Management of side effects of androgen deprivation therapy.

Androgen deprivation therapy (ADT) is a major component of the contemporary management of prostate cancer. ADT's use is increasing rapidly. The side effects of this therapy include loss of bone mass and fractures, increase in fat mass, and worsening of insulin resistance, the metabolic syndrome, diabetes and cardiovascular risk, and anemia and loss of muscle. Neuropsychological and sexual symptoms are common. The impact of these side effects is often overlooked or underestimated in decisions about prostate cancer therapy. This review surveys the data relating to the side effects of ADT and provides recommendations regarding their minimization and management.