Sexual/Erotic Dimension of the Estrogen Highway

[42CSurprise!]

Again, respect to everyone here willing to tell the truth about how this journey unfolds.  It is worth noting that as we age our testosterone levels diminish, which is associated with reduced libido and for some men an increase in breast growth as estrogen becomes dominant.  Prostate issues appear to begin for men around the same time... over age forty.  I did a bit of research on the correlation of testosterone and prostate issues and found this quote...

...men with low testosterone developed a larger prostate than men with normal testosterone.

https://www.nature.com/articles/s41598-021-93728-1


We're the big winners here with all the issues discussed on this thread AND with breasts growing on our chests.  It all fits together.  None of this means we've done anything wrong... these are the cards nature dealt us at the beginning.  Yes, we are all different when it comes down to details simply because we each have our own unique genetic, social and psychological histories.  It is wonderful that we can talk about it all.  This about so much more than whether we need to wear brassieres... though that can give great pleasure when we're so inclined...

[Evolver]

It's not just the correlation between prostate size and testosterone levels. There is also one between testosterone levels and prostate cancer, but it is direct, not inverse. That's why hormone therapy either with an anti-androgen or what are known as LHRH drugs (also known as chemical castration, as opposed to the old fashioned surgical type) is an effective treatment for prostate cancer in conjunction with radiation, for example.

In my case, I have a biochemical recurrence. It is only a technical term and I am well, but I do have some residual cancerous cells in me somewhere (they haven't been able to detect their location yet) which are multiplying. This is indicated by a rising PSA level (mine is at 0.6 and has tripled in two years, but it should be at or near zero). If they can't be found and irradiated at some stage in the future, I will go on hormone therapy to slow the bandit down. That obviously has some side effects that we are all used to talking about here. 

[gotgyne]

If I were in this situation with some residual cancerous cells which multiply I'd opt for as you've called it "the old fashioned surgical type", castration, also called a bilateral orchiectomy. Why? At first: My balls already don't function properly in regard to the sexual act, thus my problems to get and maintain an erection. Second: I'm almost in my mid 60s and there are many other ways to give my wife sexual gratification than my own penis (we already had the discussion in this forum), third I have a hereditary thrombophilia and these LHRA drugs have side effects as edema and blood clots. The surgical castration is very safe and reliable to drop the testosterone level. Of course it is permanent, but exactly for this reason I'd do it. To counteract the side effects of the testosterone deprivation as mood swings, depression, hot flashes and especially osteoporosis, I'd take low dose bioidentical(!) estrogen as patches, spray or gel. Advance: The liver needn't metabolize it as in the case of oral estrogen and the dose can be much lower through the skin. Also no risk of liver damage. But in my case always with maintaining a good anticoagulation therapy.
It is more than possible that the breast growth shall skyrocket after castration and taking estrogen (some of us remember "Hammer" aka Bob, who lost his balls some years after vasectomy. He developed huge breasts even without taking estrogen), but as most of us like their breasts and are wearing bras already, this should be the least problem. Staying alive is the goal.
Disclaimer: This is only my opinion based on my knowledge of the facts but no medical advice!

[Evolver]

Yes, I would have no hesitation getting an orchi IF it was decided that I needed to be on hormone therapy permanently. it is a relatively minor procedure. The way any future treatment has been described to me, is that I would get intermittent treatment via subcutaneous implants of Zoladex every 3 months for typically, 9 months, then if my PSA rose again, rinse/repeat. This minimizes the side effects which are wide and varied. It does get to a stage where hormone therapy becomes less and less effevctive though. it does not kill the cancer, it only slows it right down and weakens it for a while.

From my own research, bilateral orchiectomy is actually the least likely of hormone treatments to induce gynecomastia, at around 15%. Strange, but true. The treatment proposed for me has about a 20% chance depending on the drug, and an anti-androgen (t-blocker) like Casodex has an almost guaranteed 'success' rate. Others in that family, like Spironolactone, are also well known about on this forum.

You are correct about the main side effects of either surgical or medical castration, and as you mentioned this can be negated by also taking some form of estrogen like estradiol patches or gel, just like menopausal women sometimes do. In effect, surgical castration and estrodiol together is exactly what those seeking to transition do. In the U.K., Zoladex is actually the treatment used to take care of testosterone for that purpose, with an orchi happening later if bottom surgery goes ahead. To be clear, I'm not trying to transition by stealth, using my medical condition as an excuse, but I won't be unhappy with how my body might end up one day.

[Justagirl💃]

an anti-androgen (t-blocker) like Casodex has an almost guaranteed 'success' rate. Others in that family, like Spironolactone, are also well known about on this forum.

I took Spiro for two years to help with leg swelling. 
About that time my C cups started growing into D's, and my doctor took me off Spiro. 
Fortunately, my growth has continued and I'm now a DDD. 🤭

[gotgyne]

an anti-androgen (t-blocker) like Casodex has an almost guaranteed 'success' rate. Others in that family, like Spironolactone, are also well known about on this forum.

I took Spiro for two years to help with leg swelling.
About that time my C cups started growing into D's, and my doctor took me off Spiro.
Fortunately, my growth has continued and I'm now a DDD. 🤭

As with all medication, side effects are also dose-dependent for spiro. Some years ago on the net I've read of a man in his 60s who took 200 mg daily and developed large breasts. From the photo I'd guess a cup D or DD. I take only 50 mg, so they have only minor side effects.

[Moobzie]

Apparently spiro low dose long term, and high dose short term, have similar gynecomastic effects.
MTF persons  on 200-400 mg / day for about three years and cardiac patients on 25 for 15+ years experience very similar anti-androgenic effects - noticeably breast development.  (Of course, with estrogen administration in MTF persons, the effects are much greater.)

[Justagirl💃]

Apparently spiro low dose long term, and high dose short term, have similar gynecomastic effects.
MTF persons  on 200-400 mg / day for about three years and cardiac patients on 25 for 15+ years experience very similar anti-androgenic effects - noticeably breast development.  (Of course, with estrogen administration in MTF persons, the effects are much greater.)

Strange, of course I already had boobs before Spiro, but taking a low dose for two years really gave my boobs a boost. 🤗

[gotgyne]

Apparently spiro low dose long term, and high dose short term, have similar gynecomastic effects.
MTF persons  on 200-400 mg / day for about three years and cardiac patients on 25 for 15+ years experience very similar anti-androgenic effects - noticeably breast development.  (Of course, with estrogen administration in MTF persons, the effects are much greater.)

Yes, this is right. My 50 mg daily have a slow but steady effect. I value it, since I don't like to buy bras of a larger cup size every year and remove all the old ones.

[Evolver]

Apparently spiro low dose long term, and high dose short term, have similar gynecomastic effects.

Yep, that's my understanding too. With low dose long term usage though, there's another factor that probably exacerbates the gyne effects as well, and that is the natural aging process, where hormone levels get out of whack anyway, as we know.

[42CSurprise!]

I revisited this thread a moment ago.  When we begin talking about these things it is clear the subject is complex.  Hormones that allow us to function "normally" can also contribute to problems.  Honestly, this feels like a very fruitful conversation, whether we're talking about our sexuality or prostate issues.  Thanks to everyone who has contributed.

[Justagirl💃]

Nipple sensitivity is definitely something that shouldn't be undersold. 🤗

[gotgyne]

Nipple sensitivity is definitely something that shouldn't be undersold. 🤗

Yes. Nipple sensitivity should be addressed, since it can even be very painful. I remember accidentally touching one of my nipples with the shower head. Ouch! Before I developed gyne I can't remember such an incident.

[Justagirl💃]

Nipple sensitivity is definitely something that shouldn't be undersold. 🤗

Yes. Nipple sensitivity should be addressed, since it can even be very painful. I remember accidentally touching one of my nipples with the shower head. Ouch! Before I developed gyne I can't remember such an incident.

OMG, I accidentally touched a hot pan out of the oven on one whilst braless one morning. 
Talk about painful!

[WPW717]

Labs drawn today 
We shall see what’s in the offing by next week.
Last 3 T & E levels were so low as to be unmeasurable. Prolactin levels were elevated and breasts remained quite tender. This drug, cabergoline, is touted to lower the prolactin level but I am not sure it’s working as the tenderness has not abated. The hormonal network complexity is massive and only made more so by genetic variability.
I am still swimming in this sea of hormonal complexity without a clear understanding of what’s happening in me. Monolithic health care today has become an anchor to swim with in these turbulent seas.
I wish all of us here well in their quest to navigate the world of hormonal health.
Glad to see more activity lately on the site.