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General side effects of hormone therapy

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This page has general information about the general side effects of hormone treatments. There is information about

 

A quick guide to what's on this page

The side effects you might get with hormone therapy depend on the type you are having.

General side effects that may affect men or women taking hormone therapy include

  • Tiredness
  • Weight gain
  • Memory problems
  • Mood swings and depression
  • Hot flushes and sweating

Other side effects for women having hormone therapy may include

  • Digestive system problems – such as sickness, constipation, diarrhoea and loss of appetite
  • Vaginal dryness and a low sex drive
  • Effects on your muscles and bones – aches, pains and bone thinning
  • Blood clots – only with tamoxifen
  • Other effects – such as fluid retention, sleeplessness, headaches and hair thinning

Men having hormone therapy may have

  • Problems getting an erection
  • Breast tenderness – a particular problem with high dose bicalutamide (Casodex)
  • Pain or worsening symptoms for a couple of weeks (for men who have secondary prostate cancer)
  • Bone thinning
  • Risk of earlier heart attack – this may be due to weight gain caused by hormone therapy.

There is information about coping with hormonal symptoms in the coping with cancer section of the website

 

CR PDF Icon You can view and print the quick guides for all the pages in the General side effects of hormone therapy section.

 

 

General side effects of hormone therapy for women

The side effects you might get depend on the type of hormone therapy you are having. Remember that the side effects we have listed are general. You can find more information about the side effects of specific hormone therapies in the cancer drugs section.

General side effects include

Tiredness

You may feel more tired when you are taking hormone therapy. For information about coping with fatigue visit the cancer fatigue section.

Digestive system problems

Hormonal therapies can cause a few problems with your digestive system.

You may feel sick. This is usually mild and settles down after a few days or weeks. Your doctor or nurse can prescribe anti sickness tablets, which should help.

You might have constipation or diarrhoea. This is usually mild and is easily controlled with diet or drugs. But as with any diarrhoea, if it is severe or lasts for more than 2 or 3 days, you need to tell your doctor or nurse.

You may lose your appetite a little. Or you may have an increased appetite, which can lead to weight gain.

We have detailed information on this website about coping with

The links above take you to different pages about these side effects.

Menopausal symptoms

If you haven’t already been through your menopause, it may start when you begin hormone therapy. This could be either temporary or permanent. If you are taking a luteinising hormone (LH) blocker, your periods will stop. If you are taking tamoxifen and are still having periods, they may stop or become lighter. You might also get other menopausal symptoms, even if you’ve already had your menopause. For example, you may have vaginal dryness, hot flushes, sweating and a lower sex drive. 

Do tell your doctor or nurse if you are having any problems coping with the sweating. There is treatment available that may help. We have a page about coping with hot flushes and sweats.

Hair thinning

Some hormone therapies can cause hair thinning. This is not usually enough for other people to notice. But if you are worried about hair thinning and would like tips on ways to cover your hair you can look at our page about hair thinning and cancer drugs.

Muscle and bone changes

You may develop pains in your joints. This often settles down after a few weeks. You can take a mild painkiller to help control aches and pains.

Some hormone therapies such as aromatase inhibitors can cause thinning of your bones. Tamoxifen can cause bone thinning in premenopausal women. In postmenopausal women, tamoxifen doesn’t cause bone thinning and it can help to maintain the strength of your bones.

Weight bearing exercise can help to build up the bones and protect them. This means any exercise where you are carrying your own weight, such as walking, running, cycling or exercise in the gym. Swimming is not weight bearing exercise. So although it is good for you in other ways, it won't help with bone thinning. Check with your doctor before starting any new type of exercise, especially if you have not exercised for a while.

Bone thinning can lead to osteoporosis and bone fractures if it continues for a few years. So your doctor may treat you with a drug (a bisphosphonate) to strengthen your bones.

Weight gain

You may put on weight. You should be able to control this with diet and exercise. But it is often a struggle to keep weight down when you are having hormone treatment. You can ask to see a dietician for advice about managing your weight.

Headaches

Some people have headaches with some hormone therapy drugs. Let your doctor or nurse know if you have this. Taking mild painkillers such as paracetamol can help.

Memory problems

Some women feel that their memory gets worse when they have been having hormone treatment for a while. Your memory may not improve while you are taking the hormone treatment. But there are ways to make life easier, such as making lists so you don't forget things. It is natural to feel cheated and upset if you have this particular side effect. Talk to your doctor or specialist nurse if you feel this is having a significant effect on your life.

Mood swings and depression

Hormone therapy can affect your mood. Some women say they have mood swings and even depression while having treatment such as Zoladex (goserelin). Talking with someone close to you may help. If you don't feel comfortable sharing your feelings with people you know, seeing a counsellor may help. We have information about counselling on this website.

Blood clots

Tamoxifen may increase the risk of a blood clot forming in the veins of the lower legs. This is called a deep vein thrombosis (DVT). You can read about the risk of blood clots and how to treat them.

 

General side effects of hormone therapy for men

The side effects you might have depend on the type of hormone therapy you are taking. Remember that the side effects we have listed here are general side effects. You can find information about the side effects of specific hormone therapies in the cancer drugs section.

Tiredness

You may feel more tired when you are taking hormonal therapy. For information about coping with fatigue visit the cancer fatigue section.

Problems getting an erection (impotence)

Difficulty getting an erection (impotence) is a common side effect of hormone therapy for prostate cancer. This is because the drugs stop you producing any testosterone. It may be possible for you to have erections again once the treatment stops. This can take 3 months to a year, or even longer. For some men, erection problems are permanent. It depends on the drug you are having and how long you have been taking it. 

Your doctor or clinical nurse specialist will be able to offer you advice. There is detailed information in our hormone therapy for prostate cancer section. There is information about ways of coping with erection difficulties in the sex and cancer for men section

Hot flushes and sweating

Hot flushes and sweating can be troublesome. They are the same as the hot flushes in women that friends and relatives may have had when going through menopause. The flushes are caused by your testosterone levels dropping. They may gradually get better as you get used to the treatment. Hot flushes are most likely with luteinising hormone blockers because these drugs cut off testosterone production altogether. Getting overheated, drinking tea or coffee, and smoking can all make flushes worse. 

Unfortunately, in some men the flushes keep on happening as long as you take the drug. If you have having problems coping with the sweating, do discuss this with your doctor or clinical nurse specialist. There are treatments that may help. We have a page about coping with hot flushes and sweats.

Breast tenderness

Breast tenderness is a particular problem with high dose bicalutamide (Casodex). The breast tissue can become painful and swollen. Taking the drug tamoxifen can help to reduce breast tenderness in about 6 out of 10 men taking bicalutamide. Or sometimes it can help to have a small dose of radiotherapy to the breasts before your hormone treatment starts.

Pain from tumour flare

Pain caused by a secondary prostate cancer can temporarily worsen when you start hormone treatment and this is called tumour flare. Your doctor should always prescribe another hormone therapy when you start leuprorelin (Prostap) or Zoladex (Goserilin) injections. The other hormone therapy helps to prevent tumour flare from causing bone pain. If the pain carries on, your doctor can prescribe drugs called bisphosphonates to treat it.

Weight gain

You may put on weight. You should be able to control this with diet and exercise. But it is often a struggle to keep weight down when you are having hormone treatment. We have a page about managing weight gain during prostate cancer treatment.

Memory problems

Some men feel that their memory gets worse when they have been having hormone treatment for a while. Your memory may not improve while you are taking the hormone treatment. But there are ways to make life easier, such as making lists so you don't forget things. It is natural to feel cheated and upset if you have this particular side effect. Talk to your doctor or specialist nurse if you feel this is having a significant effect on your life.

Mood swings and depression

Hormone therapy can affect your mood. Some men say they have mood swings and even depression while having treatment such as Zoladex. Talking with someone close to you may help. If you don't feel comfortable sharing your feelings with people you know, seeing a counsellor may help. We have information about counselling on this website.

Bone changes

Men taking hormone therapy for prostate cancer are at risk of bone thinning (osteoporosis). There is evidence that the risk of problems, such as bone fractures, is slightly higher for men having long term treatment to block testosterone (for example, Zoladex). Your doctor may suggest taking vitamin D and calcium to help lower your risk of problems from osteoporosis. Other advice is to 

  • Stop smoking
  • Reduce the amount of alcohol you drink
  • And take regular weight bearing exercise, such as walking

We have detailed information about bone thinning and osteoporosis risk and hormone therapy.

Risk of earlier heart attack

There is some evidence that if you are over 65, and at risk of dying from a heart attack, this is more likely to happen sooner if you have been taking hormone therapy for 6 months. This may be because some of the side effects of hormone therapy, such as weight gain, can make heart disease worse.

 

More about hormone therapy side effects

We have a section with detailed information about coping with sex hormone symptoms. It includes many of the effects mentioned on this page. 

We also have information about individual cancer drugs. If you want to find out about the drug you are taking, go to the cancer drugs section. You can choose the name of your drug from the dropdown menu.

Let your doctor or nurse know about any symptoms that are worrying you.

If you want to report a side effect you can fill in a yellow card form on the Medicines and Healthcare products Regulatory Agency (MHRA) website.

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Updated: 1 April 2014