I know there's a lot we could cover there as far as mitigating maybe some of those issues
but one of the things that you mentioned is having an uninterested partner and I
remember I had the honor of working at your practice for a while and getting to shadow you
and one of the things you would talk to men about is if their partner was uninterested, their wives
could possibly take bioidentical hormones, and I know we don't talk about that often
considering we're a prostate cancer channel, but i think it's an important fact and I know a lot of
women who take it and they seem to have, you know, it kind of helps prostate cancer patients from
a caregiver's perspective because they're more interested in taking care of their mate, they have
more energy, so can you talk about the benefits of bioidentical hormones and who would be eligible?
Yeah, so this sometimes comes up when men have low testosterone and now they're recovering
and in the course of conversation they're concerned now that their libido is coming
back that their postmenopausal spouse has a low libido, something that
goes along with being postmenopausal women lose their estrogen and testosterone after menopause,
and and we know these hormones drive libido. Women can take testosterone
and it does restore libido—sounds a little daunting, but it can be a very attractive thing
because testosterone can give you more energy and improve weight loss, help with concentration,
and of course restore libido, and the doses that are used are much smaller than in men and there
are doctors that bill themselves as experts under the heading of bioidentical hormones. So people
can just google that and find an experienced practitioner in their area if they want to pursue
that further. One other thing that could work for spouses is medicine another antidepressant
that can have the opposite effect. We talked about the Prozac's causing low libido, but there's one
antidepressant called wellbutrin which has been used to help people quit smoking, it's been used
to help people lose weight, and also in some cases can enhance libido. So that would be another thing
to talk about if people are reluctant to pursue the testosterone or the bioidentical hormone idea.
So if somebody is on an antidepressant that's possibly causing libido loss
could they talk to their doctor about switching to Wellbutrin?
Absolutely, I think that it's a well-tolerated medication and it is
a prescription medicine but it's prescribed very frequently as a mild antidepressant.
So going into prostate cancer patients who have received hormone therapy and have,
you know, had a loss of libido what do you do to help them gain that back? You know,
I know there's a lot of talk about testosterone replacement therapy what are your thoughts?
Right, so sometimes patients are shocked when we tell them that they might be able to take
testosterone. We use testosterone-blocking agents to cause cancer to regress and shrink
so people think of testosterone as feeding the cancer like gasoline would feed a fire. So,
it's a controversial topic; it's becoming less controversial; studies have been done now
showing that even men with prostate cancer as long as they're carefully monitored
can take testosterone. We got on this line of thinking a long time ago because when
intermittent hormone blockade came along 20 years ago we realized that that's just allowing
the testicles to bring testosterone back in men that had previously low testosterone
levels from their hormone blockade. Now they're stopping, they're taking a holiday,
and they're getting their natural testosterone back. What we found in aging men is that sometimes
they wouldn't fully recover their testosterone if they've been on lupron for 6, 12, 18 months
and that's when we started venturing into supplying enough testosterone to restore the
levels to normal. So giving testosterone and men that have low testosterone is certainly
a practical consideration as long as the type of prostate cancer permits its use. There low grade
types which would be fine with; there are men that have hormone-sensitive disease that that can
take it on an intermittent basis, so there's expertise involved in selecting people but in our
practice, I'm sure we have well over 100 men that are taking testosterone in some form or another.
Besides testosterone, is there any other things that men can do as far as medications
they can take or anything else that they can do in order to get that loss of libido back?
Yeah, I think it would be just correcting the other things; I think fitness and then,
of course, you know getting off antidepressants, dealing with life stresses in an effective
way so that they don't burden people down, and then of course the the real issue is that
if they're struggling with issues of potency and men are doubting whether they're going
to be able to get an erection that's a huge issue and that needs to be corrected as well.
Thanks for watching, if you would like more information you can visit our website at pcri.org
Also subscribe to our youtube channel we come out with new prostate cancer videos every week.