What are the major long-term health risks associated with ADT?

Knowing the risks associated with ADT can be a helpful step in developing an ‘action plan’ to prevent or minimize the adverse effects of ADT. Researchers recently used Medicare claims records for over 200,000 men with prostate cancer in the USA to investigate potential long-term risks of ADT. Records were compared for the occurrence of side effects in men who received ADT versus those who did not. The researchers had 19-years of follow-up data, and employed statistical methods to estimate the relative risk of several major long-term side effects.

Results:  When compared to men with prostate cancer who had not receive ADT, men who received ADT had increased incidence of:

1.      Bone fractures (highest risk among all potential side-effects)

2.      Diabetes

3.      Dementia

4.      Coronary heart disease

5.      Acute Myocardial Infarction

6.      Sexual Dysfunction

There was a dose-response relationship between the number of doses of ADT and the risk of bone fractures and diabetes; more ADT was linked to higher risk of bone fractures and diabetes.

Further, men who received ADT had a 12% increase in the risk of sexual dysfunction, when compared to men who didn’t receive ADT (e.g., on active surveillance). This risk was even greater when ADT was combined with other therapies like radiation and surgery.

Importantly, greater awareness and knowledge of these risks can inform efforts to prevent or minimize those side effects. For example, we know that physical activity can reduce bone-loss and the risk of bone fractures, weight gain, and fatigue for men on ADT.

To read the study abstract, see:


Nguyen, C., Lairson, D. R., Swartz, M. D., & Du. X. L. (2018). Risks of major long-term side effects associated with androgen-deprivation therapy in men with prostate cancer. Pharmacotherapy, 38(10), 999-1009. doi: 10.1002/phar.2168