Another Cialis Question

[Tigger2022]

I think this is in my profile, but: Gleason 8 (4+4), RP done 5/2022 showed ECE and a positive lymph node. PSA rising by 6 weeks post-op. ADT started 8/2022 and he had radiation 9-11/2022. After some ups and downs with his liver values, he is currently taking Orgovyx, Abiraterone, and Prednisone. PSA and T are undetectable, and he is doing as well as can be expected.

Now, my husband is in “cruise control” mode (his MO’s words). We’re of course hoping that at some point he’ll get to come off ADT. He had been taking Cialis back before radiation, but I think his RO told him to stop it. Someone did, we can’t remember if it was urologist or the RO. Anyway, since there’s still a ways to go on this ADT journey, I wanted to see if he should be back on Cialis again. We saw the MO this week, but he didn’t know anything about using Cialis/Viagra to maintain penile blood flow (he says penile atrophy & loss of blood flow shouldn’t be a problem for my husband, who is 54 and otherwise in excellent health??) but would be happy to prescribe if he found some literature. Or, hubby could go back to the urologist.

My husband does have a pump, but doesn’t use it much. Does anyone have any papers that show the meds improve blood flow, or should we just make an appointment with the urologist or ED clinic associated with it? Or, any other suggestions? I tried to do a search, and couldn’t come up with anything that showed it preserved blood flow. We’re not currently trying to use it for intercourse.

Thanks, everyone!

[Tall_Allen]

auajournals.org/article/S00...

[Tigger2022 in reply to Tall_Allen]

OK, thanks. I found this article on my search, but was wondering if there was anything newer, or with Cialis. Do you know why it seems like many men are taking Cialis/Viagra but there is little research to recommend this practice? My husband’s MO sounded like he’d literally never heard of someone taking it, and MO did not seem concerned that he would have atrophy. Felt that because he was “young and healthy” that it would bounce back right away.

[Tall_Allen in reply to Tigger2022]

It was before daily Cialis became available, I think, but I expect the benefit would be the same with any ED med.

[dimerofeee in reply to Tall_Allen]

Cheap Cialis without a prescription - onlinecheappills.com/tadala... I am in my early 50's and suffered with erectile dysfunction and benign prostatic hyperplasia the last few years. I love Cialis. After ONE WEEK, I was urinating normal, and not waking in the middle of the night to go! After two weeks I was getting erections like a teen again, middle of the night, mornings and when I wanted sex. I couldn't be happier, no more pain, more sex and a happier wife.

[Amadeus71]

I'm mid 50's, started on the same Org/Zytiga/pred treatment in January 2022, have undetectable PSA and T, and work out regularly. I have experienced significant shrinkage. It is only thanks to this forum/group that I was made aware of Cialis benefits and just recently started taking it.

[London441]

Cialis can help, I can’t imagine why he would be advised to not take it. Penile rehab matters more, and the cialis pairs with it much better than alone. Sexual function on ADT is a challenge, especially for those who experience significant loss of libido (most). It’s hard work but well worth it if it’s important to you. Great luck to you!

[Tigger2022 in reply to London441]

Totally makes sense to me, but I wonder where are the actual research to recommend it. Is it just something all urologists know and understand? We haven’t seen my husband’s urologist since the post-op visit, when he was running super late, and just dropped the bomb of the 0.94 Decipher score on us, and the “don’t worry, there’s lots of treatments that can be done when it keeps popping up in the future” when we were still hopeful for cure. Ugh. Anyway.

[London441]

Many urologists do not know and understand, often by their own admission. I suggest seeking out a urologist who is also a sexual health expert if you are invested and can swing it. Dr Rachel Rubin in the Washington, D.C. area is but one example, one I know personally.

The contrast between a rushed urologist who tells you 'lots of treatments can be can be done' on his way out the door and one who specializes in sexual health and will take their time with you is as obvious as it sounds!

[Bethpage]

I have these two podcasts linked in my spouses' FB support group. They're from The Penis Project.

Podcast #55: thepenisproject.org/episode...

Podcast #61: thepenisproject.org/episode....

Both are directed toward preservation of penile health. The main site is: thepenisproject.org/

[Carlosbach in reply to Bethpage]

awesome info Beth. I wish I had heard this information in the beginning, it would have saved me a lot of anguish.

Thank you for sharing this

[j-o-h-n]

GG = Get Going......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 06/25/2023 5:22 PM DST

[gsun]

It is well known that a low does Cialis/Viagra helps with penile health. Why he was told to stop is not correct unless there are issues associated with taking it. Yes he is young, but that will not matter when he has been on ADT for a while. And the changes may be permanent. He should use the pump often. I use mine at least five days a week and it really helps. I take daily Cialis and have noticed a better blood flow. You can also take the Cialis at regular strength at anytime and enjoy!

[Stevecavill]

daily low dose cialis helps by maintaining “natural” nocturnal elections. Those regular erection are necessary for penile health in EVERYONE. I wish doctors would just say “I don’t know” when they don’t know

This doctor explains it well

youtu.be/4ELsojPFNV8(Not working as expected?)

[fast_eddie]

ADT will definitely cause penile atrophy. Don't know if cialis will help as my urologist never clued me in.

[Adlai]

I’ve been taking Cialis for quite some time due to similar issues, and I can say it’s been incredibly helpful in maintaining penile health and blood flow. I order it from a reliable pharmacy - world-delivery-service.com/..., they always have good quality, it might be helpful to you. While your husband isn’t currently using it for intercourse, Cialis is often prescribed as part of penile rehabilitation to prevent atrophy and preserve vascular health, even during periods of ADT. The low-dose daily version (2.5 mg or 5 mg) can be especially effective for this purpose without the need for timing it around activities.

It’s worth seeing a urologist or an ED clinic, as they tend to have more expertise in this area than oncologists. Many specialists recommend a combination approach: regular use of medications like Cialis or Viagra alongside a vacuum pump to maintain tissue health. Even if the pump isn’t used for long sessions, consistent use (a few times a week) can complement the effects of the medication.

If your MO is open to prescribing it but needs literature, there are studies showing that PDE5 inhibitors like Cialis can aid in preventing fibrosis and maintaining blood flow. You might also want to look into urologists who specialize in sexual medicine for a more comprehensive plan. Best of luck to you both on this journey—it sounds like you’re doing everything right to support him!

[Tigger2022 in reply to Adlai]

My post is two years old now, so many of your recommendations (which I know to be good ones!) are moot. My husband has finished up his ADT, but did very little penile rehab during that whole time. He has not been on Cialis, and didn’t use his pump. His testosterone is starting to slowly rise, but no libido has returned yet. He isn’t at all shy about the ED clinic — we went together between his surgery and his ADT/radiation back in 2022 — and he has plans to go back once he starts to feel some libido. I’m assuming we’ll just start back with the Trimix, but I don’t know.

Thanks for your recommendations!