PSA levels during and after hormone therapy.

I’m probably being very naive - but, are a slowly returning libido, slight signs of the potential for an erection and a bit more energy signs of returning to testosterone production? Also, again very naive, if we were to attempt full sexual intimacy and there was failure would it have a very negative impact on my husband? Also, would it be ‘different’ if successful? Please forgive me for asking some very personal questions but I don’t want him to be upset in any way!

Hi WW. Yes it does sound as if the testosterone level is beginning to rise but from what I have read the increase in level is rapid once it starts. Libido and erection are two different parts of the equation as men are encouraged to try and maintain blood flow to the penis throughout hormone therapy as this also improves time to recovery. Loss of libido is a direct consequence of the hormone therapy so if he is beginning to want sex then it does imply testosterone levels are on the rise.

I cannot answer your question about attempting intercourse but would suggest that you let him take it at his own pace if you have not been having intercourse during treatment, but it is something you need to talk about and maybe discuss both of your attitudes as to who initiates sex and whether you want full penetration initially or are happy just to explore feelings without any pressure. I think other men are in a better position to answer the question about it being "different" but the pelvic radiotherapy can reduce the amount of semen produced or it may indeed be a dry ejaculation. Don't forget that there are tablets available which might help plus a vacuum pump.

Hi WW (Worriedwife ), from a male perspective I wouldn’t rush him.  Failure is (from memory) quite a negative thing for us chaps.  He will probably know when he can get and maintain an erection and if his libido has returned I imagine he will be keen to try anyway. This is all from memory as I have been on HT for years and am on it for life. David

Thank you AH and David. I was hoping for male and female replies 

Hi

Sorry to jump on this thread but the context is quite timely for myself and OH.

He told me today that he had awoken with an election at the weekend and is terrified that it is a sign of his testosterone rising again.

Is this something we should be worrying about?

Apologies for the sensitivity of the subject, I hope it does not offend anyone

Thans

Amanda 

Hi Amanda. Men can still have an erection even though they have low testosterone levels, but low testosterone levels can contribute to erectile disfunction. This is why men are encouraged to try and look after their penile health with the aid of manual stimulation, vacuum pumps or drugs. Some men are still able to perform normally when on hormone therapy whilst others need assistance. The hormone therapy can result in up to a 50% reduction in size of the penis and testes but this level of reduction can be reduced by helping to maintain the blood flow. Men on HT invariably have a loss of libido so they are less inclined to maintain their penile health which then results in a greater likelihood of ED. Don't apologise, it is a subject which is not discussed enough with men and their partners when they are first offered hormone therapy. 

This made me wonder why men wake up with an erection which is quite normal and apparently it is to do with when they are in the REM (rapid eye movement) stage of sleep. Most people have several cycles of sleep each night and the REM stage is when they dream the most. Men are more aware of the erection in the morning because they also wake up wanting a pee because of a full bladder.

I think I might be speaking for everyone by saying there is no need to apologise. Your question relates somewhat to our situation so I did a google and came up with the following article

https://www.uclahealth.org/cancer/cancer-services/prostate-cancer/patient-resources/educational-materials/dealing-with-erectile-dysfunction#:~:text=Some%20men%20on%20hormone%20therapy,and%20have%20erections%20and%20orgasms.

I actually found it very useful for our own situation which seems to be a half way point between ED and ‘business as usual.’ I hope you find it useful.

Thank you!

It is such a minefield and there are so many directions that your thoughts can take you, it is grest to recieve a common sense answer.

Amanda

Thank you!

Hi, new member to this forum, but nice to chat with other guys in similar positions. 
I had treatment last year chemo followed by rt mine was Gleason 9 as well. I got put on the Pearls trial run by Royal Marsden which is for expanded prostate cancer. 
Finished treatment last September psa has been undetectable since. ( 3 reviews) 

Feel ok generally put weight on which I attribute to hormone treatment. That continues until this time next year. Still pee a lot but that comes & goes. 
Im in Lincolnshire can’t fault my treatment. 
I get quite emotional sometimes especially as I’ve recently got two new granddaughters.