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Fatigue on ADT: why you're tired and what helps

Reviewed October 2026

Feeling drained is one of the most common, and most frustrating, effects of ADT. Lower testosterone, muscle loss, poor sleep from night sweats and changes in mood can all add up.

The best evidence: move more

It sounds backwards, but exercise is the most effective tool we have for ADT fatigue.

• 12 weeks of resistance plus aerobic exercise reduced fatigue compared with usual care (Galvão et al. 2010).
• Over a year, every type of exercise tested reduced fatigue and increased vitality. Men who were most fatigued at the start improved the most (Taaffe et al. 2017).
• In the UK STAMINA trial, a supervised exercise and lifestyle program improved fatigue scores (Lancet Oncology 2026).

Start small: a 10-minute walk, or a couple of sit-to-stands from a chair. Build up week by week.

Other things that help

• Protect your sleep. Manage night sweats (see Hot flushes on ADT), keep regular sleep and wake times, and keep naps short and early.
• Pace yourself. Plan demanding tasks for when your energy is best.
• Eat well. Regular meals with enough protein help maintain muscle.
• Talk about mood. Low mood can feel like tiredness. It’s common on ADT and treatable.

Tell your team if

• Fatigue is severe, getting worse, or stopping you doing everyday things.
• It comes with breathlessness, chest pain, dizziness or weight loss.
• You feel persistently low or hopeless.

Fatigue can have other causes, such as anaemia or thyroid problems, so it’s worth checking. If you ever have thoughts of harming yourself, call your local emergency or crisis line (AU Lifeline 13 11 14; US/CA 988; UK Samaritans 116 123; NZ 1737).