Erectile Dysfunction After Radiation

madman

Super Moderator

With the rapid advancements in radiation and imaging technologies since the development of IMRT in the early 2000s, impotence has become one of the last major side effects of men who undergo radiation to cure their prostate cancer. Here, Medical Oncologist Mark Scholz, MD, discusses the sexual side effects of radiation and the steps that men can take to try and mitigate these side effects.

0:26 What are the sexual side effects of radical treatment with radiation? ("radical," meaning that the radiation is administered to the entire prostate gland.)
2:09 What is the proper dosage and timing of drugs like Cialis?
4:29 What is the timeline for erectile dysfunction after radiation?
5:39 Is there anything patients can do prior to radiation treatment to reduce the probability of having erectile dysfunction?
7:10 Why do the side effects of surgery happen immediately, while impotence from radiation can occur a year or more after treatment?
8:41 Can focal therapy help mitigate sexual side effects from prostate cancer treatment?
9:46 You have mentioned using injection therapy after surgery as an attempt to have regular erections as a form of maintenance to prevent penile atrophy; is the same true for radiation?
10:58 When would a patient start injection therapy to try and prevent penile atrophy?
 
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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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