Bicalutamide-only has a low side effect profile compared with the other hormone therapy medications.
Hot flushes are less likely.
It strengthens bones rather than weakening them.
It will cause loss of body hair acquired a puberty, except beard and pubes.
It can cause reversal of recent balding.
It does have some impact in libido and semen, but not as much as the other hormone therapy medications.
It doesn't risk permanent reduction or loss of Testosterone.
The one side effect which is worse is breast gland growth (gynecomastia) and breast gland pain (mastodynia), which can start after a couple of months. If you will be on Bicalutamide longer than 2 months, you should ask to take low dose Tamoxifen with it. If you start Tamoxifen with the Bicalutamide, 1 x 20mg/week is usually enough, but can be increased if symptoms break through. A higher dose will be required if you wait until breast gland symptoms before you start taking the Tamoxifen. People with a history of DVT or serious liver or cardio issues are unlikely to be prescribed Tamoxifen. Liver function should be checked after a few months to make sure it's coping with Bicalutamide and Tamoxifen. Another treatment for this is a once-off blast of radiotherapy to the breast glands, but it's not as successful, and comes with the risks of radiotherapy to another part of the body.
Edited by member 20 Aug 2025 at 20:39
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