Androgen deprivation therapy for prostate cancer causes bone loss, weight gain with loss of muscle, insulin resistance and adverse lipid changes, alongside fatigue, hot flushes and low mood. These effects build over months and are easy to attribute to age.
Baseline and periodic assessment of fracture risk, glucose, lipids and blood pressure is established practice, as is advice on calcium, vitamin D and weight-bearing exercise. Men on long-term therapy with low bone density or a high fracture risk may need bone-protective treatment.
- Assess fracture risk, with bone density where available, when starting long-term androgen deprivation.
- Check glucose, lipids and blood pressure at baseline and during treatment.
- Advise on calcium, vitamin D and resistance exercise from the start.
- Ask about fatigue and mood at each review, as both are common and treatable.
Why it matters
Its harms build quietly and are easily mistaken for ageing.
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