Can anyone relate? On answering Why?

[guy26 (imported)]

Hi Hash,

I have wanted to write back for a while, but I'm just now getting around to it. The joy of procrastinating.

you're really psychoanalyzing yourself, which isn't a bad thing, but you can over do it.

I suppose I am doing a kind of psychoanalysis on myself. Writing has a way of refining my thoughts and giving them a bit more order and structure. Sometimes it is a way for me to make sense out of how I feel and what is going on in life. And sometimes it is a way for me to be able to articulate to others on what I'm experiencing. It is rarely obvious to others what is going on inside of me. LoL. It could be a scary thing if we could read one another's minds. I have no idea what that world would look like!

Maybe ultimately why I have written over the years about my desire for castration is I simply don't understand it. It seems irrational, illogical, and self destructive on the surface. And yet, no amount of logic, contemplation, or time dealing with it seems to make it go away. If there were a way to just wave a magic wand and not feel driven toward that end, I would so take it. It isn't happening, so I continue to write and give it thought.

I've yet to really understand or know why in my mind I had to be castrated, but I was and I am now a eunuch. Sometimes I think about becoming a nullo but the compulsion to remove my penis isn't near as strong as my compulsion to be castrated.

How do you feel about having acted out on a desire that is life altering and yet you don't have a clear understanding of why you did it? My impression is that it doesn't bother you too much and have accepted it and moved on in life.

I mostly understand my drive toward castration. Maybe ultimately it isn't something that I can entirely grasp. The drive may be somewhat outside the reach of consciousness. Who knows? I don't. LoL.

It's been an interesting journey, I think it would make a good movie, but who would make it?

You never know. There are a LOT of people on this planet with different needs and desires. I have often wished that I could play music so I could better articulate my feelings in a way that other people could relate to on a deeper level. Words seem to only get me so far.

[guy26 (imported)]

I am finally complete

Hi Riverwind,

Do you know what the basis for your desire was? Maybe BIID or a kind of GID issue or maybe something else? When you say, "I am finally complete," that makes me wonder if it was more of a BIID issue.

[guy26 (imported)]

My pharmacy finally got my

prescription for leuprolide acetate

in yesterday. It was WAY more expensive than I thought it was going to be. I'm willing to pay that kind of money once, but not twice. It took some investigation to find out why it was so much more than I expected and what I priced online. Right now there is a shortage of the 14-Day kit. ( http://www.ashp.org/Import/PRACTICEANDP ... spx?id=737 ) There are three manufactures of it: Caraco, Teva, and Sandoz. Teva sells the kit for $130, but the other two sell it for TWICE that amount. As of Feb 25, 2001, Teva has manufacturing delays and has not announced an estimated release date. So I'm not for sure what I'll do at the end of the month. I found an online Californian pharmacy that has it in stock, so maybe I'll try them if things seem to go well.

For now I prefer the daily form since I feel more in control and it is possible to either stop right away or more quickly make adjustments. There are options of taking leuprolide in 1, 3, 4, and 6 month increments. I don't think it is well understood on how much you should be taking if you aren't wanting to go ALL the way down and with the long acting forms that might not even be possible. The only possibility I could imagine is trying the monthly 3.75mg dose. After a few days from the intramuscular injection, levels can be found in extremely small quantities… in the single digit ng/dL. It takes very very little of this stuff to act on your pituitary. leuprolide acetate is engineered to be 80 times more powerful than your own GnRH and have a longer half life. The idea is to overwhelm the pituitary and get it to radically down regulate its sensitivity to GnRH.

I suppose with the long acting stuff you could go all the way down and just add testosterone back. But that seems more expensive all the way around. The 1 and 3 month form seem to be the least expensive long acting versions, which are around $330/month at best. Yikes. I'm hoping that if I can secure the daily form with Teva, I will be able to use a 14 day supply over 1 to 1.5 months. That would make it reasonably priced. For this month, I am obviously headed down to at or below castrate levels. I'm pretty sure this will be a new experience and excessive, but I'm willing to test the waters. I've taken depo provera twice and while I never got my testosterone levels measured, I never got hot flashes either. So I'm fairly sure this is going to be a lot further down and in uncharted territory.

I did a bit of research before I committed to trying this and it seems that leuprolide is one of the safest ways to lower testosterone, but it is by no means the cheapest. It is the most expensive from what I can tell! It is not hard on your liver like cyproterone. But like cyproterone, it is way more effective than depo provera if you REALLY want to be down to castrate levels.

I also found a few interesting factoids that I'll share with you. When you first start taking leuprolide it will generally result in a remarkable 50% increase in testosterone of your base line levels. It is referred to as a testosterone flare. But by the end of the week two it should be headed down hard and fast. By week 3, 98% achieve castrate levels, which is considered less than 20 ng/dL. Castrate levels use to be considered less than 50 ng/dL but the availability of more sensitivity testing and comparisons to physical castration made them rethink the acceptable level for prostate cancer victims.

You can take a look at this link for more interesting facts and figures. ( http://www.dovepress.com/six-month-depo ... t-of-a3232 ) It is about a study on the 6 month leupron formation. If the powers that be want me to cut and paste this whole article into this thread, I'm more than willing to do that. But please don't delete this post. LoL.

I thought the two most interesting quotes were:

"Historically, the FDA had established the castrate threshold, or the testosterone level consistent with that obtained after surgical orchiectomy, to be 50 ng/dL.41 However, this was largely based on the sensitivity of available laboratory assays at the time. With the development of newer assay techniques, substantially lower testosterone levels (15 ng/dL) have been observed in men after bilateral orchiectomy, which has led to reassessment of the historical threshold level by the medical community. The National Comprehensive Cancer Network amended its guidelines to suggest that serum testosterone level < 20 ng/dL reflected optimal control of testosterone after surgical or chemical castration, and several other expert opinions have been published on this matter in agreement."

"There was an initial rise in testosterone level, which increased to a mean level of 588 ng/dL by day 2. By day 28, 108 patients (97%) had achieved a serum testosterone level at or below the castrate threshold (50 ng/dL), and 92 (83%) had achieved optimal control of testosterone (<20 ng/dL). After 12 months, 102 of the 103 (99%) patients who completed the study had testosterone levels below castrate threshold, and 91 patients (88%) had optimal control of testosterone. Median time to reach castrate level was 21 days."

One of the most fascinating articles I found was titled "Depot-leuprolide acetate for treatment of paraphilias: a report of twelve cases." You can find the article here. http://www.ncbi.nlm.nih.gov/pubmed/11446201 . (You probably won't have access, so I'm more than willing to just cut and paste the whole thing into another post in this thread. Just let me know moderators.) I kept thinking "Um wow…" as I read the whole thing. I'm not for sure what was more striking--the content of the article or the author's ability to write serious things with no emotional context at all.

For example here is one case… "Patient #12 was a 25-year-old male with a history of exhibitionism, frotteurism, voyeurism, public masturbation, psychotic disorder NOS, and multiple rapes of women, who had been found not-guilty by reason of insanity for the crime of sexual assault. After incarceration for 3 years pending trial, he was committed to a state mental health facility. He reported continual preoccupation and sexual fantasy of raping and exposing himself to women, which was not affected by fluoxetine intake of up to 80 mg/day. He was started on leuprolide acetate 7.5 mg intramuscularly and maintained on this for 12 months. He reported a loss of all sexual functioning and interest, and in particular of the deviant sexual fantasy and arousal. However, he developed unilateral gynecomastia and complained of the loss of sexual functioning and discontinued the depot-leuprolide acetate. His testos- terone went from a pretreatment level of 525 ng/dl (normal being 286–1511 ng/dl) to a posttreatment of 41 ng/dl at 1 year of treatment. It took 3 months after discontinuation of the depot-leuprolide acetate before the patient’s sexual functioning fully returned. His gynecomastia had not returned 5 months after discontinuation of leuprolide."

I thought this point raised in the discussion part of the paper was interesting too.

"Although long-term treatment with anti-androgens might be necessary to continue reduced sexual arousal (Thibaut et al., 1996), the use of leuprolide acetate for a shorter duration of treatment with a focus of helping an individual obtain control of his sexual impulses and behavior and make use of other treatment modalities is illustrated by some of the cases discussed previously (Patients #1, 2, 5, 8, and 9)."

[guy26 (imported)]

I might mention that my mood has been noticeably up for the last couple of weeks. I'd say that it is above base line and I'm in hypomanic territory. The mild hypersexuality lately only adds to my impression.

I'm really not for sure how my mood is going to react or change to this trial of leuprolide. My intuition is that it will kill the mild hypomania as soon as my testosterone levels start falling. My only hope is that it doesn't trigger ultra rapid cycling. That would make for a very bad time.

I took my first dose yesterday. It is easy to do after some instruction. I'd say it is much easier than giving oneself an intramuscular injection on the back side. It certainly hurts less! I have a slight reaction at the injection site that lasts for about 30 minutes to an hour. It isn't anything bad and it just happens to some people.

I noticed that toward the evening yesterday I felt unusually relaxed, chill, and satisfied in life. I'm not for sure how to better describe it or whether it was really associated with the injection or not. There are all kinds of possibilities for psychosomatic effects as I proceed with this. This morning I woke up with the hardest morning erection that I can ever recall. And my cardio workout felt easier even though I kicked it up a notch.

I'll try to post as I notice things or if I have something interesting to say. Feel free to ask anything too. Who knows, maybe I'll be less motivated to write as this progresses. LoL. I have seen too many people disappear after they start something like this. But in my case I still have a desire to write when *interesting* things are happening in life.

[Caith721 (imported)]

Here's hoping the T flare doesn't severely impact you. At best, it could give you some insight into what higher T levels would be like for a few days. Just remember if it becomes too intense during the period of flare, that it's strictly a chemical cause of any new thoughts and impulses, and it should pass within days. Don't obsess on it too much, because you're aware in advance what's causing it.

I wish you great results with your lupron treatment.

[nullorchis (imported)]

guy26,

Copy and paste your postings into a word processor. You have the makings of a journal that might wind up being a book or major motion picture some day.

You write well, and a lot. It is interesting reading. Some of which I can relate to when I was young. For some people going from young to old is like going down a slide. For others it is like slogging through a field of mud.

Hopefully drugs, therapy, both, or something else will help you to work through these thoughts so that you can go about each and every day just enjoying life, not struggling through it. If I had a magic wand I would wave it and give you the peace of mind you seek, and deserve.

But I have no magic wand. If I did can you imagine the line of people at my door? Guys wanting to look like Matt Damon or Brad Pitt and wanting 19 inch cocks and ball as big as lemons. Wow, could that get boring.

[guy26 (imported)]

Thanks nullorchis,

I have had a journal for a little over 5 years now. It is quite hefty as is. It is around 130,000 words by now, so it could be turned into a book of sorts. It is a mixture of both my struggles with bipolar and the surrounding issues of being driven toward castration. I generally copy down everything that I post on the eunuch archive. But obviously my journal contains writings from a number of sources that I've written else where.

It even has numerous dreams. I post practically all of my dreams that I recall on Facebook and in my journal. I started having sleep issues for the first time in life last year. They started about a year ago when I entered rapid cycling for the second time ever. Despite getting over the rapid cycling and the sleep issues, I continue to wake up to nightmares and weird dreams at least once a week. They are more frequent when I have transient mood issues, especially right before bed.

At first I started posting my dreams just to get them out of my head. Sometimes a bad dream could negatively affect my mood throughout the day. And somehow sharing it with others allowed me to let go of it. It's strange but people tell me in real life that they really enjoy reading about them. And I've even had some of their friends add me on Facebook just so they can read them too. I've asked others rather they wish they could recall their dreams regularly, but few seem to like the idea of remembering them especially in such detail. And virtually no one would post them on Facebook because somehow they seem too personal. Mine are bizarre and really I would be hard pressed to make up such strange things without the help of drugs. LoL

I have decided to create a book once I get 356 interesting dreams recorded. I want to have my other half illustrate some of them. It seems like a cool project to do. I don't know if I will continue to have such interesting dreams and dreams that I can remember, but I hope so. Otherwise, I won't be able to complete the book. If I have to have so many nightmares, I want them to have a purpose besides soaking the bed sheets with sweat and irritating the hell out of me. LoL

Getting back to what you were saying… I've wondered at times whether my life story is really all THAT interesting or not. It is certainly uncommon, but is it really worth the attention of a large number of people to be made into a book or movie? That I don't know. LoL. If I thought so, I would think I was being conceited or hypomanic. For now I settle with sharing my castration related journey on the eunuch archive in hopes that someone else benefits from it.

I'm not for sure that I will ever escape the struggle in life. Without medication to control bipolar, I highly doubt it will spontaneously get better. If I'm lucky, I will get a few years of reprieve here and there. If I could be rid of the castration struggle, that would be worth just as much to me as getting rid of the bipolar. Having both problems can be a nightmare at times. Sometimes there is nothing to do but face reality and deal with the situation as painful as it might be. You can run away from a lot of things, situations, and people. But you cannot run away from yourself. I actually tried that once! LoL. After 40 miles I realized that that was a stupid idea. It was a critical moment in life and I was at my breaking point, so you can't fault the ridiculousness of it too much.

Sometimes I wonder how different my life would be if I was some other guy--straight, normal mood and emotions, and no castration fixation. All of these have led to huge struggles in life. I'm completely fine with being gay, but holy hell did it take a lot of struggling during my teenage years. If I'm lucky, the castration fixation is something that I will eventually resolve.

There isn't much reason to think about it, other than as a thought experiment. No amount of wishful thinking can make you be someone you are not. Life would most likely be a whole lot easier, but it would come at a price. I feel that many of the struggles I have had in life have allowed me to better understand myself and my place in life. Without serious struggles, people can become so complacent that time passes them by and much of their time is spent without really enriching them or having spent the time well.

Don't get me wrong. Everyone has problems. It is just a matter of what kind, how many, and how extreme. When I went to Guatemala for three weeks, I didn't go as a tourist. I went there and lived like they did. Maybe part of my problem is that in the absence of any real difficulty in life, my mind takes up the slack with its own special concoction of suffering and pain. LoL. I may be forever screwed if that's the case.

So maybe it is good that you don't have that magic wand after all. You probably would have already broken it off in some guy's ass anyway after he pressed you too far to grant some wish. LoL. I mean how many 19" inch cocks can the world have?

I'm glad that you can relate to some of what I write about. I don't know where I'm going with this reply, so I better stop now.

[experiment (imported)]

My inlaw was on leuprorelin for 2 years with the injections every three months. I accompanied him during the initial doctor visits and injections. The doctor told him he would experience an increased sexual ability for about two weeks followed by a sudden crash. As the doctor said, you can forget about the Playboy pictures after that. The leuprorelin was intended to shrink the prostate as well as supplement the radiation treatment. He was not a candidate for surgery.

While I did not discuss my inlaws actual experience, he did complain about frequent hot flashes and discomfort. He started on radiation for 13 weeks about a month later and continued the leuprorelin injections until this past Sept.

During the two year period he also gain a lot of weight in the midsection, although that may also have been a partial result of a sedentary life style, which could also have been a result of the hormone treatment.

Now that he is off the leuprorelin, it reamins to be seen if he will lose any weight. The hot flashes seem to have become less frequent.

[guy26 (imported)]

Hi experiment,

Thank you for relaying your in laws experience with leuprorelin. From everything that I have researched, it sounds spot on. Today I finally found what I was looking for on pubmed. I knew that there was an increase in testosterone levels followed by a crash, but I didn't know exactly what that curve looked like. If you go here,

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC

1472892/figure/F1/ , and look at the picture on the left you can see what a typical course of leuprolide will look like. (If you want to read the corresponding article it is free and can be found here, http://www.ncbi.nlm.nih.gov/sites/ppmc/ ... MC1472892/ .) You should note that this is the average response. Sometimes it takes longer before the crash happens and some guys don't see a large spike in testosterone levels.

From what I have read there is virtually no difference between the daily injections and the monthly or longer intramuscular injections. If there was a difference, I'm sure the treatment protocol for prostate cancer would favor one over the other. The larger reason for the monthly or longer injections has to do with compliance and convenience.

It is noteworthy that the amount of leuprolide acetate typically prescribed is a LOT more than is actually necessary to cause a profound down regula

tion in LH/FSH, which causes te

stosterone levels to fall at or below castrate levels. It has even been given in the 20mg/day range without problems. But because of the expense of leuprolide acetate, it has been studied whether it is necessary to give as frequently as initia

lly approved for treatment of prostate

cancer by the FDA. http://www.ncbi.nlm.nih.gov/pubmed/17509298 . From the abstract, you can see the frequency could be reduced by as much as 40% to get the same effect. And since I'm not REALLY wanting to go all the way down, it's likely that we will need to cut the amount I'm taking by a significant amount. The reason I'm on the daily injections is so that we can adjust the amount of down regulation. That isn't really possible or as flexible with the longer acting intramuscular injections. Initially with those, a large amount of the GnRH agonist is in the blood stream, but it falls to just a constant trickle in the low ng/dL. With the daily injections there is a large rush of it in the blood stream and it is cleared from the body in hours. I have not found a protocol for what we are trying to do in my case on pub med, but everything I've read suggests that it is possible and reasonable. The GnRH agonists given in nasal spray form are typically given in the least amount necessary to delay puberty in children with central precocious puberty. My wild guess is that I will need to go from 1mg/day to between .25 and .5 mg/day or maybe just increase the time between doses. The plan thus far is to start at castrate levels and work up to what I feel is right. I have a feeling this is going to take a while to get right.

[guy26 (imported)]

Today is day 6 of being on 1mg/day of leuprolide acetate. I began to notice some changes, but not because of low testosterone. The most prominent thing that I have noticed is waking up at 3 to 4 am with a very hard erection and being excessively aroused. I'm not kidding. I pretty much have to take care of business right then and there and it doesn't matter rather I'm tired or not. I would almost describe it as an overwhelming drive to relieve the sexual tension.

Two days ago was remarkable. I felt beyond great. I physically felt as young and vibrant as a 15 year old. I truly can't convey to you how great that felt. I was filled with joy, but it didn't feel like any kind of hypomania. I've been there enough times to know what that is all about. Maybe my testosterone levels were simply beyond normal--125% of the high end of normal? I would trade a lot if I could feel like that every day. I have not felt that way in well over a decade. If it was because of more testosterone, having less certainly makes me go, "hmmmm." LoL

As a reminder, I was hypomanic and had a bit of hypersexuality before starting the leuprolide acetate. The hypersexuality has surprisingly NOT gotten any worse. This is despite my testosterone levels having most likely gone up significantly since starting the GnRH agonist. I went from reaching climax 2-3 times a day down to about once a day when initially starting treatment. Then it went back up to 2-3 times a day. And yesterday and today was an exception with only climaxing once. I don't think this means much, but now you know anyway.

I continue to feel a sense of inner peace and relaxation a few hours after injecting the leuprolide in the morning. This has truly been a reprieve from the inner chaos that I normally feel. In fact, this inner peace has finally opened up my mind to its full intelligence and focus to working on life, real problems, and not just trying to manage the internal craziness that I constantly feel. It has been a very long time since I have felt normal because of the bipolar. I would describe this chaos as always under my skin, boiling, and ready to explode at any moment. Or maybe I would describe it as a constant vibration that is distracting at best and reaches a harmonic that tears me apart at worst.

My hypothesis for this inner peace is that the leuprolide is causing the production of testosterone to continue to rise after it should normally be peaking in the morning. And this extra boost of testosterone really improves my mood. If I recall correctly, natural testosterone production peaks at around 8 to 9am. Maybe it is instead peaking around 2 to 3pm. The idea with this is that the injection is trigging the pituitary to again release more LH and FSH which in turn immediately triggers the production of testosterone. I really don't know how fast each system responds to the other, so this could be entirely wrong. I have found no support for this idea on pubmed, so I have no idea. It could easily be my imagination. Or maybe the leuprolide acetate is shifting my normal production of testosterone to a different time compared to my natural rise and fall in testosterone levels? Or maybe the time and curve of the rise and fall of testosterone is the same, but it is just reaching higher levels?

I'm kind of curious about the guys on the Eunuch Archive that have been castrated, but then gone on to use HRT especially as an injection of testosterone. Did you notice any change in your mood or sense of well being by not having the daily rise and fall in testosterone levels? Is this even something that someone could be cognitively aware of? And if you are aware of it, how does it affect you?

Having started the leuprolide acetate, it is has given me a lot of opportunity to reflect on what it is that I hope to accomplish. This isn't just a single injection that I have to build up the internal drive and will power to do. A single injection of depo provera has quite noticeable effects on testosterone levels for about 3 weeks for me. And once you do it, it isn't coming back out. You just sit back and let it do its thing. Instead with this, I have to actively do something every single day and that means I have to feel that this IS the right thing to do. So from that perspective, this trial of leuprolide acetate is much different than the previous intramuscular injections that I have done with depo provera. I think that this can be a good thing though. When my testosterone levels are much lower AND I continue to inject the medication, that will be a positive sign to me that I am doing the right thing.

My other half has been very supportive of me. He feels strongly that I should definitely not play my own doctor. I've been guilty of it way too many times. For once in my life, I have agreed to work with my doctor and follow through with what we both agree on. So that means I will take 1mg/day for 28 days consecutively and then re-evaluate what I am going to do.

I was really happy with the outcome yesterday. I suddenly had a bad case of anxiety and I was unable to inject the leuprolide acetate. I couldn't do it. It wasn't because I didn't want to. I just couldn't because of the anxiety of sticking myself with the needle. It doesn't hurt, so I don't why I couldn't do it. I gave my other half a quick run down on how to do it after he washed his hands. Everything was all ready to go but the actual injection. He was happy to do it and he didn't hesitate. He told me not to beat myself up over it. He attributed it to my mind being in conflict about really wanting to take it or not. He said he has no problems giving it to me every day if that is what I want to do. I may do that. It is an easy way for him to be an active part of this process too.

Hopefully I didn't wander too much in this post. LoL