Side Effects from Treatment with Hormone Therapy

Sexual side effects

Hormone therapy can lead to sexual side effects, including:

Genito-urinary symptoms due to decreased hormones

• Vaginal dryness is a common and frustrating side effect that can limit sexual activity. Medications are available to treat vaginal symptoms.
• Erectile dysfunction may be a side effect. Sometimes this can be treated with medications known as PDE5 inhibitors, such as Viagra and Cialis. There are other possible treatments for erection problems if these medications are ineffective.
• A special type of physical therapy known as pelvic PT may help alleviate symptoms and improve sexual function.  

Loss of libido 

Libido refers to a person's level of sexual desire. Hormone therapy can reduce libido in both men and women. Other factors may contribute to libido loss. Let your doctor know if you are experiencing this symptom, so that you can be evaluated for other possible causes. 

• Medications that affect libido or sexual function can sometimes be changed or doses adjusted. Lifestyle changes, such as weight loss, increasing physical activity, smoking cessation and avoiding alcohol can improve libido. Integrative therapies, such as yoga or meditation, may also help. Healthcare providers who are trained in couples counseling, intimacy or sexuality may help you work through some of these challenges. 
• In women, medications such as bupropion or flibanserin may improve libido.

Hot flashes

Hormone therapy can cause hot flashes in both men and women. During a hot flash a person typically experiences mild to extreme heat throughout the body, which may also be accompanied by sweating, flushing, and a rapid heartbeat.  Certain antidepressants, called selective serotonin reuptake inhibitors (SSRIs), may relieve hot flashes. Men with prostate cancer may be able to take a type of hormone replacement known as progesterone to treat hot flashes. Progesterone is not safe for women or men with breast cancer. 

Supplements do not effectively treat hot flashes, and some supplements may be harmful. Some people who experience hot flashes find handheld fans and "chillows" that reduce body temperature to be helpful. Others have also reported that exercise, hypnosis, yoga or acupuncture relieves their hot flashes.

Infertility

Some hormone therapy may interfere with the ability to have children in both men and women. This may be temporary or permanent, depending on the medication and the length of time you are on it. If you are interested in having children, speak with your doctor about your fertility options before starting hormone therapy.

Joint pain 

Certain hormone therapies—especially aromatase inhibitors—may cause joint pain. Nonsteroidal anti-inflammatories, such as ibuprofen and antidepressants such as duloxetine (Cymbalta) may improve joint pain caused by these therapies. Exercise, yoga and acupuncture may also help relieve joint pain.  

Fatigue

Fatigue may be caused by cancer or treatment, including hormone therapy. Fatigue is common in cancer survivors and can persist years after treatment. 

It's important to tell your doctor about any changes in your energy level during your regular visits. Your doctor can check and treat you for any underlying causes, including depression, sleep disturbances and medication side effects. 

Although no medications can counteract fatigue caused by hormone therapy, you can take steps to try to improve your energy level, including: 

• making sure that your diet is balanced and provides you with adequate nutrition. Ask your doctor for a referral to a nutritionist if you need help meeting your nutritional needs.
• making sure that you get adequate sleep. 
• trying to stay physically active, which can help improve your energy level. 

Difficulty focusing or cognitive changes

Hormone therapy may affect your memory and cognitive function. You should report cognitive changes to your doctor, so that they can check and treat you for underlying causes, including depression, sleep disturbance, fatigue and medication side effects. Limiting alcohol and drugs may improve your memory. Some research has shown a benefit from yoga, exercise, mindfulness, meditation, cognitive training and modafinil (Provigil), a drug used to treat sleep disorders.