[While not the perfect model for hypogonadism (ASIH), ADT does show the adverse effects with hypogonadism on a short term basis. One can imagine the long-term effects and risks.]
Allan C, Collins VR, Frydenberg M, McLachlan RI, Matthiesson KL. Androgen deprivation therapy complications. Endocr Relat Cancer. http://erc.endocrinology-journals.org/content/early/2014/05/28/ERC-13-0467.abstract
Androgen deprivation therapy is increasingly used to treat advanced prostate cancer and is also utilised as adjuvant or neo-adjuvant treatment for high risk disease. The resulting suppression of endogenous testosterone production has deleterious effects on quality of life including hot flushes, reduced mood and cognition, and diminished sexual function.
Cross-sectional and longitudinal studies show that androgen deprivation therapy has adverse bone and cardio-metabolic effects. The rate of bone loss is accelerated increasing the risk of osteoporosis and subsequent fracture. Fat mass is increased and lean mass reduced, and adverse effects with deleterious effects on lipid levels and insulin resistance are observed, the latter increasing the risk of developing type 2 diabetes.
Androgen deprivation therapy also appears to increase the risk of incident cardiovascular events, although whether it increases cardiovascular mortality is not certain from the observational evidence published to date.
Until high-quality evidence is available to guide management, it is reasonable to consider men using androgen deprivation to be at higher risk of psychosexual dysfunction, osteoporotic fracture, diabetes and cardiovascular disease especially when men are treated with these modalities for extended periods of time and are therefore subjected to profound and prolonged hypoandrogenism.
Health professionals caring for men undergoing treatment for prostate cancer treatment should be aware of the potential risks of androgen deprivation therapy and ensure appropriate monitoring and clinical management.
Allan C, Collins VR, Frydenberg M, McLachlan RI, Matthiesson KL. Androgen deprivation therapy complications. Endocr Relat Cancer. http://erc.endocrinology-journals.org/content/early/2014/05/28/ERC-13-0467.abstract
Androgen deprivation therapy is increasingly used to treat advanced prostate cancer and is also utilised as adjuvant or neo-adjuvant treatment for high risk disease. The resulting suppression of endogenous testosterone production has deleterious effects on quality of life including hot flushes, reduced mood and cognition, and diminished sexual function.
Cross-sectional and longitudinal studies show that androgen deprivation therapy has adverse bone and cardio-metabolic effects. The rate of bone loss is accelerated increasing the risk of osteoporosis and subsequent fracture. Fat mass is increased and lean mass reduced, and adverse effects with deleterious effects on lipid levels and insulin resistance are observed, the latter increasing the risk of developing type 2 diabetes.
Androgen deprivation therapy also appears to increase the risk of incident cardiovascular events, although whether it increases cardiovascular mortality is not certain from the observational evidence published to date.
Until high-quality evidence is available to guide management, it is reasonable to consider men using androgen deprivation to be at higher risk of psychosexual dysfunction, osteoporotic fracture, diabetes and cardiovascular disease especially when men are treated with these modalities for extended periods of time and are therefore subjected to profound and prolonged hypoandrogenism.
Health professionals caring for men undergoing treatment for prostate cancer treatment should be aware of the potential risks of androgen deprivation therapy and ensure appropriate monitoring and clinical management.
