have believed for many years, considering that Huggins won a Nobel prize for medicine for his work linking T and PCa. It is also quite clear that castration levels of T help to suppress the disease. The dogma associated with that study has been tough to overcome, but it seems to be changing slowly. Morgentaler addresses the original study and the topic at length in his "Testosterone for Life" book.

My surgeon's comments to me were as follows:

"There might still be come cancer in there. There might not. The testosterone is not going to make any difference at all in whether or not you have a recurrence."

That might be true. It might not be. I have done a huge amount of homework and I am willing to accept the potential risk.

There may be no one here who has had any similar experience and could address my original question. I only know of one poster here who started testosterone in less than six months.
Posted 8/6/2014 2:04 AM (GMT 0)
Dmlvt,
I suppose you had nerve sparing RP?
Bill
Posted 8/6/2014 2:24 AM (GMT 0)
Bill,

Yes. Or at least what the surgeon told me. I did talk to my other doctor's office and they said they have received reports from other patients that resuming T seemed to speed the ED recovery a bit. But, they normally don't allow patients to resume for 12 months vs.the 6.5 months when I re-started. Totally un-scientific and it could be placebo or just coincidental resumption of T when other healing has progressed.

Damon
Posted 8/6/2014 3:17 AM (GMT 0)
You are pushing the envelope to places I will never consider going.

As my T rises, my PSA shoots for the moon.

Tread carefully. You may be in a mine-field.
Posted 8/6/2014 3:20 AM (GMT 0)
 

I have been using the Testopel for about 4 months. The first time I used it I felt as if I was recovering quicker. Looking back now I think it gave me some hope that the "T" was juicing me up. That relieved some of the anxiety from having the ED and that will help right away to give you more erection power. I believe increasing your "T" levels increases your desire to have sex, so naturally your never going to get to ED recovery of any sort if you have no interest in sex to begin with. So by increasing your "libido" you are more then likely going to recover from ED quicker then if you have a reduced desire.

I think that makes good sense. So yes I would agree that the "T" enhancement should lead to a faster recovery.

 

Posted 8/6/2014 6:22 AM (GMT 0)
dmlvt,

I've been on T replacement since month 4 post RALP. My PSA was < .01 before and after T supplementation. I recently went back to my 3 monthly T injection.

As far as "hard-ons" go - I think T has had a marginal effect, but the PDE5is appear to work better lately. Could be T or just Time or both.


Like you, I've done some research on T replacement post RALP, and I'm not too concerned.

There is always a risk of Cancer returning whether you are on T or no T. Many on this forum have had elevated PSAs after RALP for many reasons not related to T. Depriving some men of T is one of the treatments, and therefore the assumption is that IF you have micro cancers somewhere in the body, T will cause it to flare up -- I'll deal with it when or if it happens.

All the best with the ED recovery. If you and your doctor agree on the T replacement regimen, enjoy and make the most of everyday.

.
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