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Loss of Sex Drive / Libido

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User
Posted 29 Jul 2023 at 12:57

Previously posted  in Sex and Relationships topic, reposted and expanded here.  As a bi man, I have recently been diagnosed with Advanced Prostate Cancer following a resurgence, so, as my oncologist said "we're now in the business of controlling it, not curing it".

Previous treatment was Hormone Therapy and Radiotherapy, followed by a nine month gap where my testosterone levels returned (higher than they were prior to treatment!) and PSA increased every three months (from 0.60 > 5.32).  I have now restarted Hormone Therapy and will next week start Chemo (6 cycles), Steroids and Anti-Androgen Hormone Therapy (see profile update for names of drugs).  Looks as if I'll be on the two hormone therapies for a good few years (now aged 64).

Loss of sex drive/libido is one of the very common side effects with HT and in my previous treatment I tried hard to 'fight against it'.  I guess I was partially successful but it was a struggle at times, and so easy to 'give up the fight'.  So wondering if other forum members have any tips or experiences about how they overcame/dealt their loss of sex drive as a result of HT?

There is the separate issue of ED, penile atrophy etc. but the treatments for this all require an active sex drive to be successful during sexual activity!  Previously did penile exercises, including pump, and took Tadalafil 5mg daily throughout treatment and planning to do the same again.  I have non-penetrative sex with my SO (female) and like to have penetrative sex (top or bottom) with male partner(s).  May have to use injections to penis instead of Sildenafil 100mg (event use) but not keen on self injection!

On a related subject and rather annoyingly, my online pharmacist turned down my last order for Tadalafil 5mg when I advised them of the additional medication to be taken as part of my new treatment plan. Will have to discuss with Oncologist whether it is incompatitible with new treatment plan when I see them on Monday.

User
Posted 29 Jul 2023 at 19:12
Hi John. I’ve been on injectable HT Decapeptyl for 2 1/2 yrs now because I’m incurable aged 56. I think I had a very very high sex drive prior to surgery 8 yrs ago. Even now I’m still very much interested but probably scuppered by my poor wife’s total menopause. I want to but need the encouragement if you know what I mean. I sometimes self-pleasure but need porn. I still take 5mg Tadalafil but only 4 nights per week. My pump regime has been solid all this time. I use it every time I shave. He still looks healthy and happy and morning wood is the norm. I would use Invicorp25 again no question if it was worth it. I’m sure it would be full erection but no fun on my own.

To be honest though we are very happy and close and warm , often intimate , but an erection isn’t needed. Good luck and best wishes ok

User
Posted 29 Jul 2023 at 22:36

I can't think of any other prostate cancer treatment drugs that Tadalafil is incompatible with. You could ask to try for 2 x 20mg/week Tadalafil instead which gives close to the same level of continuous dosing, but also gives a couple of boosts which might be good for trying for erections at those times.

Penile physio doesn't require a sex life, and even if you do have a sex life, it generally requires more activity than most people are likely to get just through their sex lives. Use the pump regularly, a bit like you clean your teeth regularly even though it's not sexually satisfying (and possibly even while you clean your teeth to kill 2 birds with 1 stone and get into a routine). This will help to prevent and possibly even reverse recent atrophy. This is important even for those who never want a sex life again, otherwise they can end up with shortening resulting in buried penis, unable to stand to pee, and unable to maintain good penile hygiene which generates risks of other serious problems.

User
Posted 29 Jul 2023 at 12:57

Previously posted  in Sex and Relationships topic, reposted and expanded here.  As a bi man, I have recently been diagnosed with Advanced Prostate Cancer following a resurgence, so, as my oncologist said "we're now in the business of controlling it, not curing it".

Previous treatment was Hormone Therapy and Radiotherapy, followed by a nine month gap where my testosterone levels returned (higher than they were prior to treatment!) and PSA increased every three months (from 0.60 > 5.32).  I have now restarted Hormone Therapy and will next week start Chemo (6 cycles), Steroids and Anti-Androgen Hormone Therapy (see profile update for names of drugs).  Looks as if I'll be on the two hormone therapies for a good few years (now aged 64).

Loss of sex drive/libido is one of the very common side effects with HT and in my previous treatment I tried hard to 'fight against it'.  I guess I was partially successful but it was a struggle at times, and so easy to 'give up the fight'.  So wondering if other forum members have any tips or experiences about how they overcame/dealt their loss of sex drive as a result of HT?

There is the separate issue of ED, penile atrophy etc. but the treatments for this all require an active sex drive to be successful during sexual activity!  Previously did penile exercises, including pump, and took Tadalafil 5mg daily throughout treatment and planning to do the same again.  I have non-penetrative sex with my SO (female) and like to have penetrative sex (top or bottom) with male partner(s).  May have to use injections to penis instead of Sildenafil 100mg (event use) but not keen on self injection!

On a related subject and rather annoyingly, my online pharmacist turned down my last order for Tadalafil 5mg when I advised them of the additional medication to be taken as part of my new treatment plan. Will have to discuss with Oncologist whether it is incompatitible with new treatment plan when I see them on Monday.

User
Posted 03 Aug 2023 at 13:33

My online Pharmacist advised they were unable to prescribe Tadalafil 5mg as i was also taking Bicalutamide and there was a theoretical interaction between the two whereby the level of Tadalafil can be increased in the body, leading to an increased risk of side effects.  They went on to say that as an internet provider they are unable to monitor this but that my GP or Hospital could prescribe it and would be able to monitor this.  

In discussion with Oncologist, who noted that Bicalutamide was only prescribed for 28 days, they have prescribed tablets for 28 days and will write to GP asking them to prescribe thereafter.  So hopefully this particular problem is now resolved.

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User
Posted 29 Jul 2023 at 19:12
Hi John. I’ve been on injectable HT Decapeptyl for 2 1/2 yrs now because I’m incurable aged 56. I think I had a very very high sex drive prior to surgery 8 yrs ago. Even now I’m still very much interested but probably scuppered by my poor wife’s total menopause. I want to but need the encouragement if you know what I mean. I sometimes self-pleasure but need porn. I still take 5mg Tadalafil but only 4 nights per week. My pump regime has been solid all this time. I use it every time I shave. He still looks healthy and happy and morning wood is the norm. I would use Invicorp25 again no question if it was worth it. I’m sure it would be full erection but no fun on my own.

To be honest though we are very happy and close and warm , often intimate , but an erection isn’t needed. Good luck and best wishes ok

User
Posted 29 Jul 2023 at 22:36

I can't think of any other prostate cancer treatment drugs that Tadalafil is incompatible with. You could ask to try for 2 x 20mg/week Tadalafil instead which gives close to the same level of continuous dosing, but also gives a couple of boosts which might be good for trying for erections at those times.

Penile physio doesn't require a sex life, and even if you do have a sex life, it generally requires more activity than most people are likely to get just through their sex lives. Use the pump regularly, a bit like you clean your teeth regularly even though it's not sexually satisfying (and possibly even while you clean your teeth to kill 2 birds with 1 stone and get into a routine). This will help to prevent and possibly even reverse recent atrophy. This is important even for those who never want a sex life again, otherwise they can end up with shortening resulting in buried penis, unable to stand to pee, and unable to maintain good penile hygiene which generates risks of other serious problems.

User
Posted 03 Aug 2023 at 13:33

My online Pharmacist advised they were unable to prescribe Tadalafil 5mg as i was also taking Bicalutamide and there was a theoretical interaction between the two whereby the level of Tadalafil can be increased in the body, leading to an increased risk of side effects.  They went on to say that as an internet provider they are unable to monitor this but that my GP or Hospital could prescribe it and would be able to monitor this.  

In discussion with Oncologist, who noted that Bicalutamide was only prescribed for 28 days, they have prescribed tablets for 28 days and will write to GP asking them to prescribe thereafter.  So hopefully this particular problem is now resolved.

 
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