Timing of hormone therapy
Research does not clearly show whether starting hormone therapy before symptoms appear allows men to live longer than if they waited until after symptoms appear to start taking medicine.3 Men who start hormone therapy almost always stay on it for the rest of their lives. So waiting until symptoms appear may allow men to delay the serious side effects of hormone therapy.
Alternatives to conventional hormone therapy
- Intermittent androgen deprivation (IAD).
This involves cycles of hormone therapy medicines. Taking breaks during hormone
therapy gives men the chance to recover their ability to function sexually. It
also gives relief from the other side effects of hormone therapy, including hot
flashes and the effects on energy as well as bone and muscle mass. The
long-term survival outcome of IAD compared to conventional ADT is not yet
- Antiandrogen monotherapy. Antiandrogens are
medicines that block the action of androgens in the body. Antiandrogen monotherapy means taking antiandrogens without other hormone medicines.
Side effects of hormone therapy
The side effects of hormone therapy increase with the length of time that a man uses this therapy. Some of the side effects from hormone therapy will go away when a man who
is taking medicine finishes his hormone therapy. For a man who has an
orchiectomy, the side effects of sterility and loss of sexual interest are
immediate and permanent.
Side effects of hormone therapy may
- Thin or brittle bones (osteoporosis).
- Increased body mass (BMI) and higher levels of fats in the
- Reduced muscle
- Low red blood cell count
(anemia) and fatigue.
- Increased risk for diabetes and heart disease.
- Emotional ups and downs.
Other side effects may include hot flashes, erection problems and reduced sex drive, breast enlargement, and cognitive impairment. Some men may experience depression.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems).
Long-term side effects of hormone therapy
long-term side effects of hormone therapy, even for men taking medicine, are
not known. But hormone therapy has been linked to a higher risk for diabetes, cardiovascular disease, and a shorter life span.3
One large study found that
hormone therapy appears to be linked to a higher risk of death from heart
problems in men who had surgery for localized prostate cancer.4
Hormone therapy and quality of life
The side effects of hormone therapy for prostate
cancer often affect a man's quality of life. But there are treatments that can
help with some of the side effects listed above. For example, exercise can help
counteract the loss of muscle mass and will help with fatigue. There are
medicines that can help with hot flashes, nausea, diarrhea, and bone loss. Low-dose radiation before hormone therapy may help prevent breast enlargement. For men
with depression, counseling and medicine may help. For more information, see
the topic Depression.
Above all, talk with your doctor about any
of the symptoms you have while you are taking hormone therapy. Your doctor may
know about a local support group for men who have prostate cancer.