Bone thinning
LHRH agonists and orchidectomy treat prostate cancer by reducing the levels of testosterone in the body. However, because testosterone helps to keep the bones strong, long term treatment with these types of hormone therapy may cause the bones to gradually lose their bulk. This can happen within 6 to 12 months of beginning treatment and the degree of bone loss may increase the longer you are on treatment. Long term treatment with LHRH agonists or orchidectomy can cause thinning of the bones that, if severe, can lead to the condition known as osteoporosis. This can result in an increased risk of bone fractures. Anti-androgens and oestrogens do not have this effect.

Breast swelling and tenderness
Treatment for prostate cancer with anti-androgens and oestrogens may cause swelling (gynaecomastia) and tenderness in the breast area. This can affect one or both breasts and can range from mild sensitivity to ongoing pain. The amount of swelling can also vary from a small amount to a more noticeable enlarged breast area. It is caused by the effect that hormone therapy has on the balance of the hormones oestrogen and testosterone in the body
Around half (50 per cent) of men taking an anti-androgen will get some swelling and between a quarter and three quarters (25 to 75 per cent) will get some degree of tenderness. Most men taking a high dose of the anti-androgen bicalutamide for more than six months will get breast swelling. However, it is less common in men who have had an orchidectomy or who are having maximal androgen blockage.
Breast swelling and tenderness can make some men feel uncomfortable about their bodies.

Tiredness (fatigue)
Hormone therapy for prostate cancer can cause extreme tiredness. While some men may not feel tired at all, other men may experience tiredness that affects their everyday life. Fatigue
can affect areas such as your energy levels, your motivation and your emotions. It is important to let your doctor know how you feel and how tiredness is affecting you so that they can help you.

Weight gain
You may notice that you start to put on weight, particularly around the waist. Some men find this physical change difficult to cope with particularly if they have never had any pro