Men who receive hormone therapy for prostate cancer may experience symptoms of hormone deprivation. This is because hormone therapy lowers levels of testosterone and other male sex hormones called androgens. Although hormone therapy helps treat the cancer, it causes the symptoms discussed below.
Relieving side effects is an important part of cancer care and treatment. This is called symptom management, palliative care, or supportive care. Talk with your health care team if you experience any new symptoms or changes in symptoms.
A lack of testosterone causes the following symptoms:
- Hot flashes with severe sweating
- Thinning of the bones, called osteoporosis
- Decreased libido, or desire for sex
- Erectile dysfunction, which is a problem with having or maintaining an erection
- Depression or irritability
Men without prostate cancer may also have these symptoms as part of aging. In men without prostate cancer, treatments to raise testosterone levels can help relieve these symptoms. Because testosterone helps prostate cancer grow, these treatments are not an option for men with prostate cancer.
Men who have received androgen ablation therapy have a higher risk of developing osteoporosis. Androgen ablation therapy is treatment to stop the production of testosterone. Options include medications to stop the body from producing testosterone or a surgery called orchiectomy to remove the testicles.
Most research on osteoporosis has focused on preventing this condition in women because it is more common in women. Doctors are studying if osteoporosis treatments should be different for men because men's hormone levels are different.
Reducing the risk of osteoporosis
The following actions may help lower the risk of developing osteoporosis:
- Perform weight-bearing exercise, such as walking 20 to 30 minutes each day.
- Maintain an ideal body weight.
- Take vitamin D supplements (see below).
- Take calcium supplements (see below).
In addition, your doctor may recommend a bone density test or offer medications, such as those listed below.
The following treatments help slow or stop bone loss. Your doctor may give these individually or in combination.
- Calcium and vitamin D may reduce bone loss in men and women older than 65. For calcium, 1,000 to 1,500 milligrams (mg) of elemental calcium is recommended each day. For vitamin D, 400 to 600 international units (IU) is recommended daily. Talk with your doctor before taking any supplements.
- Alendronate (Fosamax) is used to treat osteoporosis in women and men.
- Pamidronate (Aredia) and zoledronic acid (Zometa) help reduce bone loss in people with cancer.
- Risedronate (Actonel) may be an option for men. It is currently approved by the U.S. Food and Drug Administration (FDA) for treating osteoporosis in women.
- Denosumab (Prolia, Xgeva) may help men receiving hormone therapy for prostate cancer maintain bone health. It may also help treat osteoporosis.
Up to 75% of men receiving hormone treatments for prostate cancer have hot flashes.
Treatment of hot flashes
The following treatments may help reduce the number and severity of hot flashes:
- Antidepressants, such as venlafaxine (Effexor) and sertraline (Zoloft), may reduce hot flashes. They can also help with mood problems or irritability from changes to hormone levels.
- A nonhormonal medication, gabapentin (Neurontin), may help to treat hot flashes in men.
- Progesterone, such as megestrol acetate (Megace, Ovaban, Pallace), may be a reasonable option for men. Progesterone works well to reduce hot flashes in women.
- Vitamin E supplements (up to 800 IU/day) may relieve hot flashes for women. However, it is uncertain how effective vitamin E supplements are for men experiencing hot flashes.
- Deep breathing and other relaxation techniques
- A cooler room temperature
Livestrong Foundation: Osteoporosis