Side Effects of Hormone Therapy
Testosterone is the primary male hormone, and it plays an important role in establishing and maintaining the typical male characteristic and a host of other normal physiologic processes in the body.
The potential effects of testosterone loss include:
- Hot flashes
- Erectile dysfunction and decreased sexual desire
- Loss of bone density and increased fracture risk (osteoporosis)
- Increased risk of diabetes and heart attacks/strokes
- Weight gain and decreased muscle mass
- Memory loss
- Rise in cholesterol (especially the LDL cholesterol)
Most men on hormone therapy experience at least some of these effects, but the degree is impossible to predict.
Before beginning hormone therapy, every man should discuss the effects of testosterone loss with his doctors to help minimize them. Exercise is probably the best thing a man can do to prevent many of these side effects.
Over the years, researchers have explored different ways to minimize the side effects of testosterone loss while maximizing the therapeutic effect of hormone therapy. The most commonly explored strategy is known as intermittent therapy.
This strategy takes advantage of the fact that it takes a while for testosterone to begin circulating again after LHRH agonists are removed. With intermittent hormone therapy, the LHRH agonist is used for six to twelve months, during which time a low PSA level is maintained. The drug is stopped until the PSA rises to a predetermined level, at which point the drug is restarted.
The time between cycles allows men to return to nearly normal levels of testosterone, potentially enabling sexual function and other important quality of life measures.
Currently, the true benefits of this approach remain unclear, and large clinical trials are currently underway to evaluate its use in men with advanced prostate cancer.