The overall increased risk of serious adverse effects, such as breast cancer, stroke and pulmonary embolism, with long-term hormone replacement therapy. As with estrogen side effects, these usually go away after a few weeks. There are things you can do to help cope with them. If you take combination hormone replacement therapy, you may experience some of the side effects of estrogen or progestin. The side effects of hormone therapy will depend primarily on the type of hormone therapy, the dose of a drug or combination of drugs, and your general health.
Fatigue is the general tiredness and lack of energy that can occur with hormone therapy. It makes a person feel more tired than usual and can interfere with daily activities and sleep. It usually gets worse when you are receiving other treatments, such as chemotherapy or radiation therapy. Fatigue may improve over time, but it can sometimes last a long time after hormone treatment. Some hormone therapy medications can cause nausea and vomiting.
These side effects usually get better as your body gets used to the medication. Taking hormone therapy medications with food or before bed can help alleviate these side effects. Nausea and vomiting may also occur a few hours after radiation therapy to the abdomen. Weight gain often occurs with hormone therapy. It is caused by increased appetite, decreased activity, and fluid retention.
It's often difficult to control your weight when you're undergoing hormone therapy, but changes in diet and exercise can help. You can request a consultation with a dietitian to control your weight. Some hormone therapies may cause a decrease or loss of interest in sexual intercourse. It can continue while you are taking hormonal drug therapy, but it can sometimes be a long-term side effect. It can be a permanent side effect if surgery or radiation therapy is done to stop hormone production. Treatment-induced menopause may be permanent in women who have their ovaries surgically removed or receive radiation therapy to the ovaries.
Treatment-induced menopause in women who have undergone hormonal drug treatment may be temporary. For some women, it may be permanent, especially if they are close to natural menopause when hormonal drug therapy begins. The symptoms of treatment-induced menopause are the same as those of natural menopause, but may be more severe because the treatment-induced menopause happens quickly. Some hormone therapies can cause hot flashes and sweating in both men and women.
These side effects usually improve as the body gets used to the treatment or when therapy with hormonal drugs is stopped. There are ways to control hot flashes. Taking hormone therapy medications at night may help some people cope with hot flashes. If hot flashes worsen at night, take your medicines in the morning. Check with your doctor or health care team before taking herbal products to treat hot flashes, as some may have hormonal properties that may affect a hormone-related cancer.
If you have side effects, they can occur at any time during hormone therapy, right after, or a few days or weeks later. The new evidence was contradictory: some new evidence indicated an increased risk of stroke with hormone replacement therapy, and other studies found no effect or reduced the risk of stroke. The Lancet asked researchers at the Cancer Research UK epidemiology unit in Oxford to review all long-term HRT trials, after the early completion of part of the trial of the women's health initiative showed an increased risk of cardiovascular events. It occurs because some hormone therapy drugs affect the cells that line the gastrointestinal (GI) tract.
Having a strong social and emotional support system can also help you during hormone therapy for cancer. New evidence seems to show inconsistent effects on all HRT-related outcomes, such as pain and swelling of the hearing or joints. Inconsistent effects on intraocular pressure were seen, with improvement with conjugated equine estrogens, but no effect was seen with combined HRT. No effect on breast cancer risk was seen in 3 studies of estrogen-only HRT or unspecified HRT, compared to no HRT (79.85.8).
A Cochrane review (suggested that compared to combined HRT, tibolone had no effect on cardiovascular, cerebrovascular, or thromboembolic events).
