ED post-radiation

[PrettyUnhappyGuy]

I've read that permanent ED post-radiation sets in about two years later. Does this mean untreatable permanent ED or do things like Viagra and injections continue to work?

[Tall_Allen]

They work, unless you have venous leak. I took daily Viagra for 9 months to prevent ED.

[PrettyUnhappyGuy in reply to Tall_Allen]

Thanks. I'm on low-dose Viagra for two years (20 mg) and then 50 mg once a week or when I want sexual activity and so far it's working.

[conbio in reply to PrettyUnhappyGuy]

Basically the same regime as TA for me, following EBRT and Brachy. I'll take 20 mg occasionally now, and of course as needed. At 68 yo hanging in there at almost 2 yrs since radiation.

[Hami6 in reply to Tall_Allen]

This is very interesting. I'm just finishing off 20 treatments of IMRT.

Should I be asking for 25 or 50mg Viagra daily now? If so, for how long?

I can see that tadalafil (Cialis) can be taken daily, is this an equal alternative to Viagra?

[Tall_Allen in reply to Hami6]

Whichever works for you. I did it for 9 months beginning with my first treatment. I did lots of exercise too, which probably helped.

[ulfhbg in reply to Hami6]

Hi

Daily Tadalafil is also an equal yes. It helps the bloodflow and have good effect on the prostate after being radiated. Any of the PDI5 inhibitors might help you with the erection. For me on hormone therapy the libido has decreased a lot but by using Tadalafil daily and sometimes adding a ’boost’ of Sildenafil or Spedra it boosts my erection.

A penile pump is extremely good tool to have and to use reguarly in the penile rehab in order to mitigate ED.

It’s really not only after you should penile rehab. It’s equally important after radiation and if / when on hormone therapy.

And excersise !!!! Big help if doing regular excersise

Best wishes - Ulf

[BWeaver in reply to ulfhbg]

What does your regimen consist of with daily tadalafil and a "boost" of sildenafil? I have been looking into this but could never find dosages.

[ulfhbg in reply to BWeaver]

Hi !

My regimen is

- 10 mg Tadalafil and 50 mg Sildenafil

or

- 10 mg Tadalafil and 100 mg Spedra

Otherwise it’s 5 mg Tadalafil daily

Best wishes - Ulf

[Jpl506]

I’m 4 years post treatment and haven’t had any problems thus far.

[PrettyUnhappyGuy in reply to Jpl506]

Thanks, good to know.

[JWS13]

I took cialis 5 mg for a 2 years to prevent ed...ADT Orgovyxx screwed up my Testosterone -(only on it 4 months) so now started TRT 6 weeks ago after waiting almost year and half of no sex (35 yo Wife) ..2 weeks ago had sex for first time with wife and erection.

[PrettyUnhappyGuy in reply to JWS13]

Do you mean your testosterone did not return after ADT? That's my big fear and I was told by my doctor that there's a good chance of it happening. Of course, I wasn't told this until I was already on it for five out of six months.

[jazzy53 in reply to PrettyUnhappyGuy]

I had two years of ADT and, at 70, am now four years past it. My testosterone did recover and sits in the middle of what's considered the normal range for someone my age. Erections happen but require some patience, and they are aided by daily Cialis. Orgasms take longer than before and are dry but pleasurable. I initially took Cialis to deal with urinary retention and frequency. It's helped with that as well as with ED. Having said all that, I also have to take my age into account. I doubt I'd be like I was at age 50 (much less age 20) without this disease and its treatments.

[tallguy86]

Had SBRT over 4 years ago and have had no ED issues. My erections have been great. Orgasms have been more intense. However, very little semen left which is okay by me. Hang in there!

[Mgtd]

It helps testosterone recovery if you have a dedicated exercise program.

[PrettyUnhappyGuy in reply to Mgtd]

That's what's been so hard for me. I've been weightlifting my whole life and I just watched all my muscles disappear while on ADT. I lost more than 40 pounds and it all muscle as I was never overweight. My gym buddies asked what was happening as the amount of weight I can lift kept decreasing. It did finally stabilize at about 1/3-1/2 of what I could do before and I did keep exercising 2-3 hours a day all through ADT and am still doing it even though I think I'm now suffering from major depression as I basically just go to the gym then lie in bed all day and have no desire to see friends or family or interact with any people at all IRL.

[Mgtd in reply to PrettyUnhappyGuy]

It maybe time to visit your local GP to get you out of that funk. The meds for that can work wonders. Do not procrastinate!

Good luck.

[Adf2529]

I’m on TRT 4 years out from SBRT. Success story except for getting up at night. Take Cialis if I need to. But don’t usually. Everything works fine.

[PrettyUnhappyGuy in reply to Adf2529]

My doctor told me TRT was a hard no after prostate cancer but if my T doesn't come back naturally I'm going to go to one of the online providers and just lie in the health screener when they ask the PC question.

[Adf2529 in reply to PrettyUnhappyGuy]

I’m not sure if you can afford to, but try finding a doctor at a university hospital or other center of urology excellence that deals specifically with post prostate ca treatment TRT. TRT after prostate ca treatment needs to be monitored for PSA rise. A “hard no” on TRT depends on the grading of your cancer before and PSA after treatment. It has helped me a lot, in terms of general well being. And we are not talking about big doses like body builders use!

[PrettyUnhappyGuy in reply to Adf2529]

I was a Gleason 7 4+3 Stage T2B. TBH I would never have consented to ADT if I knew six months of ADT could mean permanent loss of testosterone (doctor warned me not to get my hopes up and said my T might not come back).

[conbio in reply to PrettyUnhappyGuy]

Hmm. I had 18 months of ADT and my testosterone came back to normal in 4-5 months once I stopped Lupron.

[Laguy01]

i am just out of radiation. My sex drive is really non existent. I am able to preform and have orgasums but just not a big desire. I just do not want my wife to be neglected.

[Adf2529 in reply to Laguy01]

From experience, a huge psychological component to this. Take it easy. You’ve been through a lot … but without the risks of surgical side effects. Take deep breaths.

[duckcalldan]

I started ADT 10 days ago and will start IMRT in two months. Should I wait until radiation begins to take Cialis/Viagra or is now as good a time as any to start for help with blood flow? I can’t find any corroborating studies linking PDI5 inhibitors with helping ADT patients before radiation begins, only once it’s started or afterwards.

[EdinBmore]

Not intending to be a smart ass but, it all depends....on a lot of factors. Pre-treatment erectile functioning, overall health, age, comorbidities, dosage of meds, etc. I had IMRT, brachy boost and ADT. A study I was in recommended and provided sildenafil and a penis pump and other "toys." The dosage was 60 mg three times a wk. My uro recommended 10 mg daily. I am not aware of any research that compares dosages - probably too many variables to try to control for - but TA is far more knowledgeable than I about all of this.

From my experience, a def "yes" to ED meds and a pump to keep the blood flowing and to reduce likelihood of genital shrinkage.

EdinBaltimore

[PrettyUnhappyGuy in reply to EdinBmore]

I'm on 20 mg a day and 50 mg every 7th day. I was told the pump is useless for rehab because it pulls unoxygenated blood into the penis which doesn't help. I did try it but it was super painful and those tiny rings were agonizing. I do make sure to get an erection every day. I haven't noticed any shrinkage but have lost a small bit of girth just around the base which looks odd but I attribute that to using those stupid rings from the pump.

[EdinBmore]

Sorry to read of your experience. Clearly, our reactions to meds and "devices" vary greatly. Yes, making sure you get elections and masturbation are crucial to good functioning.

Keep UP the good work.

EdinBaltimore