On my MO's recommendation, I've started DepoProvera [DP] injections to combat serious sleep deprivation and other side-effects of Lupron/Zytiga. So far, I've had 3 shots, roughly a month apart. It really helps! But I'm concerned about using this drug, and my MO is basically ignoring my questions about it. Any thoughts/facts to share? Specifically:
1. Since it's an off-label use of the drug, there is no recommended dosage. I read a couple of articles (found here on MaleCare) that suggest "ONE 400mg shot" for this purpose. But Kaiser only has 150mg, and re: frequency, my MO says 'get another one when the effects seem to be wearing off.' That I've found to be about a month.
2. The prescribing info from Pfizer is limited to the approved use as a female contraceptive, so this info might not apply. There is a giant warning box that reads: WARNING: LOSS OF BONE MINERAL DENSITY, and goes on to say, "Women who use [DP] may lose significant bone mineral density. Bone loss is greater with increased duration of use and may not be completely reversible." Doctors are warned not to give to a woman for longer than 2 years. Given that my MO wants me on Zometa, doesn't this suggest I shouldn't be using DP?
3. Recommended dose for women is 150mg injection every 3 months. Given #2 above, re: bone loss being greater with increased duration of use, should I be concerned about monthly shots, or about using long-term?
Thanks in advance to each and every one of you, whose insights I appreciate very much!
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Useful for hot flashes. Usually Megace. Downsides are weight gain/appetite stimulant in some and gynecomastia in some. It has a therapeutic role in correcting osteoporosis when paired with an antiresorptive agent (Zometa) or estrogen. What you are reading is only about progesterone used by itself - ignore all that.
Thanks for your timely response. Sorry, but I'm confused. What did you mean when you said "Usually Megace"? Are you saying that Megace (megestrol acetate--MGA) is the same thing I'm taking, which is medroxyprogesterone(DMPA)? From what I read, what I'm taking is, to use your phrase, "progesterone used by itself". They seem to be different; e.g., the most common side effect listed for MGA is weight gain; whereas weight gain isn't listed at all as a side effect of MPA. So they seem to be different. Could you explain?
Progesterones or progestins are a class of steroids that have a similar molecular structure and have similar biological effects. Megace is the progestin (synthetic progesterone) version often prescribed for hot flashes. Other important steroids are those derived from testosterone, estrogen, cortisol and Vitamin D. Steroids often interact and activate or deactive other steroid receptors. All progestins may cause similar side effects to a greater or lesser degree. Here is a primer on progestins:
Thanks again. But I'm still confused about one thing: the usefulness for correcting osteoporosis as you described. That seems contradictory with the warning label that says it can CAUSE osteoporosis. How can it both cause and correct osteoporosis? Is that only when paired with other drugs as you have describe?
This kind of treatment could be useful to alleviate symptoms of androgen deprivation therapy.
One potential problem is that there are androgen receptor mutations in castration resistant prostate cancer which can be stimulated by progesterone. It is one of the postulated mechanisms of the cancer resistance to abiraterone.
There are other published studies postulating the possibility that progesterone could feed cancers developing mutations of the androgen receptor which could be stimulated by progesterone,
It could be kind of theoretical but I would not risk it and I would not use these progesterone or progestin products to treat symptoms of androgen deprivation, You could discuss the use of estrogen patches instead.
Megace can help with hot flashes sure-for some. But you don’t mention them per se, you say you are suffering from ‘serious sleep deprivation and other side effects’.
By now I’m sure you know there are a buffet of drugs and supplements for the many side effects of ADT. Some help, some
have a awesome placebo effect, many do nothing, some do harm.
Antidepressants, blood pressure meds, stimulants, Tamoxifen, ginseng root and other herbs, metformin, statins, DepoProvera, CBD’s, ointments, gizmos… the list is literally endless.
You’re considering adding a med with possible side effects you specifically don’t want on ADT- weight gain/appetite stimulation and gynecomastia at the least.
All drugs come with a cost; sometimes they’re on the warning level, sometimes not. Further, what they do in the combinations many men employ on ADT is not known.
On the other hand, there is one thing that reduces or eliminates every side effect-cardiovascular fitness and weight bearing exercise.
How much do you exercise and what kind?
I do not suggest replacing medications that truly help at low cost with any ‘natural’ remedy, including exercise. However, what makes exercise different is how supremely beneficial it is overall.
Thanks for your reply. I completely agree about the value of (esp. weight-bearing) exercise, as attested to by many others here. Despite being totally non-athletic my entire life, I am trying hard to maintain a regimen. I attend 3 one-hour classes a week thru 24 Hr Fitness ; each is about half strength bldg using hand-weights, and half cardio. I also walk and hike a lot. But I sure don't notice any correlation between when I exercise and my sleep disruptions. Yesterday, e.g., I drove from near sea level to 7,000 ft, then hiked 7 miles with another 1k elevation gain. I was pooped when I got home, but my sleep last night was pretty typical = awakened every 1.5 to 2 hrs with heat flash and feet pain that req'd me to get up and walk. I'm not a pill taker, but I've gotta find some other remedy to keep me from being an emotional wreck due to sleep deprivation!
That is wonderful to hear. Every man who has trouble with the fatigue, hot flashes, brain fog, fat gain, depression and all the rest of it should exercise as much as possible. We can always do more, most of us can do much more.
Of course, some of us will have persistent side effects regardless, whether insomnia like you or fatigue like bean1008. I like to think that no matter the drugs and lifestyle changes we make, adding hard exercise is ALWAYS essential anyway, and pays huge dividends at the time of life we need it the most.
I don't have any sleep issues except like many of us I have to get up several times a night to pee. Going back to sleep quickly is a skill I thankfully developed years ago when I thought I only had BPH.
However, I've had serious bladder and incontinence issues as a result of this disease and its treatments. They are under control now, but I found around a year ago it was getting harder to go back to sleep. Over the counter sleep aids don't work for me, neither does tea, counting sheep or melatonin.
Lunesta, Sonata, Ambien etc work for me but I don't like taking that class of drugs for personal reasons.
HOWEVER, CBD oil has really helped. As with all THC and cannabis products, the results and types of effect vary quite a bit obviously. But for me it's the perfect sleep aid. Just my experience. Great luck to you!
I thought a lot about CBD products, but I don't know where to start in terms of picking the right product -- most vendors seem to be " sales types" who have little serious knowledge to go on. I used to enjoy pot a lot in the "old days" but now that strengths have skyrocketed, I'm scared to go near it. I'm a real wus when it comes to just about any mind-bending drug, when I need an IV sedative for dental or medical work, they barely give me anything before I'm OUT! And there's been discussion on this Web site about how little is known about which cannabanoids might be helpful vs. which are known to promote cancer cell growth. Anyway, I'll keep searching.
I just bought a neck fan on Amazon for my hot flashes… Oh my God it is wonderful! I don’t think anyone even realizes that I’m wearing it as it looks like some headphones that a kid might be wearing around their neck. As to sleeping, I have found that melatonin really helps. I don’t like to take it all the time but if I take it a few days a week I think it really helps me to get in that extra couple of hours of sleep in the morning. I wish there was a cure for the fatigue but my La-Z-Boy recliner and an afternoon nap seems to be my answer. Good luck!
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Can a new drug mimic the effects of exercise on bone and muscle?
Lupron vs Orchiectomy
Radiation PSA, Orgovyx, Bone density
A couple days ago there was a post about a drug that can mimic exercise. Here is an alternative of sorts. 
Cost comparison between Lupron and Oestrogel
