What are the metabolic changes that can occur in men who undergo ADT?

Metabolic Syndrome, a common side effect of ADT, is linked with increased risk of heart disease and Type 2 Diabetes.  This cluster of symptoms is defined by changes in:

1.       glucose metabolism (regulation of blood sugar levels),

2.       insulin sensitivity (insulin’s ability to shuttle glucose into cells),

3.       body composition (e.g., loss of muscle mass, increased fat storage around the waist),

4.       elevated blood pressure,

5.       and levels of triglycerides and/or cholesterol in the blood.

A recent study out of Russia examined metabolic changes in men with metastatic prostate cancer who were prescribed ADT. One hundred and fifteen men with metastatic prostate cancer were involved in the study. The men received either a LHRH agonist drug (like Lupron or zoladex) alone, or they were given the LHRH drug along with an anti-androgen (like Casodex). The researchers measured various parameters of metabolic health prior to the start of treatment and again 6 months and 1 year after the start of treatment.

Results:  After 6 months and 1 year of ADT, men in both groups showed comparable changes in various measures of metabolic health. In both groups, increases in body weight and body mass index were observed after 1 year. Waist circumference increased by about 5% in both groups after 1 year. Fasting glycemia, an indicator of glucose metabolism, increased by about 2% after 6 months in both groups. By the 1-year mark, fasting glycemia increased by about 4% in both groups. Moreover, about 10% of patients in each group received a new diagnosis of diabetes mellitus over the 1 year period from the start of ADT treatment.

Overall this paper confirms the risk of metabolic syndrome with ADT. However…

Men starting on ADT can take action to reduce their risk of developing metabolic syndrome. Physical activity is one powerful strategy that can help control body composition, blood pressure, and glucose metabolism.

To read the study abstract, please see:


Demidova, T., Gritskevich, E., & Mishugin, S. (2019). Metabolic changes in men undergoing androgen deprivation therapy for prostate cancer. Endocrine Abstracts, 63, GP205. doi: 10.1530/endoabs.63.GP205