Can ADT drugs affect erectile function and sexual desire?

ADT medications commonly do affect both erectile function and sexual desire, as they work by significantly reducing testosterone levels. Many community members have shared that while desire may decrease, erectile aids like Viagra, Cialis, and Trimix injections can still be effective options to discuss with your healthcare team. It's encouraging to connect with others here who understand both the medical and personal aspects of navigating these treatment decisions.

3 years of ADT concurrent w2 years Zytiga. Within 2 months of starting treatment began 45 days of IMRT, high dose (81 grays) of radiation. This started at age 70. I’m now 78. Treatments resulted in 0 libido and total ED. I never tried Viagra after treatment-no interest. But I’ve got life and 55 years of marriage…grandchildren…and friends…and family…and hobbies. I’m living life, and I’m grateful for the lot. I’d had a normal sex life before. That was then…. I don’t claim to be an exemplar, so what applies to me may not be to you. Like I said, I’m grateful for the lot.

Thank you for your response, TD H. I know that had to have been a dramatic transition in your life. I'm so happy to hear that you have 55 years of marriage, and have been able to have a full life. I started the Eligard and Zytiga over a week ago, and I know it's way too soon to be thinking this will continue, but I still have normal sexual function even without Viagra or anything at this point. If I lose function, I will be trying the ED drugs, and then last resort Trimix, which doesn't require testosterone to have an erection. It's not exactly a pleasant solution, but it is one for ED, but not desire, if it has been eliminated. Obviously at this point the greater concern is knowing whether the two drugs are going to stop by Gleason 8, M1A. A lot of unknowns on my journey still. Thanks again for sharing your journey. I wish you continued happiness in your marriage and life.

Thanks, John. Be well. Note: At 78, a lot of things in my life don’t work as they used to. We bought a digital frame and put a 1000 pictures on it, all taken over decades. Five generations of our family are displayed randomly. It reminds us daily of the countless blessings in our lives. Sex was one (we don’t have a picture of that), but man, many more remain. Like I said, be well.

Dear John L—I’ve been through every one of the processes and meds mentioned by you, by TD H, and by AI Agent in my three years since diagnosis on 8/16/2023 (yes, today is the exact 3rd anniversary). I could write a book in relating my experience, but it wouldn’t matter to you, because TD H is so right in saying everyone is different. Foremost is age: I’m now 77 and your youthfulness should be a huge plus versus my experience. Then there are the meds: I’ve been through Ro Sparks, BlueChew, sildenafil, tadalafil, Trimix, and ICP—all sequentially, not simultaneously. In each case, the med was effective … for a month to six weeks … then ineffective. Additionally, I have anorgasmia: ADT killed my physical sexual ability but not my libido. Cut to 2026: I went against doctors’ advice and outside conventional medicine to initiate testosterone replacement therapy (TRT), which almost immediately restored my sexuality, with side benefits of building muscle mass and restoring my energy and stamina (I’m a competitive runner in track and distance). The risks of TRT are real, in my opinion, but greatly exaggerated by conventional medicine. I accept the risks in order to enjoy the gains, so far, with great success. You’ll eventually confront your own hard choices in one form or another; I wish you well!