TRT and Prostate surgery
I have done a lot of reading lately, but haven't found enough information on this subject. I'm hoping someone has been through this or knows enough to be of help to me.
I recently had TURP surgery to remove a blockage in my prostate it was non cancerous. Simply age related swelling and calcification. I have read that after prostectomy TRT is stopped at least until PSA levels are back to normal for at least a year in most cases, but this is usually because of cancer not blockages. I was on self prescribed TRT because Doc and Insurance both thought 285 ng/dl test level was good for a fifty year old. Now I feel like shit 12 weeks after surgery and would like to restart TRT again , but I want to be sure I won't make things worse. I hope someone out there can help if not perhaps point me in the right direction to find the answers I need
Peace mk
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I have some medical explanation if you want it... If not don't read this as its pretty in depth, but I remember it from back when I had to study it. Im taking some of this from my old medical textbooks, but just for your info, I am also reading some of the latest medical journals just to brush up on the topic...
Prostatic enlargement depends on dihydrotestosterone. In the prostate gland, type II 5-alpha-reductase metabolizes circulating testosterone into DHT, which works locally, not systemically. DHT binds to androgen receptors in the cell nuclei, potentially resulting in BPH.
In vitro studies have shown that large numbers of alpha-1-adrenergic receptors are located in the smooth muscle of the prostate, as well as in the bladder neck. Stimulation of these receptors causes an increase in smooth-muscle tone, which can worsen lower urinary tract symptoms. At the same time, blockade of these receptors can reversibly relax these muscles, with subsequent relief of urinary symptoms.
The prostate enlarges with age in a hormonally dependent manner. Notably, castrated males (ie, who are unable to make testosterone) do not develop BPH.
The traditional theory behind BPH is that, as the prostate enlarges, the surrounding capsule prevents it from radially expanding, potentially resulting in urethral compression. However, obstruction-induced bladder dysfunction contributes significantly to lower urinary tract symptoms. The bladder wall becomes thickened, trabeculated, and irritable when it is forced to hypertrophy and increase its own contractile force.
I would imagine that the doctor is putting you on finasteride if he hasn't already? this will worsen your crappy feeling you have as it blocks the conversion of test to DHT SYSTEMICALLY!! not just locally around your prostate. So I would say that if you were to stop this medication, assuming you are on it, and continue with your TRT, you will develop slowly, the same prostate symptoms you had before. Perhaps its worth the risk as it definetly makes you feel like yourself again.
Do any of you know your drugs well enough to know of an AS that will not depend on Alpha-1-reductase to become active? This would be worth discussing to me.
I hope that helps!
Kona
Thanks bro that does shed some light on the situation. I do take Flomax, but this should stop after my next appointment with the urologist. I have started taking clomid to see if it will raise my natural levels. I have read that it can increase test levels and is being prescribed off label for TRT
I hope it starts to improve and feel better.
Cheers!
Tell your doc that you feel like shit, and your having hot flashes like a women, and you can't control your emotions. Tell him you want to be referred to a endocrinologist or specialty clinic.