hypogonadal for one reason or another, and in general have tried to do my homework. Thirteen months after
castration, I am still getting hot flashes. Due to the stress I am under, from the circumstances of having to file a Chapter 13 bankruptcy, I am still flashing every hour or so. The flashes alternate between mild and serious. At night I sleep through the mild ones, and wake up every two hours from the serious ones. I am having major problems from my lack of sleep. The weather in LA is hot and getting hotter. I work in hot conditions 8 hours a day at the Post Office, and my flashing shows no signs whatever of abating in frequency or intensity.
Donna Garnier, my physician, has discussed options with me, and on 25 June I began estrogen, 1.25 mg. of Premarin per day, taken with supper.
Whilst some studies have been done on men who take estrogen in the aftermath of prostate cancer, the studies tend to be incomplete, contradict each other, and pretty much leave it up to you to decide what is best. The main advantage is that it will work for about 70% of the men suffering from hot flashes. The disadvantage is that one might be in the 30% for whom it is a waste of time and money. It may or may not also help in thwarting osteoporosis. There have been no reliable studies done on whether men taking estrogen benefit in the battle
against osteoporosis. The biology of the hypogonadal male and hypogonadal female are similar but not identical, and what works for one may not work for the other.
Donna and I discussed other potential side effects. Although some studies have suggested that there might be an increased chance of heart attack or stroke, Donna doubts this would ever be a problem. She measured my blood pressure at 105/60. My cholesterol is great, and my weight is now down to 175 pounds, the lowest I have been in years. My diet and exercise program is working fine, although I am quite aware that weight loss is the easy part and that keeping it off is the hard part.
Another potential side effect is mild feminization of the body, including gynecomastia.
The most serious side effect may be psychological. Most men with prostate cancer who have taken estrogen as part of their therapy report that there are changes in feelings and attitudes that may be unacceptable to non-transgendered males. This may adversely effect my current "eunuch calm". If it gets bad enough, I will discontinue the therapy. In any case, Donna and I plan to discontinue the therapy anyhow once the summer is over and cooler conditions prevail.
