HRT and Sexual Functioning

[JesusA (imported)]

Since the subject of Hormone Replacement Therapy (HRT) keeps coming up, it's probably time to repeat one of the bits of information from the Eunuch Archive survey. The data below has not yet been published, but an article is in the final stages of preparation for submission.

Two questions on the large Eunuch Archive survey (asked with other questions in between) are relevant. All respondents who had been castrated either chemically or surgically were asked, "Six months to a year prior to your castration how often did you engage in sexual activity, either solitary (e.g., masturbation) or with a partner?" Later in the survey they were all asked, "Today how often do you engage in sexual activity, either solitary (e.g., masturbation) or with a partner?"

The same multiple-choice options were given each time:

Several times per day

Approximately daily

Several times per week

Once a week or less

Never, or almost never

There were 71 respondents to the survey who had been surgically castrated and who took FULL REPLACEMENT TESTOSTERONE HRT. Of the 71, 28 (39%) reported no change in frequency of sexual activity. Nine (13%) actually reported an increase in sexual activity, but 31 (44%) reported a decrease in frequency and 3 (4%) reported that they had become asexual after castration, even with full testosterone replacement.

The full article will explore this, together with the data on those who used no HRT, who used minimal doses of T or E, and those who used an MtF transitional dose of estrogen. The article will also explore differences according to sexual orientation and will look at questions about sexual fantasy and sexual partners.

What is important, though, is to remember that YOUR MILEAGE WILL VARY. There is no way to accurately predict any changes in sexuality after castration, no matter what HRT regimen you choose.

[nvrgag44 (imported)]

Jesus, you always come up with interesting topics. I look forward to reading your article.

[JesusA (imported)]

To give the other end of the HRT spectrum, there were 68 survey respondents who had been surgically castrated and were taking NO HORMONES OF ANY KIND. Of these, 9 said that they were asexual before castration.

Of the remaining 59 who had been sexually active before castration, 27 (46%) reported that they had become asexual. Of the rest, 7 (12%) reported that their level of sexual activity had remained about the same and 25 (42%) reported a reduced level of sexuality -- 18 of that 25 to the level of "once a week or less." No one reported becoming more sexually active.

Castration and complete lack of HRT does not result in compulsory asexuality any more than full replacement HRT always results in maintaining full male sexual functioning. YMWV!

[ZeuterMe (imported)]

Really interesting data, Jesus!

I just wish the data set was bigger, to allow for the statistical comparison of distinct sub-populations - it doesn't seem shocking to me that those who do without HRT might be there seeking a libido reduction, for they're a vocal minority on the Archive, and they generally seem to find what they're after once they're fixed. It'd be interesting to bring more cosmetic, cancer, and trauma-induced eunuchs into the study, and see how much one's motivation has to do with their outcome.

New statistical methods based on the magnitude of statistical error can - as of last week! - tease apart cause and effect, I just wish there was a big enough dataset to feed into it.

(Every method has statistical noise in it. An independent variable has statistical noise, but a dependent variable is influenced by its own statistical noise PLUS the statistical noise of the independent variable. Recently published algorithms now allow one to tease apart simple causal relationships from easily observed correlations. It chokes on iterative functions, but this might be as significant a discovery as Student's T-Test.)

[jcat (imported)]

Jesus, this is very stimulating food for thought.

I have always been able to get aroused if I set my mind to it. Even when on cyprotone or depro provera and at my lowest T level of 46, I could with mental concentration get aroused.

There is something in this about mind over matter! Your stats are interesting and YMMV may have an emotional/psychological driver despite the lack of Testosterone. My mileage is that I can do whatever I set my mind too and quite often I am asexual and sometimes I wind myself up to be mega horny, it is all down to what I want at any given time.

It would be most interesting to understand this more in a holistic way (if that is the right term).

It could also be the case that a eunuch mind can stimulate hormone production in other areas to assist in stimulation by mental effort!

I can say that for me, my erections don't last as long, but the orgasm is much more intense and therefore better than before I started messing with my balls and hormones. I have never needed an erection to get get an orgasm either, it is just a different kind......

I think that human sexuality is enormously diverse, complex and many people never really discover the whole karma sutra! We often get stuck in a rut because of our aversion to diversity and variety!

I hope this makes sense...it does to me!

[nvrgag44 (imported)]

Jcat, you make a couple interesting statements.

First you mention a T level of 46 and still having some sexual interest. I've often wondered where the threshold is that puts us over the edge and all sexual interest disappears. I have no idea what my T level was while on Lupron but it made me miserable. I had no idea it was the Lupron causing it but that's another subject. Since stopping Lupron my T levels run from a low of 130 to highs in the upper 200s, tops being in the 280 range. My libido isn't what it used to be but still active. So I wonder how low my T levels would have to go before my libido disappeared. Is it one of those "your mileage may vary" things?

Second you mention being able to orgasm without an erection. I also fall in to that category. I always say, "It doesn't have to get up to get off".

[Wellesley (imported)]

I think age may play a factor in the "your millage will vary" argument

I find that stress also plays a factor. I tend to use a lot more T (i.e. I find my self feeling the lack much faster) while stressed.

[jcat (imported)]

Jcat, you make a couple interesting statements.

First you mention a T level of 46 and still having some sexual interest. I've often wondered where the threshold is that puts us over the edge and all sexual interest disappears. I have no idea what my T level was while on Lupron but it made me miserable. I had no idea it was the Lupron causing it but that's another subject. Since stopping Lupron my T levels run from a low of 130 to highs in the upper 200s, tops being in the 280 range. My libido isn't what it used to be but still active. So I wonder how low my T levels would have to go before my libido disappeared. Is it one of those "your mileage may vary" things?

Second you mention being able to orgasm without an erection. I also fall in to that category. I always say, "It doesn't have to get up to get off".

Nvrgag44 like you I got terribly depressed and felt crap when my T was so low. However, I could still get an erection and I could still arouse myself. It is definitely a YMMV and we cannot make generalizations about it. Just as there is a wide spectrum of T levels in the normal range for men so to in libido. I am convinced it is not just T that enables libido but the will.

[jcat (imported)]

txcowboyw2balls, I think HRT works differently for those with a full set and those who are either eunuchs or who have destroyed the testes with injections. In the scenario of a normal male with low testosterone it is normal for counseling to be given along side HRT as there is little doubt that our emotional state affects libido.

Testosterone replacement interferes with the Pituitary gland that sends messages to the testes to produce testosterone and when it gets wind of high levels of T it tells the testes to slow down....it seems that eventually the pitutiary gives up and the testes shutdown. This is called secondary testicular failure.

So the decision to to take Testosterone replacement is a big one as it may destroy what you produce naturally. Many opt for counseling, diet and natural remedies to enhance T production.

This may sound a bit outrageous: I think (my opinion) that there are two types of men those who think about sex and those who just resond to sexual stimuli or natural arousal. For me sex has always been something that starts in head and I think there is some mileage in this analysis. It is just my opinion.

[Kangan2008 (imported)]

I had a strong desire to eliminate all sexual drive/activity before surgical castration. After surgery, all sexual drive/activity ceased, not surprisingly. Your brain is a sex organ. T reacts with your brain to produce sexual behavior. No T + brain dead set against sex = no sex. I suppose the reverse is true if you are castrated and still desire sex. Kind of a no-brainer (pun intended).