There is no monitoring for the HT side effects - this surprised me a bit. I had seen some mention of monitoring on US forums.
It really is up to you to make yourself familiar with them, and avoid those side effects which you don't want and can be avoided, and ask for appropriate meds where necessary. This is important because some of the symptoms can be reduced or avoided, but become permanent if you don't. That's where this forum comes in really handy.
Do you have an assigned urology or Macmillan nurse? They can be a good first contact point. They may have given you a booklet on handling side effects of HT - I got a load of leaflets/books on diagnosis, and it's worth reading them twice with perhaps a month between, as you won't take it all in first time.
At each consultation, I take a list of things I want to ask, and I also include a list of side effects in case it comes up. In one consultation, there was also a guest GP present who was spending a couple of days shadowing the urology consultant to get more urology experience. The consultant did ask me to go through the list or HT symptoms for the guest GP's sake, and that sparked a few discussions. The consultant was unaware of some of the side effects.
Here's a quick list of side effects (and I'll probably miss some). No one gets them all, and the order you get them may be completely different to anyone else. Some research has shown the medical profession think people don't want to know in advance, but when researchers questioned patients, that is not borne out, and most do want to know what to look out for. In the case of HT, many can be avoided if you know what to do at the time.
Loss of nocturnal erections and "morning wood".
This is more important than you might think - see Reduction in erection size below.
Loss of libido.
This can have a major impact on relationships, and it's important you both communicate and understand this, and find ways to keep your relationship working. Counseling may be available.
Loss of semen (dry orgasms).
This doesn't stop you having orgasms, but they may feel different (for some people, better).
Improvement in urinary flow, if it was slow.
This is because it shrinks prostate, and so it may press less on urethra.
Reduction in erection size.
This is also tied in with Loss of nocturnal erections, and loss of libido.
Loss due to HT is avoidable, see https://community.prostatecanceruk.org/posts/t21301-Penis-size#post216227
(However, loss due to other treatments is unavoidable.)
Shrinkage of testicles.
Unavoidable (although I don't know if everyone gets it or notices it). May be some reversal after HT ceases.
Nipple pain and breast growth (gynecomsatia).
Most people can avoid or reduce this by taking tamoxifen (70% success rate, but contra-indicated in case of other medical conditions such as DVT) or a one-shot RT blast to breast tissue (50% success rate, but 1-2% chance of minor damage to heart muscle, although this is not normally even noticed). There is some disagreement about whether these have to be started or done before gynecomsatia starts, but certainly you don't want to leave it for any length of time after it starts if you plan on using either of these. Some people who get gynecomsatia report a little breast shrinkage when they come off HT, but not a return to no breasts. Breast reduction surgery afterwards may be available in some cases too.
Thinning and loss of body hair acquired at puberty.
This mainly impacts chest, back, arms, legs, armpits. Beard and pubes tend to grow slower, but for most people are not lost. (Maybe they are for people on lifelong HT - I don't know.)
Hair on head - may get some reversal of balding, or a pause in balding getting worse whilst on HT.
This is often identified as a particularly annoying side effect. It can start soon after starting HT, or after as much as a couple of years, but not everyone gets it at all. If it's bad, there are drugs which might help, but they are also backstop drugs if your PC later becomes uncureable, and use at this early stage may reduce your options later. Also things like acupuncture help some people, and identifying and avoiding particular triggers.
Change in body composition.
There's a tendency to put on fat on waist and thighs (a more female form). Watching what you eat and doing exercise can reduce this, but it's difficult to completely avoid. People report some reversal after HT finishes.
Loss of calcium from bones.
Bones need testosterone, calcium, and vitamin D to remain strong and healthy. You will be missing testosterone, and the alternative which works for some people is exercise which involves stress/shocking bones (together with the calcium, and vitamin D). Jogging is the most effective, and weights, and you might want to discuss taking calcium and vitamin D supplements with your GP. If you can't exercise and you are suffering from loss of bone calcium, there are other drugs that may be used.
Loss of body odor.
Deodorant no longer required, although perspiration is as before. Very useful for summer exercising.
A hand and nail moisturiser may work.
Difficulty in gaining and retaining muscle.
Testosterone is an important factor in muscle gain in men, which makes it much harder to gain muscle, or even retain muscle. Exercise may be key here, providing you are eating enough protein.
Can cause an increase or decrease in blood pressure.
Can raise blood glucose levels, resulting in Type 2 Diabetes
Edited by member 18 Jun 2019 at 21:36
| Reason: Added more possible side effects.