Testosterone Recovery Profiles after Cessation of Androgen Deprivation Therapy 

My doctor did none of that.

Neither my urologist nor my external beam radiation oncologist fully explained the effects of ADT. Borderline malpractice if you ask me. I came VERY close but fortunately I educated myself before getting the shot. I now have an appointment with a doc who does HDR Brachytherapy. I'll do everything I can to avoid ADT.

Or, you were in the small percentage who do not lose the ability to orgasm mentioned around 7:00. One data point.

@@scottwillis5434 This whole thing is interesting as one point in time Dr. Mulhall totally discounted the idea of being able to reach orgasm without testosterone. Actually, the ability to have orgasm appears to be the last thing lost no matter the treatment. I'll have to ask some men who have been on years of ADT for confirmation. I do know that without testosterone keeping our attention on sex, it can take a long time to reach orgasm. One gent mentions taking 45 minutes. Without testosterone, sex is driven by the mind and it is easy to get distracted. I had to learn new ways to masturbate when my wife could not participate as the traditional full fist move caused a series of what looked like blood blisters behind the corona with the long time to orgasm. I am fully on board with Dr. Mulhall that men are not well informed about ADT side effects. Men on ADT go into instant menopause. Not quite andropause as I understand andropause often does not reach the intensity of menopause. ADT is the real thing and men don't handle it well. However, we can justify using ADT given the man is fully informed as it is one way to extend length of life while battling cancer. I will look into how much loss of testosterone with continuing sexual activity affects smooth muscle health. This was one question and worry I never had answered. I think this study is sloppy in that it is just a measurement of what happens when treatment is not done correctly. One problem is that the subjects had sex only once a month. What would more frequent sex have had on ED and recovery? Doctors are also guilty of not encouraging men to have daily sex while on ADT. I also question whether total testosterone is the correct target. There is a complex interplay in the feedback that controls the amount of testosterone. There is bio available testosterone (which I suspect should be the real target), free testosterone, total testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and sex hormone binding globulin (SHBG) just for starters. My TT went to 483 in less than 2 years, but my bio available testosterone is lower than normal. I am still experiencing fatigue and emotions I felt under ADT and suspect the low bio available testosterone is the reason. Soooo, with TT at 483 ng/dl why is my bio available low? Testosterone cannot mix into blood serum for delivery so SHBG binds with the testosterone (and estrogen) to transport it. That bound testosterone is not bio available. SHBG is sometimes a bit stingy about giving up the bound testosterone and bio available testosterone remains low. In my case, I have more than normal SHBG. When my TT went up 30%, the SHBG went up 25% and way over norm. I believe SHBG is produced by the liver (?) so there could be liver (?) problems involved. Dr. Mulhall has given no consideration to any of this, just a study of what happened with the treatment in place. I think that he may also need to put more thought on how surgery affected recovery vs no surgery given about half the subjects had surgery. I also agree that doctors should be doing baseline measurements. I very much regret not having the insight to request this from my urologist. My medical providers really didn't seem concerned about my sexual function and seemed embarrassed to discuss it.

What kind of side effects still persists?

@@phenababitol Probably all the usual menopausal side effects we get while on ADT. I'm still dealing with some of it after 2 years off Eligard/Lupron.

Doctors and drug manufacturers deliberately withhold the critical information from patients and never inform them that 20% of older men on ADT will never recover their TESTOSTERONE level above castrate level and they will suffer the rest of their miserable lives existing as just another ZOMBIE EUNUCH created by the NARCO MEDICO CARTEL. Without free and informed consent, the administration of these toxins is criminal assault causing greivois bodily harm.

Demand testosterone replacement therapy if Big Pharma successfully leaves you castrated for life, as happens in up to twenty percent of older men. Ask the doctor why it's ok for the lucky guys to regain normal testosterone levels, but if you are unlucky enough to end up below castrate level, you have to suffer the rest of your life existing as just another ZOMBIE EUNUCH CREATED BY THE NARCO MEDICO CARTEL???

Its not just having sex, its all the other side effects that having no testosterone cause...its aweful

Having sex, or more clearly, getting erections to ensure that oxygenated blood gets into the penis prevents Penile atrophy and shrinkage. It may not be important to some men with terminal cancer with short life expectancy, but for many men, it is hugely important. In the same way that women with breast cancer feel devastated by mastectomies and try to preserve their breasts. Chemical castration is cruel and barbaric treatment

His arrogance makes listening difficult.

@@Wheels44735 Indeed. I don’t want him caring for me, for sure

Me either. Optimism leads to hope. This guy instills neither.