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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taking testosterone and had a PSA test and digital rectal exam. Prescribed with Cialis. Need advise

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Dr. G.Srinivasan

Urologist

Practicing since :1991

Answered : 1414 Questions

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Posted on Sat, 16 Nov 2013 in Brain and Spine
Question: After a month of 60 mg of testosterone and then a shot of 300 mg two weeks ago, my free testosterone has increased from 230 mg to 372 mg. I'd like to increase that to about 600 mg free T. I'm meeting with my internist tomorrow. I had a PSA test done yesterday and my PSA has increased in five months from 6.7 to 10.8. My prostate gland is 101 cc. I had a digital rectal exam yesterday, and the gland was smooth. I have had three negative biopsies in the last ten years and a sonogram which my urologist said indicated to him that another biopsy was not called for. However, my urologist is concerned with the testosterone therapy. I told him that a modest increase in free T does not cause cancer and I gave him the name of a book by XXXXXXX Morgenthaler, MD that explains that thinking. He is still worried, but my internist is not. My PSA readings fluctuate quite a bit and I think it is unreliable as an indicator of cancer. My urologist also gave me a prescription for 10 mg of Cialis to use on the days I will be having sexual intercourse in order to give me firmer erections. I can get erect, but I can't maintain the firmness for penetration for very long. I haven't tried the increased dosage yet, but I'm eager to learn if this will help. What are your comments on these thoughts?
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Answered by Dr. G.Srinivasan 5 hours later
Brief Answer:
Better to biopsy, try cialis

Detailed Answer:
Welcome to the forum.
I went through your detailed history.
For a gland size of 101 cc, PSA is acceptable and not worrisome.
But, due to the sudden rise in PSA plus the plan to increase the testosterone, it is worthwhile doing a biopsy to be on the safer side, especially if the biopsy is more than one year old.
Cialis should help you.
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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