T Nation

TRT and Enlarged Prostate

I been on testosterone therapy now for a little over 1 year and half (I’m 34 years old). It’s been life changing and ingrained in my routine but recent development have me worried. My PSA levels have gone from 2.1, 3.3, 4.1 and back down to 3.4. The big scare happened when my PSA showed 4.1, but my doctor prescribed me flow-max and it dropped back down which indicates an enlarged prostate.

My doctor told me I should get off TRT and prescribed me Clomiphene and HCG to taper me off. I had enough refills of testosterone that I haven’t started that treatment, I’m super conflicted because I know what’s waiting for me when I revert back to pre trt level (low 300s).

On top of that, I am experiencing symptoms of an enlarged prostate, at least I think. When I ejaculate (which I also lose control over and kind of just leak out during intercourse), I have this urge to urinate that eventually goes away after a few minutes. It sucks for my sex life, but with flomax those symptoms go away as long as I take it everyday.

I know these are question better suited for a doctor, and I will but hoping someone in the community knows what I’m going through and can shed additional insight.

My questions

  1. Will getting off trt revert my enlarged prostate back to it’s natural state?

  2. What options are available to me outside of stopping trt?

For reference on numbers; I currently take 40 mg every other day with no AI. The community helped me dial in, removing HCG helped stable my levels. Thinking about it now, these symptoms started around the time I discontinued HCG if that helps get me some answers.

Difficult to say, many older men, with low testosterone, have enlarged prostates.

5mg tadalafil is an option. I’ve seen it lower the PSA and relieve enlarged prostate symptoms.

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@xelork, second this, Cialis was originally designed for BPH. If your Dr doesnt know this then he is an idiot. He should be able to prescribe it for you for BPH and have insurance pay for it. If not, I’d find another Dr or find some other way to get it.

so instead of flomax, change it to cialis?

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If flomax isnt giving you any relief. Its worth a shot. It would be daily, probably 5 mg/day.

Sounds like what the community dialed you into is clinically significant BPH.

You average 280 mg a week. By any reasonable standard, that is far more than a TRT dose. I suggest you have an honest conversation with your doctor about your concerns re stopping TRT, and see how he feels about monitoring you on a more reasonable dose. 34 is awfully young to begin playing the ‘BPH game.’

First thing I’d rule out is a chronic prostate infection. I have a very similar story except that I have been on TRT for well over 8 years. My PSA levels didn’t budge one bit from 0.7 all during that time. It’s only been the last 10 months that prostatitis has been a problem. To me this indicates that there is no connection to TRT.

About 10 months ago, I started having urination problems and an odd feeling during ejaculation. I never made the connection with an infection because I was blaming the problem on another issue that coincidentally flared up at the same time (hemorrhoids). A couple months into this, things got bad (I started to have regular nigh sweats and numerous other major symptoms) and we finally did a PSA test ahead of my annual check up and it shot up to over 7. My doctor immediately put me on a 40 day course of cyproflaxicin. The night sweats went away within a couple days and the urination began to flow much better.

During the worst of the infection, erections, let alone ejaculations, were non existent. That slowly came back around weeks 2 of treatment. My PSA levels came back down to below 1 again after about 3 months. They have been stable until recently and I’ve go that got an odd feeling again when I urinate and/or ejaculate. I checked my PSA 2 weeks ago and is back over 1 (1.3 to be exact). My doc gave me a standing order for PSA for a year, so I’m going to recheck again this week. I suspect that the infection has returned and it may become a chronic condition that I’ll have to deal with. If so, I’ll probably do another round of cyproflaxicin, I want to avoid any further damage to the prostate.

As for what else I do to mage the condition, in addition to Flowmax, I use 5mg daily Cialis, Saw Palmetto supplement, Pumpkin Seed Oil Supplement, and about 2mg/day finasteride (eye dropper method). You’ll get a lot of finasteride bashing from many people in this forum, but I doubt any of them have severe prostate problems they have to deal with, and I simply have not had ANY side effects from the medication. Enough said, you need to make your own decision.

Hope it all works out for you!

TRT does not effect prostate. The prosostate contains and manages its own internal levels of dht and etc

Plenty of info out there on this.

New studies show TRT should be used doing prostrate issues. Lots of doctors are reporting this. Closely monitored. But qualify if life for a man with prostate health issues.

Or listen to your doctor and don’t find a doctor who really knows snag they are doing . Zap your hormones and be a walking zombie for years to come until the doc says “oh no worries. It was a false alarm”.

You need a doctor who actually understands hormones and prostate. Not a sick care doctor Who was taught something in medschool and never learned anything new on these topics. They do not even understand hormones and are not taught hormone health in med school. Literally one day maybe.

They do not study hormones and therefore are not the right professional to listen to when they say stop hormones.

Go find the studies. I think jay cambell wrote one. There’s many more.

Google TRT beneficial for prostate health or something.

Do not listen to this doctor. Unless someone who understands how TRT is beneficial and says get off TRT.

Why is it that when we are healthy we don’t have prostate issues? Now we are on TRT and we need to stop because it’s bad for the prostate?

Yah a cluster fuck of huge proportions.
I know

I don’t think anyone should listen to studies by Jay Campbell. That guy is a total disaster these days. I’m not saying you’re wrong, but use a better source than that lol

I agree with you that trt does not affect the prostate(well at least not for me)
I’m 60 and have been on trt 8 tears. I was diagnosed with BPH in my mid 40’s. Never took any drugs for it because it wasn’t that bad.
TRT has not made it worse but it worse but my daily dose of cialis has helped quite a bit.

I have blasted in the past up to 400mg of test for 16 weeks (even though that’s been a while)with no side effects on my prostate.
For me, cialis is huge.

sorry if I wasn’t clear on my dose. I do 40 mg every other day, which is 140mg a week which is lower than the 200mg I prescribed.

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I was prescribed antibiotics for 7 days. My PSA came down but I was also taking flomax, so not sure if it was the antibiotics or flomax that helped.

What antibiotic? From what I’ve read, treatment typically lasts for 4-6 weeks. One week seems a short. There are only a few antibiotics that are effective for prostate infection. Ciprofloxacin is one of the more common. It does have a potential side-effect of weakening tendons, but I did not experience that problem while I was being treated.

Anyway, the point of my original reply to you is that PSA levels can increase for reasons other then cancer. But it sounds like you are aware of this. I’m glad my doc gave me a 1 year standing order for as much PSA testing as I feel I need. I want to be able to catch the problem earlier than I did last time before things get really bad like it did before.

Misread it. My apologies.

Levofloxacin 500 mg 7 pills

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I don’t have prostate issues but I also have read about Cialis helping with prostate problems. Plus you get the added benefits that come with Cialis!! I take Cialis for fun… my wife loves that med!!

I’m now on cialis 5mg but it’s not as effective as flomax.

There’s no reason to discontinue the flomax while on Cialis. The two work by different mechanisms and should be synergistic in their actions.