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What I wish I'd asked at the start of ADT

Reviewed October 2026

Starting androgen deprivation therapy (ADT) is often rushed. The appointment is about the cancer, the injection or tablets start soon after, and the side effects come later, when you’re at home.

Men and partners who have been through it say the same thing again and again on the big online communities: nobody really prepared us. One family member recently wrote that everyone talked about the cancer, but no one prepared them for the hormone therapy itself: weight around the middle, losing muscle, emotional ups and downs, and hot flushes at night (paraphrased from a public online patient community, October 2026). Another man said his team mentioned weight gain and not much else. No one talked about exercise. He wished he’d asked more before he started.

The research agrees. Men on ADT report unmet needs for information, emotional support and sexual health support (bi-national study of men on ADT, Australia and UK). Many say they felt inadequately prepared for the impact ADT has on their lives (Australian study: Sara et al., Eur J Oncol Nurs 2025).

This page collects the questions people most often wish they’d asked. None of it replaces your own team’s advice. It’s meant to help you get more out of the time you have with them.

1. “How long will I be on it, and why that long?”

People often find this out late, or not at all. Some men on forums say that knowing the end date helped them get through. Others only found out partway through that their doctor was open to a shorter course. Some made the decision to stop on their own, without good information.

Worth asking:

Please don’t stop or change treatment without talking it through with your team. Whether a shorter or intermittent course is safe depends on your cancer. For the basics, see our guide What ADT is.

2. “What side effects should I expect, and when?”

Common effects include hot flushes, tiredness, loss of sex drive, weight gain around the waist, muscle loss, bone thinning, mood changes and brain fog (Prostate Cancer UK). Everyone is different. Some men on forums say the worst of it eased after a few months. Others found the later months harder.

Worth asking:

Our guides: Hot flushes · Fatigue

3. “Should I be exercising, and can you refer me?”

This is probably the most common piece of hindsight. Men who’ve been through ADT keep telling newer men that regular exercise, especially resistance (weights) training, made the biggest difference to how they felt. Many add that it’s much easier if you start early, before the tiredness sets in.

Worth asking:

Our guide: Exercise on ADT

4. “What about my bones?”

ADT can thin your bones, so it’s worth asking early. Men who have been on ADT for many years sometimes say they wish they had pushed for bone checks sooner.

Worth asking:

Our guide: Bone health on ADT

5. “What checks should I have for my heart, weight and blood sugar?”

ADT can affect weight, cholesterol and blood sugar. Guidelines recommend checking cardiovascular risk before and during treatment (PC360 working group, Urology Practice; Hong Kong consensus statements, 2024).

Worth asking:

6. “Could this affect my mood, and what do I do if it does?”

Many men and partners say they weren’t warned about this. Hormone therapy can make you more emotional, teary, irritable or low (Prostate Cancer UK: hormone therapy and your feelings). Men on forums describe crying more than they ever have, losing their temper more easily, and life feeling grey and flat. Partners describe feeling worn down and alone with it. Recommendations for doctors include checking mood at the start of ADT and during treatment (PC360).

Just knowing it can be the treatment, not a personal failing, helps a lot of people.

Worth asking:

If you or your partner are struggling, please reach out. If you’re feeling very low, hopeless, or having thoughts of harming yourself, call Lifeline on 13 11 14 (24/7, Australia), or text 0477 13 11 14. In an emergency, call 000. Outside Australia, contact your local crisis line or emergency number (911 US/Canada, 999 UK, 111 NZ). For non-urgent support and information, you can also call PCFA’s Prostate Cancer Specialist Telenurses on 1800 22 00 99 (Mon 9am–5pm AEST, Tue–Fri 9am–7pm AEST; not a crisis line).

7. “What will this do to our sex life and closeness?”

Losing sex drive is one of the most talked-about effects. Men often describe it as feeling switched off, and partners can find it hard not to take personally. Plenty of couples say they stayed close in other ways: lots of touch, honest conversations, and keeping physical affection going even when desire wasn’t there.

Worth asking:

8. “What happens when I stop?”

Many men assume everything goes back to normal soon after the last dose. For some it does. For many it takes longer. In a pooled analysis of radiotherapy trials, men who had 6 months of ADT took a median of about 12–15 months for their testosterone to recover, and men who had 18 months took a median of about 2½–3 years. About a third never fully recovered to normal levels (MARCAP Consortium, ASCO 2023). In a US study of 307 men, about a quarter had not recovered normal testosterone two years after stopping, and older men and men treated for longer recovered more slowly (Nascimento et al., J Sex Med 2019). Men coming off ADT on forums often suggest asking for testosterone to be checked alongside PSA.

Worth asking:

For partners: you’re in this too

Partners often say they felt invisible in the clinic. They do much of the research, notice the mood changes first, and carry a lot of the worry. Research backs this up. Partners have their own unmet needs, including intimacy, emotional support, practical help with daily life, and being informed and included by health services (Roberts et al., Cancer Nurs 2024), and some describe feeling left out of conversations about sex and intimacy (qualitative study of female partners).

Things partners say helped:

Your question checklist

Print this, or take it on your phone. Tick off what you’ve asked.

About the treatment

Side effects

Staying well

Mind and relationships

After ADT

My own questions:

Get the free ADT check-up card

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Print it, stick it on the fridge and fill it in once a week. Partners can help fill it in too.

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