Many of the side effects of hormone treatment are related to the low levels of male hormone in the body and occur whether you choose orchidectomy or medications. These are summarised in Table 2.

Most men have poor or absent erections (impotence) and a lack of interest in sex (reduced libido). Your voice will not change. Some men notice a change in their body hair: a different texture and growth on previously bald areas. Tiredness is common and is related to the main ‘male fuel’ being suppressed.

Hot flushes are very common in the early stages of treatment but may decline after several months of treatment. Medications can reduce the intensity of this symptom if required. Over many months or years there may be a decline in muscle strength and some tenderness or enlargement in the breast area. Hormone treatment may also increase the risk of diabetes.

Before beginning treatment, it is helpful to discuss the possibility of side effects with your wife or partner. Good communication is important in dealing successfully with these changes and maintaining your close relationship.

What you can do to minimise side effects:

Recent research has shown that exercise, particularly resistance exercise, can reverse some of the side effects of hormone treatment. This kind of exercise builds up muscle mass and muscle strength in the body. Examples include chest presses (‘push-ups’), leg presses and lifting weights. They have been shown to increase muscle strength, reduce fatigue, improve mood and reverse some of the changes in the body that predispose to diabetes (3). Further information is given in the ‘Advanced prostate cancer: A guide for men and their families’ (see Resources). Check with your doctor regarding an exercise program that is suitable for you.

Do not hesitate to discuss distressing symptoms such as hot flushes with your doctor as there are medications and supplements that can help.

Intermittent hormone treatment can also reduce the effects for periods of time off the drugs.

Table 2: Common side effects of hormone treatment
Poor erections or impotenceWeight gain
Reduced libido Reduced muscle strength
Altered body hair and skin textureBreast changes
FatigueChanges in appetite
SweatingDry eyes
Hot flushesMood swings
Memory problemsBalance problems
Reduced ability to concentrate Insomnia
Reduced bone strength (osteoporosis)