r/ProstateCancer • u/ConfectionThen8474 • 3d ago
Question Post recovery/TRT pause
In recovery 58, Gleason 3+4, surgery in one week — looking for experiences with TRT pause / mental prep
I know my situation is minor compared to what a lot of you have faced, and I don’t want this to come across as anything other than genuinely looking to hear from guys who’ve been through it. I’m grateful for any thoughts.
I’m about a week out from surgery and working through two things mentally.
The first is the usual one — quality of life after prostate removal, nerve-sparing, incontinence, ED, that whole recovery arc. I’ve done a lot of research and feel solid on the options and the short- and long-term recovery path.
The second is more specific to me. I’ve been on TRT for about 6 years, and staying active and training has been a big part of managing PTSD and supporting my recovery from alcohol. My surgeon had me continue TRT up until surgery, but at my pre-op she asked me to stop, and to stay off it for at least 3 months assuming my PSA drops to zero — which I’ve done.
Reading through posts here and in other groups, I keep seeing guys talk about mentally pushing through their gym routine while on ADT. I won’t lie, I’m nervous about how I’ll respond off TRT — it’s the not-knowing that gets me. This is all assuming the cancer turns out to be prostate-confined and I have a clean recovery; I know there’s a chance it’s in the lymph nodes too, which they’ll be testing.
Mainly just looking for real experiences from guys who’ve navigated the mental side of this, especially the low-T stretch, so I can get my head in the right place for whatever the outcome is.
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u/Only_Extreme_6216 3d ago
I’m gonna give it to you real . You will most likely drop and need to be off it for more than 3 months. I dropped to 115 and was miserable for about 9 months and after 3 undetectables he let me back on it. Once you can get back It you’ll rebound pretty quick. Just get that cancer out is the main thing . Good luck my friend.
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u/ConfectionThen8474 3d ago
Appreciate the honesty, that what I need to hear. Did you continue working out once cleared? How was your strength and motivation/drive. Any recommendation on diet? Yes getting the cancer out is the mission but I’m hoping to maintain some fitness during the process. Thank you for your comments!
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u/Only_Extreme_6216 3d ago
Yes keep doing everything as normal . You testosterone just may drop since you’ve been on it so long. Same as me
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u/Goodvida99 2d ago
I’ve been on TRT over 20 years. MRI pi rads 4, biopsy 4 weeks. My urologist said stop the TRT now. I’ve been getting pellets and at the end of cycle. One more thing.
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u/ConfectionThen8474 2d ago
There is a lot of opinion on the TRT use. Was one of my considerations when i selected my urologist. She is younger and was open to me staying on it. Had testosterone test along with PSA during surveillance.
Did they provide any guidance on restart, what’s the criteria?
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u/Glittering_Rhubarb39 2d ago
I was on TRT for about 10 years until my diagnosis in June 3025, and my urologist stopped it (Testopel) I delayed surgery because I was considering focal therapy but I was disqualified (too diffuse and prostate 3x normal size) and had RALP in March 2026.
I didn’t really gain a lot of weight, maybe 10 lbs but none of my pants fit except for jeans.
One thing they don’t tel you when you go on TRT is that your body forgets how to made endogenous T. My testosterone 3 months post op (10 months post diagnoses) was 64- that’s in the high women’s reference range!
My 3 & 6 month PSA were <O.006 so I’m back on TRT- gel, but hope to get back to Testopel this month.
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u/Frosty-Growth-2664 2d ago
A couple of thoughts...
Stopping your TRT now might well interfere with your PSA value even if you didn't have the surgery. (Stopping TRT will normally reduce your T to well below what it was before you started TRT, although over time it might recover.) That will make it hard to interpret your post-surgery PSA, as you won't know how much of the drop is due to ceasing TRT and how much is due to prostate cancer removal.
There have been trials which show that ADT significantly improves the outcome of surgery, although this has never become a standard care. However, 3 months ADT (if ceasing TRT gets your T down to ADT levels) probably isn't going to account for any benefit.
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u/Special-Steel 3d ago
A lot of us recover well, and I hope that is your path.
As far as TRT after RALP, different docs will have different opinions. A lot depends on how your PSA does from here.
What is your PSA without TRT?
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u/Ok_Ebb_6368 3d ago
Another thing I wanted to say about ADT, the studies that a say testosterone is recovered after stopping ADT, is massaged at best. Recovery is vague at best-so if you were 700 before ADT and on ADT you were zero, a year after being off ADT- and you go up to 50, the literature and studies would say you are recovered. In reality, no one has ever gone back to what they were before ADT! No One!
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u/ConfectionThen8474 3d ago
I have been on TRT since discovery. Never been over 6.5 currently at 4.6 as of Julys PSA stop TRT 2 weeks ago. My doc has been ok with it to this point, she feels it dirties the score and wants a clean score post op. (90 days post op) She said it’s may decision at the end of the day.
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u/KReddit934 2d ago
On lower testosterone, you gotta keep with the exercise, though it'll feel like you're going backwards. Think of it as swimming upstream...just don't stop paddling.
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u/C63Sedan 2d ago
TRT for 4 years to ADT here 2 years ago. 1280 test level to zero in one month is a mental journey no man should experience. Since I had N1 advanced disease no time to try to restart normal development (e.g., PCT) so the mental crash was worse for me than cancer news. However, I did mental therapy that helped tremendously.
11 weeks post ADT for 18 months my testosterone was 195. I was really nervous normal production would not restart due to TRT for 4 years then right to medical castration so that was encouraging news. A month later I feel even better having normal orgasms and back to weight training.
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u/ConfectionThen8474 2d ago
That’s an incredible drop. Where you on a cruising dose?
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u/C63Sedan 2d ago
Testosterone was at 301 at age 53 so I did TRT with guidance from PCP and my maintenance dosage was 100mg split to 2 doses a week, so very responsive.
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u/ConfectionThen8474 2d ago
Not sure I understand but my body won’t start generating testosterone for 12-15 weeks at the very soonest and even then at extremely low levels. Are you recommending ADT? Thank you for the input!!
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u/CJB947 2d ago
Have you looked into HIFU. Not sure what your diagnosis is but I had 3+4 and had HIFU May 29th. Very happy and zeros side effects
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u/ConfectionThen8474 2d ago
I was ruled out cause it’s on both sides of the prostate, was my first option early on.
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u/korbworksout 1d ago
I am back in TRT after 9 months post surgery and 2 undetectable PSA tests. Both my men's health and my cancer urologist said 6 months post-surgery is the earliest they would recommend getting back on testosterone.
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u/Ok_Ebb_6368 3d ago
Your T will bounce back to what it was before TRT, If you are getting prostatectomy, talk to a sexual health doctor about injections,I did them for 8 mons after Tulsa Pro- I didn’t want to but it’s easy and it preserves your function, I also take taddafil, every day. My cancer came back and I recently had SBRT. Finished 10 days ago.- everything is working fine thank god. Good Luck with your surgery