Sex hormones, heart disease and diabetes

Hormone therapy for prostate cancer reduces the level of testosterone in the body. Low levels of testosterone can increase your risk of heart problems and diabetes.

Does hormone therapy for prostate cancer affect the heart?

Yes, research suggests that hormone therapy increases the risk of heart problems.

Why does hormone therapy cause heart problems?

Researchers think it's because it increases the amount of fat in the body.

Can hormone therapy cause diabetes?

Yes, hormone therapy can increase the risk of diabetes.

Some cancer treatments can lower the levels of sex hormones in the body. The sex hormones are oestrogen and progesterone in women, and testosterone in men. The cancer treatments include hormone therapy for prostate cancer.

Prostate cancer needs testosterone to grow. Hormonal therapy aims to:

  • stop the testicles from making testosterone
  • stop testosterone from reaching cancer cells

Research suggests that low levels of testosterone can cause heart problems and diabetes in men. More research is needed to find out more about this and ways to prevent these complications. 

How can low levels of testosterone affect the heart?

Low levels of testosterone can affect the amount of fat in your body. It can:

  • cause a build up of fat around your tummy (abdomen). This is called central obesity
  • increase the amount of fats called cholesterol in your blood

A build up of fat and cholesterol can cause different heart problems. Some problems can be serious. Talk to your doctor about this risk, especially if you already have heart problems.  

Low levels of testosterone and diabetes

Insulin is a hormone that controls the level of sugar (glucose) in your blood. Low testosterone can make your body resistant to insulin, which keeps your blood sugar high. Insulin is important in helping glucose to be absorbed by the cells in your body.

If you already have diabetes your body may need more insulin to keep your blood sugar level within normal ranges. You may need to test your blood sugar level more often.

Tips to help lower your risk of heart disease and diabetes

  • Maintain a healthy weight
  • Eat a healthy well balanced diet
  • Be physically active, exercise regularly
Talk to your doctor before starting any physical activity if you aren’t normally very active. They can help you to work out what is best for you.

Physical activity and diet

Physical activity

UK Guidelines recommend adults are active for 30 minutes each day for 5 days a week. What you can do will depend on what you do already. You may need to build up gradually. This might mean starting with a few minutes walk and slowly building it up over a number of weeks.  

Exercise can be an important part of your physical recovery after cancer treatment.

Exercise should include activities to increase your muscle strength on 2 days a week. This can help with changes to your muscles with hormone treatment. This might include carrying shopping or more formal exercise such as lifting weights or yoga.


A healthy well balanced diet will help to maintain your weight. Check with your dietitian if you have diabetes. 

Coping with prostate cancer

It can be difficult coping with prostate cancer and its treatment. There is support available. 

  • Impact of Hormonal Therapies for Treatment of Hormone-Dependent Cancers (Breast and Prostate) on the Cardiovascular System: Effects and Modifications: A Scientific Statement From the American Heart Association
    T Okwuosa and others 
    Circulation: Genomic and Precision Medicine, 2021. Volume 14, Issue 3.

  • Androgen deprivation therapy and cardiovascular disease
    C Melloni and M Roe
    Urologic Oncology: Seminars and Original Investigations, 2019

  • Androgen deprivation therapy and cardiovascular disease: what is the linking mechanism?
    P Zareba and others
    Therapeutic Advances in Urology, 2016. Volume 8, Pages 118-129

  • Androgen deprivation therapy is associated with diabetes: evidence from meta-analysis
    H Wang and others 
    Journal of Diabetes Investigation, 2016. Volume 7, Pages 629-36

  • Metabolic syndrome in prostate cancer: impact on risk and outcomes
    M Karzai and others
    Future Oncology, 2016. Volume 12, Pages 1947-55

Last reviewed: 
18 Oct 2022
Next review due: 
18 Oct 2025

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