Like all treatments, hormone therapy can cause side effects. These are usually caused by low testosterone levels.
Hormone therapy affects men in different ways and you may not get all of the possible side effects. Some men only get a few side effects or don’t get any at all. This doesn’t mean that the treatment isn’t working.
Some men find their side effects improve or get easier to manage the longer they’re on hormone therapy. But if side effects don’t improve, there are usually ways to manage them.
Side effects will usually last for as long as you’re on hormone therapy. If you stop using it, the side effects should improve as your testosterone levels start to rise again.
Your side effects won’t stop straight away – it may take several months or years. For some men, the side effects may never go away completely.
The risk of getting each side effect depends on your type of hormone therapy and how long you take it for. If you have hormone therapy alongside another treatment, you may get side effects from that treatment as well.
Surgery to remove the testicles (orchidectomy) can’t be reversed, so the side effects will be permanent. But there are treatments to help manage them.
Discuss the possible side effects with your doctor or nurse before you start or change your hormone therapy, or call our Specialist Nurses. If you know what side effects you might get, it can be easier to manage them.
If you have any concerns about your side effects or get any new symptoms, such as bone pain, speak to your doctor or nurse, or call our Specialist Nurses.
We describe the most common side effects of hormone therapy below. Find out more about side effects of hormone therapy and how you can manage them.
Hot flushes are a common side effect of hormone therapy. They are similar to the hot flushes women get when they’re going through the menopause.
They give you a sudden feeling of warmth in your body. You might feel very hot in your face, neck, chest or back. They can vary from a few seconds of feeling very hot to a few hours of sweating, which can be uncomfortable.
Some men find that their hot flushes get milder and happen less often over time, but other men continue to have hot flushes for as long as they have hormone therapy.
There are things that can help manage hot flushes, including lifestyle changes and medicines. Speak to your doctor if you get hot flushes.
Some men also use complementary therapies to manage hot flushes, such as acupuncture, cognitive behavioural therapy (CBT) and herbal remedies. But there isn’t any strong evidence that these work.
If you’re thinking about using any complementary therapies, make sure you tell your doctor or nurse as they might interfere with your cancer treatment. You should also tell your complementary therapist about any cancer treatments you’re having.
I have hot flushes through the night. I used to be angry but now I use the cooling off time to stretch and plan the next day.
Extreme tiredness (fatigue)
Hormone therapy can make you feel extremely tired, which could affect your everyday life. Fatigue can come on quite suddenly and can affect your energy levels, motivation and emotions.
This may improve over time and there are things you can do to help manage fatigue.
These include being physically active and planning your day to make the most of when you have more energy. Read more about fatigue and prostate cancer.
Support for fatigue
Our fatigue support service is a 10-week telephone service delivered by our Specialist Nurses. It can help you make positive changes to your behaviour and lifestyle, which can improve your fatigue over time. For more information call our Specialist Nurses.
There are also lots of tips on how to manage fatigue in our interactive online guide.
Changes to your sex life
Hormone therapy can cause the following changes to your sex life:
- less desire for sex (low libido)
- problems getting or keeping an erection (erectile dysfunction)
- producing less semen and having less intense orgasms
- changes to the size of your penis and the size or shape of your testicles.
There are treatments and ways to manage changes to your sex life. Hormone therapy reduces your desire for sex. So treatments that only work when you have desire, such as tablets, are unlikely to work.
But injections, pellets, cream or a vacuum pump may still help you get an erection, even if your desire for sex is low.
Read more about prostate cancer and your sex life.
Some people put on weight while they’re on hormone therapy, particularly around the waist. Some men find this hard to deal with, especially if they’ve never had problems with their weight in the past.
Physical activity and a healthy diet can help you stay a healthy weight. Read more about diet and physical activity.
Strength and muscle loss
Testosterone plays an important part in the physical make up of men’s bodies. Hormone therapy can cause you to lose some muscle tissue. This can change the way your body looks and how physically strong you feel.
Regular gentle resistance exercise, such as lifting light weights or using elastic resistance bands, may help to prevent muscle loss and keep your muscles strong. Read more about diet and physical activity for men with prostate cancer.
Some men may also get aching muscles or joint pain while they’re on hormone therapy. This can happen when you lose muscle.
Talk to your doctor or nurse if you have any pain in your muscles or joints. They can talk to you about ways to manage it.
Memory and concentration
If you’re having hormone therapy you may find it difficult to concentrate or focus on certain tasks. Or you might struggle to remember things as well as you used to.
But we don’t know for sure whether any changes are caused by the hormone therapy or by something else, because the evidence isn’t very strong. For example, feeling tired, stressed, anxious or depressed can all affect your memory or ability to concentrate.
Memory problems can also happen naturally as you get older.
Whatever the cause, you may find problems with memory or concentration very frustrating. If you’re having problems with your memory, talk to your doctor or nurse. They will be able to suggest things that may help.
Breast swelling or tenderness
Hormone therapy may cause swelling (gynaecomastia) or tenderness in the chest area. The amount of swelling can vary from a small amount to noticeable breasts.
Tenderness can affect one or both sides of the chest and can range from mild sensitivity to long-lasting pain.
Breast swelling is more common in men who are taking anti-androgen on their own.
If you put on weight while you’re on hormone therapy, this can also lead to larger breasts.
There are ways to reduce your risk of breast swelling and tenderness, or help treat it. These include treating the breast area with a single dose of radiotherapy during your first six months on hormone therapy, taking tablets (such as tamoxifen), or sometimes having surgery to remove some of the breast tissue.
Loss of body hair
Some men lose their body hair while they are on hormone therapy. This is because testosterone plays a role in hair growth. So when testosterone is reduced, you might lose some of it. This can happen anywhere on your body, including your face, chest and pubic area. The hair should grow back if you stop hormone therapy.
Testosterone helps to keep bones strong. Long-term hormone therapy can make your bones weaker and cause a condition called osteoporosis. This means you may be more likely to have broken bones (fractures).
Anti-androgens are less likely to cause bone thinning than other types of hormone therapy.
Your doctor may suggest you have a type of X-ray called a bone density or DEXA (dual energy X-ray absorptiometry) scan before you start hormone therapy. This will show any areas of weak bone.
You might also have a bone density scan after you’ve been on hormone therapy for a few years. This will check for any signs of bone thinning.
Lifestyle changes such as being more active and changes to your diet may help reduce your risk of bone thinning.
We don’t yet know whether exercise can help to prevent bone thinning in men who are on hormone therapy. But regular physical activity could help to keep you strong and prevent falls that could cause broken bones.
These types of exercise may be particularly helpful:
- gentle resistance exercise, such as lifting light weights or using elastic resistance bands
- weight-bearing exercise, where you’re standing up and have to support your own weight, such as walking, climbing stairs, tennis and dancing.
Risk of other health problems
Hormone therapy may slightly increase your chance of developing other health problems, including:
- heart disease
- type-2 diabetes
- blood clots.
Before you start hormone therapy, tell your doctor if you’ve ever had any of the problems listed above, or if you’re taking medicines to treat another health problem, such as high blood pressure (hypertension) or high levels of cholesterol (hypercholesterolaemia).
You can reduce your risk of many health problems by making lifestyle changes, such as eating a well-balanced diet, drinking less alcohol, being physically active and stopping smoking.
Read more about diet and physical activity for men with prostate cancer.
Changes to your mood
Hormone therapy can affect your mood. You may feel more emotional than usual or just ‘different’ to how you felt before. Some men find that they cry a lot. You may also get mood swings, such as feeling tearful then angry.
Just knowing that hormone therapy might be causing these feelings can help.
Some men experience low moods, anxiety or depression. This could be caused by the hormone therapy itself, or by dealing with your prostate cancer diagnosis. It could also be due to the impact that treatment is having on your life.
If your mood is often very low, you are losing interest in things, or your sleep pattern or appetite has changed a lot, speak to your doctor or nurse. These can be signs of depression, but there are things that can help.
If you are on degarelix, the skin around the area where you have the injections may feel red, hard, swollen and sore. This usually settles down after a few days and is often worse after the first injection than the later ones. Mild pain-relieving medicines, such as paracetamol, or using a cool pack on the area can help.