Iain1028 Posted January 21, 2011 Share Posted January 21, 2011 If you have a patient that has no testosterone (androgen blockade, prostate cancer tx), can one still get an erection using Viagra? Thanks in advance. Link to comment Share on other sites More sharing options...
SocialMedicine Posted January 21, 2011 Share Posted January 21, 2011 Why would someone have no testosterone following these treatments? And if they have no testosterone they should be treated with it, no? Viagra should work .... but i feel these guy should have his testosterone level addressed adjacent this. Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 21, 2011 Moderator Share Posted January 21, 2011 androgen blocking for prostate CA - would not want to give test supplement as this is the whole point of drugs like avodart (at least I think so) Link to comment Share on other sites More sharing options...
SocialMedicine Posted January 21, 2011 Share Posted January 21, 2011 I thought the prostate Ca was a hypothetical scenario not the case we were discussing sorry. can anyone with a little more experience in re to ventanas statement comment? Link to comment Share on other sites More sharing options...
cinntsp Posted January 22, 2011 Share Posted January 22, 2011 I thought the prostate Ca was a hypothetical scenario not the case we were discussing sorry. can anyone with a little more experience in re to ventanas statement comment? Androgens stimulate prostate cancer growth so blocking testosterone production and DHT conversion can help. Link to comment Share on other sites More sharing options...
Madison1979 Posted January 22, 2011 Share Posted January 22, 2011 From what I remember for our GU unit in school - viagra works by inhibiting PDE5, which leads to increased blood flow. Although testosterone controls libido, the parasympathetic system is responsible for the stimulus that produces an erection. I think as long as the parasympathetic innervation to the genitals is intact, then Viagra and other PDE5 inhibitors will produce an erection. But I don't have any experience with these patients; I'm still in PA school. Link to comment Share on other sites More sharing options...
NewtonsApple Posted January 22, 2011 Share Posted January 22, 2011 I understand it be that viagra and the such do not themselves cause the erection. By inhibiting PDE5 you enable the individual to achieve erection through sexual stimulation. Thus, low testosterone levels will make it difficult for a male to achieve erection even while taking ED medication. Link to comment Share on other sites More sharing options...
Iain1028 Posted January 23, 2011 Author Share Posted January 23, 2011 I think Newton's answer is correct but it is kind of a guess, can an experienced GU PA comment? Ventana is correct in patients with Prostate Cancer, you do not want any Testosterone. And I know that Viagra's pathway is not involved with Test, but what I want to know is, and many Prostate Ca. patients ask and get different answers, "Can I stil get an Erection with Viagra, Cialis, etc?" I would imagine that if you had no Test. you would have minimal drive to even have an erection, but still need a good solid answer please. My Rad Onc MD is asking too as she gets different answers from different GU doctors. Link to comment Share on other sites More sharing options...
Iain1028 Posted January 23, 2011 Author Share Posted January 23, 2011 I mean, if you could produce and erection with these drugs in patients with no Test., wouldn't you just have a stiffie with nothing to do (at least for you)? Link to comment Share on other sites More sharing options...
kittryn Posted January 24, 2011 Share Posted January 24, 2011 erection is a blood flow problem, not a hormonal problem. the chemical mechanism is easy to find with google: http://health.howstuffworks.com/sexual-health/sexual-dysfunction/viagra.htm Link to comment Share on other sites More sharing options...
bradtPA Posted January 24, 2011 Share Posted January 24, 2011 The issue is further complicated by whether the patient has had a prostatectomy or not. The percent who have nerve damage and inability to obtain an erection without the use of an implant is high..... Link to comment Share on other sites More sharing options...
NewtonsApple Posted January 24, 2011 Share Posted January 24, 2011 Viagra does work by increasing blood blow, however, the patient needs to be sexually stimulated first. Without testosterone it is hard to see how a man will be sexually aroused. While anecdotal, I have talked with body builders who, while going through post cycle therapy, have extremely low testosterone production due to testicular atrophy from synthetic test use. These bodybuilders discussed the limited effects that ED drugs offer presumably due to their depleted test production. Iain, if you find out I am curious as to your findings. Link to comment Share on other sites More sharing options...
lzypanda Posted January 28, 2011 Share Posted January 28, 2011 I asked my attending to comment, although she is not a GU expert.. we see a lot of patients who have ED - a minority have ED due to testosterone deficiency, vast majority, vascular problem.. but in general her recommendation is that sometimes it can be somewhat psychological, and even though you do a complete androgen block, the blue pill may still help the patient if they think it helps. Link to comment Share on other sites More sharing options...
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