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Advanced Prostate Cancer
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Does Viagra work when your on Hormonal Therapy

I have discussed this with my oncologist and he said it would not. Has anyone tried this while on Hormonal Therapy?

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Yes. Definitely works for me. Not perfect but it does allow sex once a month. My dr recommended it two or three times a week to keep everything from going to hell down there and I wake up with an erection when I do.

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It doesn’t work for me. Limp and turtled most of the time. Made me curious since you provide no details of your PCa and and age. How old are you and how long have you been on ADT?

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Emphatically does help me. I take small doses every night to avoid permanent ED. This isn't my invention, but recent suggestions for treating men on ADT.

We know now that losing nocturnal erections deprives the penis of oxygen and nourishment. Nocturnal erections, mostly during dream sleep, are the body's way of keeping the organ healthy. Without them, the tissues atrophy, scar tissue develops. The scar tissue makes the corpora cavernosa start to leak, and firm, lasting erections become impossible.

Nocturnal erections are reduced or lost entirely due to hormonal therapy, as well as poor sleep, excess alcohol, excess weight, smoking, diabetes, heart conditions, RP, castration, radiation, many chemo drugs. Left untreated the damage is largely irreversible.

Taking low doses of sildenafil (Viagra) will restore nocturnal erections in most men. Instead of the 50 or 100 mg doses used by men with ED, the dose is 20 mg before bedtime.

Sildenafil 20 mg is used to treat pulmonary hypertension. Your urologist, MO, or PCP can prescribe it "off label" perfectly legally. This low dose version is off patent so it is far less expensive than Viagra: $22.50 for 30 tablets compared to $50 a tablet for the patented product.

Frequent use of a pump does the same thing, but only when you are awake. You can use both pump and low-dose sildenafil.

Good luck!

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Here's one recent reference from Harvard.

harvardprostateknowledge.or...

Everything after the bold is quoted from that article. Everything they wrote applies to ADT as well. Pay particular attention to the last paragraph.

New insights into erectile dysfunction

When erectile function becomes impaired following radical prostatectomy, the problem has traditionally been attributed to nerve damage. The nerves that trigger erections may become damaged during surgery (even during so-called nerve-sparing surgery), leading to a problem known as neuropraxia — a temporary loss of function that theoretically should recover in time. The problem is that it can take as long as two years for the nerves to recover sufficiently to enable a man to have a spontaneous erection, and by then other damage may have occurred.

Recent research suggests that when the penis is flaccid for long periods of time, and therefore deprived of a lot of oxygen-rich blood, the low oxygen level causes some muscle cells in the columns of erectile tissue (corpora cavernosa) to lose their flexibility and gradually change into something akin to scar tissue. This scar tissue, moreover, seems to interfere with the penis’s ability to expand when it’s filled with blood. In fact, imaging studies indicate that blood may drain away from the penis rather than fill it.

Less research has been done about impotence after radiation therapy, but it appears that the underlying cascade of damaging events is similar to what occurs after radical prostatectomy. Radiation damages the lining of the small blood vessels, but this damage may take months or even years to manifest itself.

What all this means is that the traditional advice given to men — essentially to wait for erectile function to return on its own — may not be adequate. Simply put, erections seem to work on a use-it-or-lose-it basis. To prevent the secondary damage that may occur if the penis remains flaccid for a prolonged period, researchers now think that a better approach is to intervene soon after treatment to restore erectile function.

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Thanks for the info. I'm still having sex two months into ADT (T < 5), but knowing that I should continue to maintain it as frequent as possible is re-assuring.

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ADT plus Zytiga is a recipe for ED. Few patients can go on, even on viagra/cialis, for long before these drugs also become ineffective. I have been using injections with a great deal of success. It sounds barbaric and painful, but it is not. It works. Agreed with the biological mechanism that FC pointed out above.Thats what my ED specialist said as well. Use it or lose it.

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Oral ED meds (Viagra, Levitra, Cialis & Stendra) only work when you're turned on (Trimix works whether you're turned on or not). Without testosterone, it's difficult to get turned on - it is instrumental in creating libido in the brain. It is possible for you to feel erotic without testosterone, but it is very very difficult.

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Trimix?

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Trimix is something brewed up at a compounding pharmacy per the urologist's prescription and as the name implies there is typically 3 magical ingredients.

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Had great time on vacation before RP which took out all nerves for control of erections. Both viagra and cialis worked great on ADT. Trimix even double strength is failure for wife and I. So yes before RP and no after.

Doug

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All men have a gherkin to jerk

Most find that their jerkin’s a perk

But woe to the guys

Who can’t make it rise

And find that their gherkin won’t work.

Good Luck and Good Health.

j-o-h-n Sunday 05/20/2018 2:20 AM EDT

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I liked the gallows humour j-o-h-n. Shukriya.

Sridhar

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😡 talked to my doctor as well told me not to do it ,not to happy but that’s life I guess

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Had radical prostatectomy 7 years ago plus 40 radiation treatments. No nerve sparing surgery. Tried viagra just for shits and giggles and no response. With ADT and then orchiectomy it makes it easier to accept no more sex.

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In 2003, I took 12.5 mg of Viagra every couple days during and after Seeds and IMRT on the theory that Radiation and Surgery caused destruction of capillaries reducing blood flow. Viagra helped to restore the damaged vascular system.

A year later, I continued this process when taking Lupron and a six month chemotherapy trial. I was able to maintain, although not was it what was, a functioning erection. I discussed it with my Cardiologist and my Medical Oncologist who were both amazed. Both said that my theory had merit and to continue.

I can't speak to nerve damage, but maintaining the vascular system is important - it takes blood to have an erection!

Gourd Dancer

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Have to say, not a major issue with what we are dealing with, in my view. get lots while off cycle while you can!!!! That said, life goes on without it, not as much fun for sure, but alive!!!!

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Yes it does !!!

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I think it does. I'm on 6th month ADT, still have sex 1-2 times a week. Able to do it without Viagra, but 25 mg definitely helps with duration and pleasure. Who would think prospective angina drug being such a wonder. )))

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I wouldn't recommend Viagra during the hormonal therapy. It's an extremely aggressive drug. There's a softer alternative called tadalafil. You can visit site worldpharmazone.org/buy-tad... It provides all the information about it.

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It depends on your test results and you should definitely consult your doctor. Every single medical case needs a thought-through attention and special medical treatment. My doctor recommended me Suhagra. Check it here sildenafilfrance.org/le-suh...

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Absolutely. There're two ED drugs which doesn't affect much the production of TST. Namely Viagra and Cialis. Well, at least these are those I've read about. And if I recall correctly the information was published in this journal imedix.com/drugs/erectile-d... It contains a ton of useful tips and little trick about the ED drugs as well as down to chemical formulas description.

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It does not work for lg.

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There's a type of Viagra called soft Viagra. You may try this type, though the casual Viagra doesn't affect the hormones. Check here pharmaciegenerique.fr/viagr... I hope it will help you.

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