Hi, my treatment was similar, but without the chemo. Congratulations on finishing it.
Libido should return when you come off HT, but you don't want to go that long with no erections, as that will permanently damage the erectile parts of the penis (corpus cavernosum). You need to try for what's called Penile Rehabilitation to keep the penis working long term, and it might even enable some sex in the short term.
While you are waiting for the ED clinic, go to your GP, and ask for 5mg daily low dose tadalafil (providing you don't have angina or take glyceryl trinitrate, GTN). Tadalafil will improve blood flow in the corpus cavernosum and help protect it from damage. (Don't be fobbed off with Sildenafil which many GP's like to prescribe instead because it's cheaper - it's unlikely to work because it has a very short duration in the body, and won't achieve anywhere near continuous dosing.)
Tadalafil is a long lasting PDE5 inhibitor, and is more usually used to improve erections. The hormone therapy (HT) significantly reduces libido, which reduces the arousal nerve signals to the penis, and also prevents concentrating on sex, a combination which makes it difficult or impossible to get and maintain an erection. The tadalafil will amplify any arousal nerve signals to the penis, so that if there's a little bit, it's more likely to be able to be able to generate an erection, so there's a chance the tadalafil will help erections return. If that doesn't work, try doubling up the dose by taking tomorrow's 5mg tablet too (and skipping it tomorrow). The most effective time to take them might be a couple of hours before trying for an erection, but it is long lasting and you may find it doesn't matter when you take it.
If that still doesn't work for erections, there are some more things you can try with it. Have your husband try masturbating by himself - the pressure to perform for you might just be too counterproductive, certainly initially when he has no clue if he can even perform for himself. Providing you're both 100% happy it won't damage your relationship, using erotica or soft porn may help him masturbate, and may generate sufficient concentration on the task in hand to generate erections. Sex toys, particularly a vibrating cock ring, many add sufficient extra stimulation that it enables erections, and may also help maintain erections when you try to have sex together.
Note that a man doesn't need an erection to orgasm and HT doesn't prevent orgasm, although loss of libido will probably make it more difficult. Something you might consider is oral sex which is probably the best way to reach orgasm without erection, and something you can do both ways if it will help maintain your relationship. (His orgasms will be dry while on HT, and might remain dry permanently due to the RT.)
If the tadalafil enables erections, he should try to do that probably at least every other day for penile health (doesn't matter about orgasm for this purpose). However, the tadalafil provides some protection even without erections, so don't give it up unless it's causing unwanted side effects (typically headache and stuffed up nose). If that happens, first try dropping it to alternate days, or asking for 2.5mg instead.
If none of this works for sex, the ED clinic has additional tools in the bag. There's the use of vasodilator drugs (Caverject, Invicorp, Muse, Vitaros), and also the use of a pump (Vacuum Erection Device - VED, for both Penile Rehabilitation, and for sex). If they offer a pump, do take up the offer of demoing on yourself in clinic - that doubles the chance of using it correctly at home afterwards. A pump also has the capability to reverse a small amount of recent damage to the corpus cavernosum resulting from a period with no erections, but not any long term damage.
Edited by member 22 Jan 2020 at 08:24
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