March 16, 2009 -- Question: What are the side effects of medical or surgical androgen ablation?
Answer: Androgen ablation, however it is achieved, drops the testosterone levels to what we call castrate -- meaning that there's such low levels of testosterone that it's very similar to when the testicles have been removed. When that happens it's very similar to a woman who is going through menopause.
One of the first things that men might notice are hot flashes, and these can range anywhere from one or two a day all the way to several a day, and it can be quite uncomfortable.
A second common side effect is a loss of strength or energy and many men will -- who are athletically oriented -- will tell you that they've lost about 30 percent of their performance, whether that's weight lifting or playing golf, etcetera.
A third side effect is a loss of libido and sexual functions, so most men have much less interest in sex and if they are still interested in sex, their ability to get erections is inhibited.
Another side effect is called the metabolic syndrome. This is a complex syndrome. It is seen in men who gain weight, and that is indeed what happens as well when you stop testosterone, and weight gain can lead to Type II diabetes, increases in cholesterol, and sometimes an increased risk for heart attacks.
Lastly, and just as women with menopause, men who lose testosterone start losing calcium from their bones, and they're at increased risk for fracture. So taking vitamin D supplementation and higher levels of calcium in the diet are very important, and in some cases drugs are used to prevent calcium loss from the bones just as treating osteoporosis in women is done.