Side effects of hormonal therapy for early prostate cancer

Reducing the level of testosterone can cause different side effects. There are different ways hormonal side effects can be managed or treated. Your doctor or nurse will explain this to you. Some side effects are only likely to affect you when you have hormonal therapy for over 6 months.

Common side effects

Common side effects include the following:

  • Erection difficulties (called erectile dysfunction or ED) and reduced sex drive. This usually improves after you stop treatment, but it may take a few months. If you have ED, there are drugs and treatments that may help.
  • Hot flushes and sweats. These may reduce as your body adjusts to hormonal treatment. They usually stop completely 3 to 6 months after treatment finishes.
  • Tiredness and difficulty sleeping. This is common, and hot flushes may make sleeping difficult. Regular physical activity can help reduce tiredness.
  • Mood changes. Talking to someone close to you or a counsellor may help.

Other side effects

If you have hormonal therapy for 6 months or more, you may have other side effects. The benefits of hormonal therapy generally outweigh the possible risks. Your doctor or nurse will talk to you about this.

Other possible side effects include the following:

  • Weight gain (especially around the middle) and loss of muscle strength. Regular physical activity and a healthy, balanced diet can help manage this.
  • Breast swelling or tenderness. This is most common with flutamide and bicalutamide. Some men have low-dose radiotherapy to their chest before treatment to prevent this. If you are taking bicalutamide, another option is to take a hormonal drug called tamoxifen to reduce breast swelling.
  • Bone thinning (osteoporosis). The risk of this is increased with long-term hormonal treatment. You may have a scan to check your bones before you start treatment. Regular weight-bearing exercises such as walking, dancing, hiking, or gentle weight-lifting can help keep your bones healthy. Your doctor may give you advice on diet and exercise. They may advise you to take calcium and vitamin D tablets. They may also talk to you about taking bone-strengthening drugs called bisphosphonates or a drug called denosumab (Prolia®).
  • An increase in the risk of heart disease and diabetes. Not smoking, being physically active, eating healthily and keeping to a healthy weight can help reduce these risks.

Different hormonal therapies have different side effects. It is important to discuss these with your doctor or nurse before treatment so you know what to expect.

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