Prostate cancer med greatly decreases libido in men

DEAR DR. ROACH >>

My romantic partner of one year (a 51-year-old male) is being treated for prostate cancer with Eligard. He received a second injection two months ago. I am satisfied with our level of sexual intimacy, even though it has not included penetration. He is frustrated that his sexual desire has decreased. This is not about an erection, per se. I am willing to be patient. He said his doctor told him he will feel closer to his normal self within a year. Is this typical for a cancer patient treated with Eligard?

Could his recovery to normal hormone levels take longer than a year?

— L.R.

The goal of androgen deprivation therapy with a drug like leuprolide (Lupron or Eligard) is to lower the blood testosterone and decrease stimulus for growth in prostate cancer and other testosterone-sensitive cancers. Sexual side effects are very common, and most men will have a decrease in libido, as well as erectile dysfunction. Psychologically,

many men, like your partner, find the loss of libido very difficult to deal with.

Most men do have an increase in their testosterone levels after treatment, and this usually means an increase in libido, although it may never reach the level it was before treatment.

Some men will continue to have improvements in their libido, and erectile function, even two years after treatment. I recommend both partners in a couple have counseling about sexual issues.

There are many concerns beyond just loss of testosterone: Changes in body image and fear of recurrence both can cause men to have sexual troubles.

A therapist experienced in treatment with cancer and cancer treatment can be very helpful.

Some men can be treated with testosterone if the prostate cancer is thought to be in remission, but this is only appropriate for some men and must be discussed with the treating physician, urologist or oncologist.