Just wanted to throw this out here. I've been using Chemical Castration to control Bipolar Issues & in particular some Hyper-Sexuality problems that are unfortunately an all to common part of Bipolar & were causing some serious marital problems & were causing various other problems too. I knew that if I didn't get the Hyper-Sexuality under control, fast, it would soon spiral down into getting out of hand & start causing legal problems. That was a line I could not cross!

Every time I've been on Physician Supervised Testosterone suppression, including this time, life has been so much nicer! Bipolar swings are much softer & not near as far up or down. Anger it seems, is way down. Thinking is clearer. And best of all, Hyper-Sexuality is basically gone!

Now comes the proverbial "Million Dollar Question"! I'm not sure how much longer Medicare & Medicaid will keep paying for the T-Supression shots. In addition, I may soon lose Medicare & Medicaid in 10 months that now I'm getting finally getting healed up & getting back to work after being laid up for the better part of 10 years.

Now here's my quandary. I'm not sure if I can afford to pay for the shots right now if Medicare/Medicaid chooses not to pay at this point. I'm not sure I'll be able to pay for the shots in 10 months without Medicare/Medicaid. I don't want to do anything without my PCP's Blessing.

I'm 52. My wife & I have been going to the same PCP for about 10 years now & we love HER! She has been with us through the Good Times & when I had to face death without surgery. She is also the one prescribing the T-Supression Shots. She knows exactly what I'm going through with my Bipolar & my Hyper-Sexuality. She cares & this is why she is giving me the shots.

Now do I take the "Next Step" or what do I do? I've had Gastric Bypass Surgery so shots are about my only option chemical wise as pills normally dissolve & get absorbed fast enough before my system clears them out the other end.

Decisions! Decisions! One of the hardest decisions ever!

Any advice?

It is remarkable the number of people whose emotional and mental state stabilizes when T is lowered. There are so many of us here , very different in so many ways and yet a common denominator is Testosterone causing issues.

It sounds like you have both a supportive wife and doctor and I would talk to them about the options. If your mental state is stable with low T and you and your wife are happy with this it is a logical step to get it done surgically and maybe have a low T supplement. With the right care and health monitoring you may well be better off as the injections also have side effects long term.

You need to keep an eye on your bone density.

jcat (imported) wrote: Wed Feb 11, 2015 12:34 am It is remarkable the number of people whose emotional and mental state stabilizes when T is lowered. There are so many of us here , very different in so many ways and yet a common denominator is Testosterone causing issues.

It sounds like you have both a supportive wife and doctor and I would talk to them about the options. If your mental state is stable with low T and you and your wife are happy with this it is a logical step to get it done surgically and maybe have a low T supplement. With the right care and health monitoring you may well be better off as the injections also have side effects long term.

You need to keep an eye on your bone density.

I totally agree with Jcat, get them removed surgically and then look at low T supplement. The great thing with TRT is that you can tailor it to suit your requirements very easily, in fact far more efficiently than with normal T production. Take it from someone who has been castrated and is on TRT, getting my balls removed was one of the better decisions in my life.

Agreed. An annual checkup -often included with insurance- should see you right.

DP or Trelstar in the long-term doesn't seem the best. A fine spouse and doc, and maybe you should consider the surgical option.

It has suited many here.

I get my PSA & T checked together every 6 months. I have to request the T check otherwise they would probably only do PSA. I never get a bill so Medicare and/or the supplemental must be paying for it.

The only thing I would add is to have the TRT plan in place

I had soul crushing depression issues with a too low T level, and the roller coaster ride in my early days of TRT

yes, I do agree with the idea of "tailoring" it to your lifestyle. It is something that I have managed to do fairly well.

Hyper-active libido problems here. I had lots of therapy to control this, but that only meant that I learned to say "No" to myself. Therapy did not control/remove the urge. Surgery ended my urges. With zero T, I am at peace with myself now.

Update: My psychologist is now on board with T-reduction/stopping T production & is sending letter to PCP. Going back to PCP this coming Wednesday. As far as I know PCP should put me on DP on a regular basis for a while, guessing for a couple of months or so to see how things go again with T-blockage. I the time being I'm going to ask my PCP for a referral back to the same Urologist that I saw a few years back when I had my vasectomy. He is Middle Eastern. My guess is that surgery is Green Lighted, he probably would have the least qualms with doing the surgery + going through him it would be covered by my insurance which would make for a ++!

Quick Update: Right now my PCP has me on Bi-Weekly injections of Depo-Provera as suggested by my Psychologist. This is to see if this is the proper treatment for me. So far so good! Today was my third injection. My guess is that this regimen will continue for three or four months and as long as results continue as well or better as they are right now, then we will start looking at a more "permanent" solution.

I do however have one slightly nagging question. If wee decide to go with the Surgical Option, would that not allow a slightly higher amount of Testosterone in my body then what I have now? It's my understanding that with the fairly high dosage rate of Depo-Prevara that I'm on, that my T-Levels are basically dropping to zero. Or is it that the slight increase in Testosterone that is produced elsewhere in the body be so little that it will be of no consequence?

bigdude1 (imported) wrote: Thu Mar 12, 2015 11:02 am Quick Update: Right now my PCP has me on Bi-Weekly injections of Depo-Provera as suggested by my Psychologist. This is to see if this is the proper treatment for me. So far so good! Today was my third injection. My guess is that this regimen will continue for three or four months and as long as results continue as well or better as they are right now, then we will start looking at a more "permanent" solution.

I do however have one slightly nagging question. If wee decide to go with the Surgical Option, would that not allow a slightly higher amount of Testosterone in my body then what I have now? It's my understanding that with the fairly high dosage rate of Depo-Prevara that I'm on, that my T-Levels are basically dropping to zero. Or is it that the slight increase in Testosterone that is produced elsewhere in the body be so little that it will be of no consequence?

First of all, when appropriate, have the PCP order a total testosterone level test. As far as the adrenal gland, which also produces T, for most people it seems to be in the 35-50 range. I would not call that too much. Of course, your levels could vary some.