The psychosexual psychiatrist is considering writing a letter to a surgeon to give the go ahead with an orchiectomy, and he prescribed me depo provera, so i wont need to order it from inhouse anymore. The urologist also seemed very hopeful. Only thing that worried me, he said eunuchs have a high risk of developing dementia, and also havinh heart attacks, which i never knew. Yet there are eunuchs on this forum, above 60 years old, that seem very mentally functional, and not with dementia.

Matthew 19:12 (imported) wrote: Wed Mar 21, 2012 2:58 pm The psychosexual psychiatrist is considering writing a letter to a surgeon to give the go ahead with an orchiectomy, and he prescribed me depo provera, so i wont need to order it from inhouse anymore. The urologist also seemed very hopeful. Only thing that worried me, he said eunuchs have a high risk of developing dementia, and also havinh heart attacks, which i never knew. Yet there are eunuchs on this forum, above 60 years old, that seem very mentally functional, and not with dementia.

I have seen nothing in the literature to substantiate the dementia claim. There is some evidence to support the heart attack claim, but as I understand the literature it is not a significant risk.

Matthew 19:12 (imported) wrote: Wed Mar 21, 2012 2:58 pm The psychosexual psychiatrist is considering writing a letter to a surgeon to give the go ahead with an orchiectomy, and he prescribed me depo provera, so i wont need to order it from inhouse anymore. The urologist also seemed very hopeful. Only thing that worried me, he said eunuchs have a high risk of developing dementia, and also havinh heart attacks, which i never knew. Yet there are eunuchs on this forum, above 60 years old, that seem very mentally functional, and not with dementia.

I found this on the college data base.

Prevalence and predictive factors for the development of de novo psychiatric illness in patients receiving androgen deprivation therapy for prostate cancer.

Authors:

DiBlasio CJ; Hammett J; Malcolm JB; Judge BA; Womack JH; Kincade MC; Ogles ML; Mancini JG; Patterson AL; Wake RW; Derweesh IH

Author Address:

Department of Urology, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.

Source:

The Canadian Journal Of Urology [Can J Urol] 2008 Oct; Vol. 15 (5), pp. 4249-56; discussion 4256.

Publication Type:

Journal Article

Language Code:

eng

Journal Information:

Country of Publication: Canada NLM ID: 9515842 Publication Model: Print Cited Medium: Print ISSN: 1195-9479 (Print) Linking ISSN: 11959479 NLM ISO Abbreviation: Can J Urol Subsets: MEDLINE

MeSH Terms:

Androgen Antagonists/*therapeutic use

Anxiety/*epidemiology

Dementia/*epidemiology

Depression/*epidemiology

Prostatic Neoplasms/*drug therapy

Prostatic Neoplasms/*psychology

Aged ; Aged, 80 and over ; Androgen Antagonists/adverse effects ; Anxiety/chemically induced ; Anxiety/physiopathology ; Dementia/chemically induced ; Dementia/physiopathology ; Depression/chemically induced ; Depression/physiopathology ; Humans ; Logistic Models ; Male ; Mental Health ; Middle Aged ; Multivariate Analysis ; Orchiectomy ; Retrospective Studies

Abstract:

Objective: Androgen deprivation therapy (ADT) remains a widely utilized modality for treatment of localized and advanced prostate cancer. While ADT-induced alterations in testosterone have demonstrated impacts on quality of life, the effects on mental health remain ill-defined. We investigated the prevalence of de novo psychiatric illness and predictive factors following ADT induction for prostate cancer.

Materials and Methods: We retrospectively reviewed patients receiving ADT for prostate cancer at our institution between 1/1989-7/2005, excluding men receiving only neoadjuvant ADT. Variables included age, race, body mass index, prostate-specific antigen (PSA), Gleason sum, clinical stage, ADT type (medical/surgical) and schedule (continuous/intermittent), and presence of pre-ADT and newly diagnosed psychiatric illness. The cohort was divided into three groups for analysis: pre-ADT psychiatric illness, de novo psychiatric illness, and no psychiatric illness. Data analysis utilized statistical software with p < 0.05 considered significant.

Results: Three-hundred and ninety-five patients with a mean age of 71.7 years at ADT initiation were analyzed. Thirty-four men (8.6%) were diagnosed with pre-ADT psychiatric illness. At mean follow-up of 87.4 months, 101 (27.9%) men were diagnosed with de novo psychiatric illness, most commonly including: depression (n = 57; 56.4%), dementia (n = 14; 13.9%), and anxiety (n = 9; 8.9%). On multivariate analysis, increasing pre-ADT PSA was predictive of post-ADT anxiety (p = 0.01). Overall and disease-specific survival outcomes were similar between groups.

Conclusions: De novo psychiatric illness was identified in 27.9% of men. While no predictive factors were identified for de novo psychiatric illness, increasing PSA was associated with de novo anxiety. Prospective investigation using validated instruments is requisite to further delineate the relationship between ADT and psychiatric health.

Substance Nomenclature:

0 (Androgen Antagonists)

Entry Dates:

Date Created: 20080925 Date Completed: 20081030

Update Code:

20111122

PMID:

18814813

Database:

MEDLINE with Full Text

Not sure if that number is above or below the normal percentage of people who would get dementia no matter what. Hope that helps.

Elizabeth

What is very real is Osteoporosis, depression, weight gain, loss of strength.

River

Matthew 19:12 (imported) wrote: Wed Mar 21, 2012 2:58 pm The psychosexual psychiatrist is considering writing a letter to a surgeon to give the go ahead with an orchiectomy, and he prescribed me depo provera, so i wont need to order it from inhouse anymore. The urologist also seemed very hopeful. Only thing that worried me, he said eunuchs have a high risk of developing dementia, and also havinh heart attacks, which i never knew. Yet there are eunuchs on this forum, above 60 years old, that seem very mentally functional, and not with dementia.

Not having a Master's Degree or Doctorate, I can only reply in ordinary language and from my own personal eperiences.

When my testosterone level quickly dropped I experienced unpleasant mental, emotional and physical consequences.

Could not concentrate or stay focused on anything; got very confused over little things.

Experienced some depression which was a new experience for me.

Got very very tired and weak and saw visible reduction in muscles.

Impossible for me to say what the invisible medical consequences were / are, such as the beginnings of osteporosis or ?

It has been 2 years now since that initial drop in testosterone, which I intentionally brought on via Siterone.

A lot of ups and downs since then, but, having eventually caused my testes to stop producing testosterone via alcohol injections, I am now stabilized on a very low dose of HRT to keep my T level somewhere around 150 or so, and it surely fluctuates as I am not all that regular with application - I get busy or forget.

Were I to do it again, or if I were to go from normal T to surgical castration, I would embark on a program that would lower my T very very slowly, over at least a year. I have no medical evidence that this would help prevent or minimize the feelings and experiences I got with Siterone. I just suspect that rapid or sudden loss of testosterone may cause such a disruption in one hormone, which affects other hormones, that it creates what I call Testosterone Withdrawal Symptoms. TWS.

But a slow reduction in T gives other hormones time to adapt and gives the mind, emotions and body time to adapt. Maybe. Just an idea.

In the long run it would be personal choice (impacted of course by insurance and bank account) if one wants to use HRT after loss of normal testosterone production, and how much to use. I have finally adopted 1/4 of a dose of prescribed HRT per day, and sometimes I go a day or more using none. When I start to feel the effects of using none, I start up again. Kind of reminds me of an old old advertisement for hair cream: A Little Dab Will Do Ya. I think that was an ad for Brylcream, really gunky stuff. Anyway a little dab of HRT does me.

More than likely what we put into our stomachs (food and drink) will have more impact on the heart than having or not having testosterone.

People perpetuate careers conducting government funded studies and then publish the results in language that can be understood only if you have a brain clot.

I understand what I have experiended, and do my best to convey that in words, which really can not convey feelings or emotions.

You have to look at what everyone says in the EA, or web, with a degree of caution, but eventually when you start to see a common thread from a variety of people in a variety of sites it can be an indication of a trend that may be true, for them, but still not necessarily for you.

Life is a roller coaster, but not like one at the amusement park. Those always come back to the same place. Life's roller coaster never returns and its destination is unknown. You either get in the car and move forward, or stay on the platform and watch everyone else go for a ride. Life is a constant battle between that within us that creates our fears and throws up walls, and another part of us that wants to be free and be ourselves. Once we stop looking at who we are not, and stop balking at doing things and just start doing things we are on the path of progress of not knowing who we are to being who we are. Too much introspection inhibits progress. Decide on what you really want, know you want it, make a plan of steps to get it, and then proceed with the plan, altering it along the way as needed. Just make sure that what you want is in your best interest, and if it affects others, in their best interest too.

And you can not think too much about what others think of what you decide you want. For no matter what you decide you want, even if you want nothing, there will be a limitless number of people who will think what you want (or don't want) is silly, odd, crazy, stupid, dangerous, dumb.

Like the guy who climbs up vertical rock mountains with no equipment.

Well, I do have a bioengineering doctorate, and was all-but-thesis at the time of my orchiectomy. I had read and studied all the identified risk factors I could find in a big city medical center research library, risk factors associated with retaining testicles and testosterone and risk factors associated with not keeping testicles and testosterone. Using Bayesian decision theory methods, I reached the resolute view that i faced much more likely than not future which keeping testicles and testosterone would be far shorter than my future without testicles and testosterone.

At soon to be age 73, objective testing suggests that I am genuinely thriving, and am without noteworthy dementia, and I an working physically, sometimes lifting and moving objects weighing far more than a hundred pounds, as I did in my younger days, and have had no problems with bone strength, though bone mineral density measurements indicate lower-than-average-for-my-age bone calcification.

I am very nearly a decade older than my dad was when he developed terminal cancer and more than two and a half decades older than my brother was when he died from the form of cancer I set out, in 1986, to delay or , if possible, prevent. Results to date? Prevention.

There is a hazard lurking in conventional human thinking, and it has at least two aspects. The first is the proximate cause error, sometimes recognized as the "after this, therefore, because of this" fallacy (cannot do without the Latin version? "post hoc, ergo propter hoc") The second is sometimes recognized as "illusory correlation."

My dad, as part of his work, sometimes visited with people in their homes. Once in a while, someone he was visiting would ask him if he would like coffee or tea. With people he thought would not summarily evict him from their home, he sometimes replied, "Yes." Having learned from my dad, I have also sometimes answered a, "would you like A or B?" question with, "Yes." And, once, as I recall, I was given a cup half coffee and half tea. Which I deemed an improvement, for me, in that situation, over either alone.

Sufficiently before a choice is made, a person may be considering a number of alternative choices. After a choice is made, the alternatives that were not chosen, and therefore did not happen, did not result in observable events because events, to be observable, need to happen.

There is no way to know about the pathways one's life did not take, this being true simply because the pathways one's life did not take did not happen, and, in not happening, were impossible to observe.

I am coming to a sort of hunch that doing single-parameter optimization of a multi-parameter situation may be fraught with more potential peril than almost any form of multiple-parameter optimization.

Around the time of puberty onset, I developed a bone fracture in a situation that would not ordinarily result in a fracture. I was advised then that I had somewhat fragile bones. It is unclear to what extent my lower than average bone mineral density preceded the orchiectomy or not.

The average age of death, in the absence of effective medical prevention, for the genetic cancer condition in my family is 42 years. While both my brother and dad did better than that, neither made it to 70.

So, I make decisions and live or die, with them. Only, I observe, as a bioengineer, that life is made of death as death is made of life, and life and death are really merely aspects of the overall process of life; in the absence of death, I can eat neither plants nor animals; in the absence of death, I cannot not live.

Information on the effects of castration on humans comes from a number of different sources, some more useful than others.

1) Studies of the impact of castration on domestic animals. Animals have been routinely castrated since before the invention of writing. We know from simple observation (not even requiring controlled testing) some of the impact of castration on sheep, goats, pigs, cows and horses. Most of us have observed changes in domestic dogs and cats after castration. More recently, there have been controlled experiments with laboratory rats. Some of this is quite useful and important. For example, one on-going set of experiments (not yet fully reported in the literature) demonstrates that castrated adult male rats given female rat doses of estrogen exhibit male rat sexual behavior at a level only a bit below that of intact male rats. Important for prostate cancer patients who are castrated to slow the progression of their disease and for whom loss of sexuality is one of their major complaints.

2) Anecdotal information on historical eunuchs and castrati. Human castration began by at least 2100 BCE. Unfortunately, the information is not very good or reliable. There are a few articles on the subject listed in the BIBLIOGRAPHY (http://www.eunuch.org/forums/showthread ... bliography) on the Non-Fiction Articles board. I am always looking for more such articles, but they are certainly rare. They do suggest a longer life expectancy for eunuchs, possibly through a lower rate of heart disease. Interestingly, osteoporosis, which is one of the most common effects noted today, does not show up in the historical literature.

3) Those presenting in hospital Emergency Rooms following botched self-castration or castrations by cutters who did not know the risks they were taking. Over the past century, about one such case per year has made it into the medical literature (though there are many more out there. One urban hospital that I checked had FIVE such cases in a single year). There are references to a few of these in the http://www.eunuch.org/forums/showthread ... bliography]BIBLIOGRAPHY[/url (http://[URL="http://www.eunuch.org/forums/showthread ... bliography]BIBLIOGRAPHY[/url")]. They mostly conclude that the patient is psychotic and provide little or no information about medical consequences. There is no follow-up once the patient is released from the Psych Ward. Many of the patients probably were psychotic at the time – performing self-surgery while drunk and without ever having done adequate research on the subject.

4) Studies of prostate cancer eunuchs. Prostate cancer is testosterone dependent and over one-third of those diagnosed with PCa are castrated within six months of the diagnosis. Most of the rest are eventually castrated if the disease progresses. All information gathered from this population is colored by their co-morbidity of terminal cancer. Loss of sexuality, depression, and osteoporosis are the major complaints noted in the medical literature. Also noted are lower energy levels (leading to weight gain) and mental changes (usually noted as loss, but not properly tested yet).

5) Results of two surveys conducted on the Eunuch Archive community. Data from the second survey has not yet been completely analyzed and published, though we’re getting closer. All articles published to date in the medical literature from this work are listed in the BIBLIOGRAPHY (http://www.eunuch.org/forums/showthread ... bliography). The results have also been discussed in various threads here on the EA. The next article up will be on personality changes – a full personality test was included in the questions on the second survey. The results are interesting and show shifts, but NOT in the direction of “female” personality structure. I’ll post when the article sees print and make copies available to members here.

Thanks guys for all the useful information. he's just informed me that he wants to put me on cyproterone 100mg daily instead of depo provera. Hasnt cyproterone got worse side effects though?

Not at that low a dosage, it doesn't. You'd have to take over 300 mg daily to begin worrying about liver impact. Cyproterone doesn't contain the synthetic progestin that Depo Provera does, so it's not as likely to cause mood swings.