DEAR DR. ROACH: I am a 73-year-old who underwent successful treatment for prostate cancer, using hormone suppression and radiation in 2015.

After the treatment concluded, my testosterone level increased back to 435 ng/dL, and my PSA remained below 0.1 ng/mL. I was once again able to perform sexually, although not at the same frequency I did before treatment.

In the past six months, I have noticed a dramatic reduction in my libido, much like it was when undergoing treatment.

My doctor wouldn’t check my testosterone level. I understand that testosterone replacement is not recommended for men who’ve had prostate cancer because it may trigger a recurrence of the cancer. Are there any other options for me, or do I just live with it?– J.C.

ANSWER: Sexual problems after a diagnosis of prostate cancer are common, no matter what kind of treatment is given. For men who are treated with surgery, sexual troubles tend to happen immediately after surgery and get better over time.

For men treated with hormone suppression, sexual troubles include both low libido and erectile dysfunction.

With radiation, sexual troubles tend to start well after the radiation is finished, up to two years afterward. This is thought to be due to long-term damage by radiation to the nerves, arteries and other structures. Since you are well past the period of time where sexual dysfunction due to radiation is expected to occur, I’d be concerned that your testosterone has fallen, as you suspect.

I disagree with your physician about testing. Even if you weren’t going to treat your low testosterone, it is important to know why you are having symptoms.

If your testosterone is low, then a decision to try testosterone replacement needs to be carefully considered.

Some evidence suggests that it is pretty safe and unlikely to cause the cancer to recur, but many prostate cancer experts recommend against it. Only your urologist or oncologist can answer this for you.

Finally, low testosterone, erectile dysfunction, and just the diagnosis of prostate cancer itself can contribute to low libido.

There are dedicated clinics to the treatment of sexual dysfunction, and these often use testosterone, Viagra, or similar medicines, injection treatments and other modalities to help.

EDITOR’S NOTE: Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.