Lupron & Erectile Dysfunciton

Every night a typical male will have erections that total up to about 1/2 hour in duration while he sleeps. When PCa patients get Lupron, that stops along with waking erections as our testosterone levels fall. If a male goes for too long a time without getting an erection, the erectile tissues (the spongiform bodies) begin to accumulate scar tissue and to loose their functional capabilities. That is why men undergoing ADT chemo with luprolides get and use penis pumps. The erections generated by the pump expand those spongiform bodies which keeps them flexible enough to function normally again when the treatment ends (if we get our testosterone back).

We are instructed to generate as many erections as possible for a minimum of 15 minutes a day. I was told that failure to have regular erections for about 6 weeks will result in permanent disability to achieve an erection due to the accumulation of the above-mentioned scar tissue in the erectile bodies.

I strongly suspect that it is not your hormones that are the problem but that accumulation of scar tissue. I do not know if your current condition is reversible. You could try the shots, though. If you have the capacity, the shot should give you an erection.

Trailguy & Fairwind thank you for taking the time to contribute to my thread! I really appreciate it.

I am able to get somewhat of an erection but not entirely (like when I was 13). While we are here, I thought it would also be good to list a few other symptoms I am going through:
1. Weak urine stream
2. Testicle pain
3. Pre-cum when involved in sexual activity. Very little clear discharge when "excited". (I did not have this before taking Lupron)
4. I tend to ejaculate within 1 minute when have intercourse, oral sex

Trailguy: What shots were you referring to when you said, "You could try the shots, though. If you have the capacity, the shot should give you an erection". If you were in my position what would you do at this point? I wouldn't mind taking extreme measures to be able to get an erection.

Fairwind: I had an appointment with my endocrinologist (who prescribed me the medication) and she didn't have much knowledge on my side effects. As a child (when taking Lupron & HGH) I do not recall ever being told anything regarding Lupron/HGH having an effect on my penis. Had I known, I would have never touched the medication. Am I out of line to put blame on the doctor? Wouldn't this be considered malpractice?

I would try using a penis pump first to see if I could get an erection. If so, the shots are called Bimix and Trimix and you would get a script for those from your urologist.

The early fluid is produced by the Cowpers gland and premature ejaculation is another problem in itself that can also be dealt with.

Hello Grant,

Welcome to the forum. We're always glad to see new guys here but at the same time we wish there were fewer guys who find themselves in a situations where it makes sense to cruise the internet for our sort of advice.

You've been getting some good advice here... sorta... only they've left out some steps... and the whole thing may wrong-way round.

I think you may be barking up the wrong tree looking for the relationship between your current problems and your hormone treatments years ago. I'm not saying it isn't related, just that whatever is going on with you now is what it is and understanding where it might have come from may be secondary to figuring out what your problem is now and getting it fixed. You can't change the past. I'd work on the future.

You haven't mentioned seeing a urologist. That would be the right specialist to address most of your complaints. The weak stream, the testicular pain, erectile dysfunction and the premature ejaculation are all things a good urologist can evaluate, at least as far as the basic functions are concerned. Be sure to tell him/her about your androgen deprivation when you were a teenager but that is just a "for your information" type thing on which you shouldn't spend a lot of time/focus/angst.

If you and your urologist still haven't gotten a handle on your problem after a few months you might consider looking for a doctor who specializes in "sexual medicine." They are still generally urologists but they further specialize in sexual problems. You could ask your urologist for a recommendation or come back here. I'm sure we have guys here who could recommend someone you could see if it comes to that although you might need to travel because not every town has a sexual medicine specialist.

The reason I mentioned that the guys here had skipped a step is that they were talking about pumps and shots but neglected to mention pills which are almost always the first thing to try. The pumps and shots are very useful for men whose erectile nerves have been damaged by surgery (for whom pills often don't work) but are never the first thing to try, even for men with nerve damage. That'd be something to try. Your urologist may have some samples he could give you.

Good luck. Let us know how you do.

Fairwind said...
Have you tried any of the Viagra type pills ?

I did try viagra once. Unfortunately the pill did not help me get a harder erection. But, it did help me last longer. I was also able to get an erection quicker after ejaculating. It allowed me to have intercourse numerous times in the same night.

trailguy said...
Every night a typical male will have erections that total up to about 1/2 hour in duration while he sleeps. When PCa patients get Lupron, that stops along with waking erections as our testosterone levels fall. If a male goes for too long a time without getting an erection, the erectile tissues (the spongiform bodies) begin to accumulate scar tissue and to loose their functional capabilities. That is why men undergoing ADT chemo with luprolides get and use penis pumps. The erections generated by the pump expand those spongiform bodies which keeps them flexible enough to function normally again when the treatment ends (if we get our testosterone back).

We are instructed to generate as many erections as possible for a minimum of 15 minutes a day. I was told that failure to have regular erections for about 6 weeks will result in permanent disability to achieve an erection due to the accumulation of the above-mentioned scar tissue in the erectile bodies.

I strongly suspect that it is not your hormones that are the problem but that accumulation of scar tissue. I do not know if your current condition is reversible. You could try the shots, though. If you have the capacity, the shot should give you an erection.

I apologize for hijacking this thread, but I was wondering how accurate your information is and why wouldn't health professionals provide the same info/advise to those who have to venture down that ADT road?

There is an article by John P. Mulhall titled "Erectile Dysfunction After Hormone Therapy" in the current issue of Prostatepedia by Dr. Myers.

Dr. Mulhall writes: "...your erectile tissue undergoes degeneration over time. It turns to collagen - a scar. It is estimated that somewhere between four and six months of ADT leads to permanent structural damage to erectile tissue." As he writes, this is just an estimate. Further: "When you don't have testosterone, erectile muscle degenerates. ...you are nonfunctional".

Here is a UK study that provides additional information: Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer

I suggest that Grand2016 visits an MD for sexual medicine. E.g. Dr. Mulhall at MSKCC or Dr. Kera in Houston.

Or read the FrankTalk forum for erectile dysfunction.

George

I am not familiar with doctors in L.A. but maybe you can see Dr. Turek:

Erectile Dysfunction in Men

George

After reading the post below I kinda freaked out because I had just completed my 8th week on Eligard (Lupron) and realized I had not engaged in any sort of vacuum therapy to prevent the damage. Before the ADT therapy kicked in everything was working fine. Yesterday I figured I'd give it a try, even though I had no desire whatsoever to get an erection except to make sure it still worked. I got no response until I thought about trying out one of my last 2 Viagra pills. That did the trick and all seems to be in order as it was before the Lupron. I guess it was worth the blue vision, head pressure and headache.

trailguy said...
Every night a typical male will have erections that total up to about 1/2 hour in duration while he sleeps. When PCa patients get Lupron, that stops along with waking erections as our testosterone levels fall. If a male goes for too long a time without getting an erection, the erectile tissues (the spongiform bodies) begin to accumulate scar tissue and to loose their functional capabilities. That is why men undergoing ADT chemo with luprolides get and use penis pumps. The erections generated by the pump expand those spongiform bodies which keeps them flexible enough to function normally again when the treatment ends (if we get our testosterone back).

We are instructed to generate as many erections as possible for a minimum of 15 minutes a day. I was told that failure to have regular erections for about 6 weeks will result in permanent disability to achieve an erection due to the accumulation of the above-mentioned scar tissue in the erectile bodies.

I strongly suspect that it is not your hormones that are the problem but that accumulation of scar tissue. I do not know if your current condition is reversible. You could try the shots, though. If you have the capacity, the shot should give you an erection.

Hi Peter,
Just wanted to thank you for contributing to the thread. I have been having trouble finding individuals my age who have been suffering the same side effects. I've exhausted my resources and don't know where else to look. Have you by any chance come across any other forums or studies that may relate more to me? Thank you in advance!

PeterDisAbelard. said...
Grant2016:

If you read the information that George_ provided you should bear in mind a couple of things.

For the UK study he linked --
1) the men in the various study cohorts they examined were, on average, four times as old as you were when you were on Lupron. Studies have shown that age is one of the most important factors in recovery after hormone therapy. None of the results presented will apply to kids your age.
2) the men in the studies fell into two basic categories: men who had a limited course hormone therapy along with radiation treatment; and men who have more advanced prostate cancer who are on hormone therapy more or less permanently. There is little or no data there for men who have a limited course of hormone therapy but no radiation.
3) if you read closely most of the sexual side effects they describe for hormone therapy are for men who are still on hormones. After three months, they say, this and that totally sucks. After six months it gets even worse. They don't talk much about what happens to non-radiated guys after their hormone therapy stops. This is because, like I said, the guys who don't get radiated are the guys who are on hormones permanently.
4) very little of this applies to you so don't get freaked out.

For the Dr. Mulhall quote --
1) I can't comment on the context of the quote since it is paywalled and I am too cheap to read it.
2) Dr. Mulhall is almost certainly talking about men much, much older than you are. By the time men get to be their age -- my age, coincidentally -- the tissues in their naughty bits are naturally starting to deteriorate. All of this prostate cancer treatment stuff makes that process worse. But the things that cause atrophy for us old guys who are already teetering on the edge of decline are much less likely to cause problems for a teenager.

So no need to freak out about that.

George_:

Thanks for finding that UK study. It has some information about the effect of ADT on nocturnal erections, saying they are reduced in terms of frequency, rigidity, duration, and volume but, by inference, not eliminated altogether as they often are with surgical nerve damage. The study they cite for that is from 1999 but I don't see any reason it shouldn't still apply.

Sorry if I missed it, but I don't recall you ever posting what your testosterone level is today......

Lamilla said...

Grant2016 said...

......I've exhausted my resources and don't know where else to look. Have you by any chance come across any other forums or studies that may relate more to me? Thank you in advance!

Grant,
Have you looked at the Franktalk website? Originally started by prostate guys with ED, however now a broad based forum on ED with a section for young guys:

www.franktalk.org/

Thanks for this! Just became a member!