So I’m no longer on Lupron. I’m now on Casodex for at least the next three months. The downside is Casodex is not quite as effective as Lupron. The upside is my loss of libido and depressions should get better. On balance I think I’m glad to be on Casodex and off Lupron.
What’s the real story about Lupron? Most men on Lupron don’t talk much about it except to say it’s like male menopause. That’s unfortunate because the side effects are very significant and can adversely affect relationships and mental well-being. A better understanding by all parties of Lupron’s effects can go a long way towards managing expectations.
First let’s start with why Lupron is used at all. Prostate cancer loves to eat testosterone. Lupron greatly diminishes the production of testosterone. While this helps starve prostate cancer cells, there are lots of bad side effects. The ones we’ll address in this post include loss of libido, depression, irritability, hot flashes and cold sweats. While the following reflects my personal experiences, several doctors and other men on Lupron I spoke with consider my reactions fairly typical.
The loss of libido sounds innocent enough, but it’s profound. It’s as if one’s male internal wiring is broken. In some cases it goes so far as to include impotence. Typically, if a man sees an attractive person or reads a steamy passage in a book, they immediately start getting pleasurable feelings and may fantasize. Under Lupron, nothing happens. There’s no reaction at all. There’s an intellectual awareness that a person is attractive, but that’s it. In my case my gaze may linger on an attractive woman, not because I find it stimulating, but because I’m hoping I’ll have some reaction. But I never do. It’s very unsettling.
Next up is an increased tendency towards depressive episodes. In my case Lupron usually produces at least one episode a day. Most last a half hour to an hour. Some are mild, some severe. The mild depressions are easy to get through. The severe depressions inevitably lead to uncontrollable sobbing for fifteen minutes or so. They are very hard to control and can happen at the most inopportune times. If I’m feeling “in control” prior to the depression, the episodes are much more likely to be mild.
Given the issues with libido and depression, it’s probably not a surprise that irritability is also a side effect. Who wouldn’t be irritable! Don’t be surprised if someone who’s normally even tempered becomes short tempered and even combative on Lupron. Friends and family need to remember, it’s the Lupron talking.
Finally, there are hot flashes and cold sweats. They seem to be daily events, especially at night when sleeping. They can lead to poor sleep patterns, which further complicates the tendencies towards irritability and depression.
In a month or two, after I get to know Casodex’s side effects, I’ll share how it compares to Lupron.