Given that lifestyle and estradiol dosage remains the same (and no anti-androgen), will orchiectomy increases or decreases libido?

Orchiectomy decreases libido.

Orchiectomy decreases libido.

Not in every man!

While it does to varying degrees lessen libido some men experience no change in their sex drive. I can't quote the exact estimate, but recall it was somewhere around 15% of men castrated experience no change in their desires. Keep in mind the things you read and even are told by your doctors are based on very old surveys of prostate cancer patients mostly in their 60s and 70s who were not overly sexual to begin with.

I have been on estradiol for almost a year. It took a few months for my body to adjust until my modest libido returned. As more androgen deprived males are being treated with estradiol for their health new research is being conducted. One study found that adding progesterone increased libido as well as tactile sensory of the penis. The initial study was in rats but has recently been tested on humans.

I have blood work and a consult with my doctor very soon and will ask about trying progesterone to see if there is anything to it.

SmartestKen (imported) wrote: Tue Apr 13, 2021 7:46 pm Given that lifestyle and estradiol dosage remains the same (and no anti-androgen), will orchiectomy increases or decreases libido?

There are two organs in the male body that make testosterone - The testicles and the adrenals. The adrenal glands make a very small amount of testosterone. The testicles make the vast majority of testosterone.

Testosterone is responsible for the male libido and removing the testicles would drastically decrease male libido.

However, you mention in your question that you are on estradiol. Estrogen is responsible for female libido. So, if your dose of estradiol has stopped your testicles from producing testosterone, your libido is being driven by the estradiol.

To get your answer, you will need your doctor to do a blood draw and test your levels of hormones both estrogen and testosterone. If your testosterone is low enough, then castration won't change your current libido.

Always remember YMMV and only a doctor can test you hormones and tell you what is happening.

Does the male libido and female libido add up or cancel each other? (The reason I ask this is that before orchi, T (not fully suppressed) has the ability to compete with E, but after orchi, same (low) dosage of E will result in E dominant)

seanthomas (imported) wrote: Wed Apr 14, 2021 7:38 am It took a few months for my body to adjust until my modest libido returned.

Just to make sure I don't misinterpret the info, what was your E2 level that help achieve this?

To much E will be converted into T, Spiro also helps depress T

T can aromatize to E as the aromatase enzyme cleaves of part of the T to form E. It does not go the other way.

The fact is there is simply not enough research in the field from which to draw unequivocal conclusions. With the proliferation of transgender treatments perhaps more studies will give better answers.

What we do know is that surgical castration leaves a small amount of adrenal produced testosterone. Generally this is 50-60ng/dl but can be as high as 100ng/dl. (low T is generally considered under 300ng/dl). Some of that testosterone will convert into estradiol and in some cases can cause estrogen dominance.

We also know that both men and women produce male and female hormones in inverse proportions and a balance of those hormones is generally necessary for a healthy libido. Women need a little T and men need a little E. But what is a healthy libido? Wanting sex once a day, once a week or once a month?

One resent study of castrated men found that estradiol alone did not increase libido. Nor did progesterone alone. However, from the limited data there is some suggestion that a combination of both female hormones had a positive effect on not only sex drive but sensitivity as well. The down side to taking female hormones is gradual feminization, so many men would reject such treatment.

However, I will say this once again. Hormones aside, the human brain is the biggest sex organ in the body. So although hormones play a major role in libido, their absense is not the end all to a sex life.

Here is one article that may help answer the question.

https://www.urotoday.com/recent-abstrac ... ersug.html

BERKELEY, CA (UroToday.com) - Many prostate cancer (PCa) patients are treated with androgen deprivation therapy (ADT) to control their cancer’s growth. ADT results in sexual dysfunctions including loss of libido, erectile dysfunction (ED), and difficulty in achieving orgasm.[1] Loss of libido is a serious side effect for men on ADT because, unlike erectile dysfunction, there is no established intervention to compensate for it. When sexual desire decreases, patients often distance themselves from their sexual partners. As a consequence, intimate relationships are damaged.

Androgens are generally thought to be the hormones that give males their libido. However, in our review we show that estrogens can positively influence male sexual interest. We present evidence that in 19 out of 25 animal species studied to date, administering estrogen to castrated (androgen-deprived) males increases their sexual interest as indicated by copulatory and/or courtship behaviours.

We acknowledge that in some species, supplemental estrogen fails to elevate sexual behaviour above castrate levels. Many factors influence the effectiveness of estrogen in restoring sexual interest including treatment regimes (i.e., dose, type of estrogenic compound, route of administration), housing condition (i.e., lighting condition, number of animals per cage), and various intrinsic factors (i.e., age at castration, strain of animals). Therefore the studies failing to show that estrogen has a positive effect on male sexual behavior need to be cautiously interpreted as some factors that seem inconsequential may actually have a prominent effect on sexual behaviours.

In contrast to animal studies, solid data on how estrogen affects sexual desire for castrated men are few. PCa patients on high dose estrogen (commonly used to treat PCa prior to the 1980s) regularly reported reduced sexual desire. However, what has been poorly investigated is the sexual interest of androgen-deprived men with and without estrogen treatment. A few studies, with admittedly small sample sizes, suggest that castrated men undergoing estrogen treatment are, in fact, more likely to engage in sexual activity than those not receiving estrogen.[2, 3, 4] The type of sexual activity undertaken by the subjects in those older studies was regrettably not defined. If ‘sexual activity’ is exclusively defined as penile-vaginal intercourse, measuring it alone may mask a positive effect of estrogen on sexual desire. The problem is that erections per se, which are essential for penile-vaginal intercourse, cannot be restored by estrogen in androgen-deprived men with severe ED. Thus, non-coital and other erection-dependent sexual activities indicative of raised libido would not be recorded if ‘sexual interest” is only assessed by the incidence of coitus.

To date, no studies have investigated if PCa patients undergoing estrogen therapy are engaging in non-penetrative sexual activity, such as masturbation, oral sex, or activities using sex toys. These activities could be indicative of a libido elevated above castrate levels. Similarly we know of no studies that attempted to assess whether PCa patients on ADT, who received estrogen, maintain greater affection toward their partners in terms of kissing, cuddling, or simply spending time together.

In our review article, we also discussed the possibility that estrogen may have some regulatory role in male orgasm and genital skin sensitivity. The mechanism for orgasm is independent from ejaculation and does not require erectile function. Indeed there are case studies confirming that there are men on ADT, with severe ED, who still achieve orgasm.[5, 6] Furthermore, some animal studies show that estrogen can help maintain the electrical excitability of the pelvic floor muscles, which exhibit spastic contractions during orgasm.[7, 8, 9] Similarly, estrogen may have a positive effect on genital skin sensitivity. If estrogen can increase genital skin sensitivity, it may also help increase sexual arousability by tactile stimuli.

The last section of our article discusses the pros and cons of estrogen therapy and its use in PCa patients. Two of the well-known positive effects of estrogen are that it helps prevent osteoporosis[10] and hot flashes.[11] In addition, estrogen may be beneficial for cognitive function, though the evidence for this is more controversial.[12] Data from our lab show that estrogen has beneficial effects in promoting wakefulness and helping castrated rats recover sleep after sleep deprivation.[13] These results warrant further investigation in PCa patients as daytime fatigue and sleep disturbances are common problems experienced by men on ADT. In terms of the disadvantages of using estrogen therapy to treat PCa, gynecomastia is a prominent side effect. However, interventions are available; these include using prophylactic radiation before patients start ADT and cosmetic surgery after the fact for men severely bothered by gynecomastia.[14] What has not been studied -- and needs to be investigated -- is ways to tell ahead of time which men would be more or less likely to be distressed by gynecomastia, as the variation here is great.

There is also concern about the thromboembolic risk associated with taking oral estrogen, although this risk can be circumvented by parenteral administration.[15] Of greater concern, perhaps, is that estrogen for men may promote breast cancer as it does for some women. Also, estrogen may be contraindicated when prostate cancer is castrate resistant.[16]

In sum, supplemental estrogen may not restore libido to intact levels in androgen-deprived men; however, it may elevate sexual interest above castrate levels. Both patients and their partners might appreciate this residual sexual desire if it helps them maintain intimacy. Furthermore, interventions for erectile dysfunction are available, so, if estrogen can help patients on ADT restore libido, those men may even be able to maintain penile-insertive sex while otherwise androgen-deprived.