Hormone Therapy Side Effects

Hormone therapy is designed to inhibit testosterone production or directly block it from acting on prostate cancer cells. It is, essentially, “anti-testosterone therapy.” Hormone therapy is used in combination with radiation therapy for patients with high-risk localized prostate cancer. It is also a mainstay of treatment for metastatic hormone-sensitive prostate cancer and today is almost always combined with other therapies.

Testosterone is a hormone that plays an important role in establishing and maintaining characteristics associated with biological males, such as body hair growth, muscle mass, sexual desire, and erectile function. It contributes to a host of other normal processes in the body. Hormone therapy lowers testosterone and causes side effects related to low testosterone.

It is important to understand how and why these side effects occur, so you can minimize their impact on your daily life. Although most patients may experience only a few of these symptoms, the list of potential effects of testosterone loss is extensive: hot flashes, decreased sexual desire, loss of bone density and increased fracture risk (osteoporosis), erectile dysfunction, fatigue, increased risks of diabetes, stroke, and heart attacks, weight gain, decreased muscle mass, anemia, mood changes, and memory loss. “Bad” cholesterol levels rise, particularly LDL and total cholesterol, and men may notice increased body fat, especially around the abdomen.

At this time, it is not possible to predict how severely you will be affected by lowering testosterone with hormone therapy. Research is underway to predict in advance which patients might experience which side effects. In the meantime, because hormone therapy is used to treat nearly every patient with advanced prostate cancer, it is important to think about ways to prevent, reverse, or identify these effects so that patients can maximize their quality of life.

Certain lifestyle changes, such as related to diet and exercise, have been shown to relieve some of the side effects of hormone therapy. Before beginning treatment, discuss these with your doctor and nutritionist, so you can alter your lifestyle to accommodate or head off the changes. Ask your doctor about the increased risk of diabetes, heart disease, stroke, weight gain, high cholesterol, and osteoporosis so that you can undergo screening and, if necessary, treatment for these other conditions throughout the course of treatment for prostate cancer.

Last Reviewed: 06/2025