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Managing side effects

Whilst it is comforting to know that treatment with Zoladex can help to lengthen survival1,2 many men find the most common side-effects of treatment distressing. In particular, side-effects that affect the way you think of yourself as a man can be hard to deal with. These include loss of sex drive, erection difficulties, hot flushes and breast swelling or tenderness. Fortunately, there are ways to help manage these problems.

You should always check with your own doctor to see which options are suitable for your own particular circumstances.

Here is some more detailed information on some of the more common possible side effects of Zoladex and how to manage them:

Hot flushes and sweating

Most men taking hormone therapy will experience hot flushes and sweating to some degree.3 Triggers include hot drinks, stress and changes in surrounding temperatures.

If you suffer from hot flushes and/or sweating, you may feel very self-conscious about it. You may think it is very obvious to other people and that they are staring at you. In reality, people probably haven't noticed that you are experiencing this symptom.

Managing hot flushes and sweats:

  • Cut down on alcohol, caffeine and spicy food
  • Keep the room cool
  • Use cotton sheets and clothing
  • Dress in layers which can be quickly removed

If your symptoms are very bad, it might be worth asking your doctor about treatments that may help you.

Some men find that complementary therapies such as auricular acupuncture can help to reduce the frequency and intensity of hot flushes and/or sweating.4,5

Sex-related problems

Unfortunately treatments for prostate cancer can affect a man’s sexual function in several ways:6

  • Loss of interest in sex (loss of libido) – tiredness, depression and bowel and bladder problems are also to blame
  • Difficulty in getting or keeping an erection (erectile dysfunction)
  • Dry orgasms – the sensation of orgasm remains, but semen is not ejaculated
  • Infertility – semen may no longer be produced or ejaculated
  • Changes in size or shape of penis

No-one can say how much a person’s sex life will be affected. Sexual desire and ability to have an erection may improve once initial treatment is over, but may also remain a problem for men being treated with hormone therapy in the long-term.6

Fortunately, there are a number of options for dealing with loss of sexual function:6

i) Lowered sex drive

Some men may suffer from a loss of sex drive. If you are concerned about your sex drive, and would like to consider treatment, then ask your doctor to discuss the options available to you.

ii) Erectile dysfunction

  • Medication, nerve graft, surgical implant and use of vacuum pumps for erectile dysfunction

iii) Sperm storage prior to treatment to overcome infertility

If you are concerned about erectile dysfunction then ask your doctor to discuss your treatment options.6

Loss of bone mineral density

Unfortunately, hormone therapy causes significant thinning of the bones (osteoporosis). This can lead to an increased risk of fractures.

Treatment with a group of medicines known as bisphosphonates can help to prevent bone loss.7

Breast swelling and tenderness

Before hormone therapy is started, a low dose of radiation to the breast can help to reduce the chances of breast swelling and tenderness.8

Mood changes

You and those around you may find that you have sudden mood swings whilst on Zoladex. It can be quite hard to know when this is affecting you, and if it’s because of your treatment, but rest assured that this is a common side effect.

If mood swings become quite severe or you think they’re becoming a problem, you can speak to your doctor about them, and access more information on the NHS MoodZone website: http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/low-mood-stress-anxiety.aspx

Yellowcard side effects reporting

You can report any side-effects that you suspect are due to Zoladex treatment using The Medicines and healthcare products Regulatory Agency’s (MHRA) “Yellow Card” system: http://www.mhra.gov.uk/yellowcard

N.B. AstraZeneca do not own the content of this external website

Reporting of side effects

Like all medicines, Zoladex can cause side effects, although not everybody gets them.

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme, Website: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

  1. Zoladex, 3.6 mg SPC. https://www.medicines.org.uk/emc/medicine/7855. (Accessed July 2017).
  2. Zoladex 10.8 mg SPC. https://www.medicines.org.uk/emc/medicine/8146. (Accessed July 2017).
  3. Evans PE et al. BJU Int 2005;95: 743-749.
  4. Higano CS. Side effects of androgen deprivation therapy: monitoring and minimizing toxicity. Urology 2003; 61(Suppl 2A): 32-38.
  5. Lee MS et al. Support Care Cancer (2009) 17: 763–770.
  6. Prostate Cancer UK: Sex and prostate cancer:
    https://prostatecanceruk.org/prostate-information/living-with-prostate-cancer/sex-and-relationships (accessed July 2017).
  7. Brufsky AM. Oncologist 2008; 13: 187-195.
  8. Macmillan cancer support: Dealing with side effects of treatment for prostate cancer:
    https://prostatecanceruk.org/prostate-information/living-with-prostate-cancer/how-hormone-therapy-affects-you (accessed July 2017).

GB-6242. Date of Preparation: Sept 2017