Table 1.
Side effects of androgen deprivation therapy related to loss of testosterone (T) and estrogens (E)
| “Big four” | What you see | What is not visible | What the patient feels |
|---|---|---|---|
| Libido loss in 80–85% of patients (T) | Weight gain (E) | Bone loss and increase in fracture risk (E) | Fatigue (T & E) |
| Erection problems (T) | Gynecomastia (E) | Metabolic syndrome (E) | Sleeping problems (T & E) |
| Hot flushes and sweating (E) | Muscle atrophy (sarcopenia) (T & E) | Anemia (E) | Loss of energy (T & E) |
| Arthralgia (joint pain); most frequently occurring symptom of estrogen deficiency (E) | Decrease in size of the penis and testicles (T) | Increase in cardiovascular risk (E) | Apatheia (T & E) |
| Change in hair pattern (T) | Mood changes and depression (E) | ||
| Cognition and memory problems (E) |