If you’re facing hormone therapy as part of your cancer treatment, you’re probably wondering what changes your body will experience.
Whether you’ve been diagnosed with breast cancer, prostate cancer, or another hormone-sensitive cancer, hormone therapy can feel overwhelming when you’re already managing so much.
The truth is that hormone therapy works by blocking or lowering hormones in your body, and these changes can affect how you feel day to day. From hot flashes to fatigue, joint pain to mood shifts, these side effects are real and they matter.
But here’s what I want you to know: you don’t have to navigate this alone, and you absolutely can feel better while on treatment using the right nutrition and lifestyle changes.
Understanding what to expect and having practical strategies to manage symptoms can transform your experience and help you maintain your quality of life throughout your cancer journey.
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Understanding Hormone Therapy for Cancer
Hormone therapy is a powerful cancer treatment that works by blocking hormones or lowering hormone levels in your body. For breast cancer, this typically means reducing estrogen that fuels cancer growth. For prostate cancer, it involves lowering testosterone levels that help prostate cancer cells thrive.
As your cancer dietitian, I see survivors every day who are confused about why hormone therapy causes so many changes in their bodies. Here’s what’s happening: hormones like estrogen and testosterone don’t just affect cancer cells.
They also play important roles in your bones, muscles, brain, heart, and sexual health. When hormone therapy blocks these hormones, your entire body adjusts to these new levels.
The good news? Most side effects can be managed with the right nutrition and lifestyle strategies, and can improve over time as your body adapts.
Types of Hormone Therapy
Different hormone therapies work in different ways and cause different side effects:
- Aromatase inhibitors (anastrozole, letrozole, exemestane) stop your body from making estrogen after menopause.
- Selective estrogen receptor modulators (SERMs) like tamoxifen block estrogen from attaching to cancer cells.
- LHRH agonists (leuprolide, goserelin) stop your ovaries or testicles from producing hormones.
- Antiandrogens (bicalutamide, enzalutamide) prevent testosterone from reaching prostate cancer cells.
If you’re ready for expert, personalized support, apply here for: VIP 1:1 Cancer nutrition & Lifestyle Coaching with me today so you don’t waste another month stuck guessing what’s right for your body to keep your hormones balanced, you feeling like yourself, and you keep your cancer risk down.
The Most Common Side Effects of Hormone Therapy
Let me walk you through what research shows are the most frequent side effects, and more importantly, what I’ve seen work for my clients who live with these every day.
Hot Flashes and Night Sweats
Hot flashes affect up to 75% of people on hormone therapy. One of my survivors told me when she first came to me, “I went from never breaking a sweat to waking up drenched three times a night.” This happens because when hormone levels drop, your body’s temperature regulation system gets confused.
The good news? You can absolutely calm them down. Through the right foods, hydration, and lifestyle adjustments, I’ve helped survivors reduce both the frequency and intensity of their hot flashes – sleeping through the night again, feeling like themselves, and finally getting their energy back.
If you’re ready to take back control of your body and your nights, apply for VIP 1:1 Cancer Nutrition & Lifestyle Coaching – we’ll create a plan that works with your body, not against it.
What I tell my clients in my coaching programs: hot flashes don’t mean hormone therapy isn’t working. They actually show your body is responding to treatment. Here’s what helps:
- Layer your clothing so you can adjust quickly
- Keep cold water nearby at all times
- Avoid triggers like spicy foods, caffeine, and alcohol
- Use breathable cotton fabrics for bedding and clothes
- Make sure you are exercising – as this will help to balance your hormones
Fatigue and Low Energy
Fatigue is more than just feeling tired. Cancer-related fatigue doesn’t improve with rest alone, and hormone therapy adds another layer that may exacerbate it – but with the right nutrition and lifestyle the cancer related fatigue can get better.
As your Oncology Dietitian, I work with survivors to understand that this exhaustion comes from your body working hard to adjust to lower hormone levels.
In my programs, I show survivors how strategic nutrition timing and balanced meals can stabilize energy throughout the day. A VIP 1:1 client recently shared: “I thought I’d be exhausted forever, but learning to fuel my body properly gave me my afternoons back.”
I have found that combining these nutrition strategies with the five approaches that specifically target cancer-related fatigue gives my clients the best results for restoring their energy levels during hormone therapy.
Energy-boosting strategies include:
- Eating protein with every meal to maintain muscle mass
- Staying hydrated with at least 8 glasses of water daily
- Moving your body with gentle exercise like walking
- Prioritizing 7 to 9 hours of quality sleep
Weight Changes and Body Composition Shifts
Weight gain affects 60 to 70% of people on hormone therapy, particularly around the midsection. But here’s what I want you to understand: weight gain on hormone therapy is NOT inevitable, and it does not have to be your story.
Hormone therapy causes your body to naturally lose some muscle mass and gain fat, a shift that can slow your metabolism slightly, but not as much as most people fear. What’s really happening is that lower hormone levels change how your body uses and stores energy.
Muscle tissue burns more calories at rest, so when muscle decreases, your baseline energy burn dips a bit. At the same time, changes in estrogen or testosterone can lead to more fat storage, especially around the abdomen.
The encouraging part? You can absolutely counteract this with the right nutrition and strength-focused movement.Rebuilding lean muscle, spacing protein strategically throughout the day, and balancing your meals can keep your metabolism strong and your body composition healthy – even while on treatment.
This is exactly what I help my 1:1 coaching clients navigate. What I’ve seen with my clients is that when they understand the “why” behind weight changes, they stop blaming themselves and start implementing solutions that actually work.
The myth that you cannot lose weight on hormone therapy is just that: a myth. I’ve coached dozens of survivors who successfully managed their weight during treatment by focusing on protein intake of at least 25 to 30 grams per meal, resistance training to maintain muscle mass, balanced plates with vegetables and lean proteins, and mindful portions without restrictive dieting.
This approach has helped my clients not only maintain their weight but actually lose weight successfully while on hormone therapy when that’s their goal, proving that it’s absolutely possible with the right strategies.
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Joint Pain and Muscle Aches
Nearly 50% of people taking aromatase inhibitors experience joint pain, particularly in hands, wrists, knees, and hips. This pain feels worse after periods of inactivity, like first thing in the morning or after sitting for a while.
As your cancer dietitian, I help survivors understand that while over-the-counter pain relievers might not help much, there ARE strategies that work. Research shows that regular movement provides the most relief for hormone therapy-related joint pain.
Anti-inflammatory nutrition strategies I teach include:
- Foods rich in omega-3 fatty acids like salmon, walnuts, and flaxseeds
- Colorful vegetables packed with antioxidants
- Turmeric and ginger for natural anti-inflammatory properties
- Staying well-hydrated to support joint health
Sexual Side Effects
Let’s talk about what many doctors don’t discuss enough: sexual side effects are extremely common with hormone therapy. For women, this includes vaginal dryness, discomfort during sex, and decreased libido. For men, erectile dysfunction and loss of sexual desire affect the majority of androgen deprivation therapy.
Using vaginal moisturizers and lubricants, staying sexually active to maintain blood flow, working with a pelvic floor physical therapist, and having open conversations with your oncology team about treatment options are all important steps.
Bone Loss and Osteoporosis Risk
Hormone therapy can cause significant bone density loss, increasing your risk for osteoporosis and fractures.
This happens because estrogen and testosterone help maintain strong bones, and when these hormones decrease, bones become more fragile.
In my coaching, I emphasize that bone health starts on your plate. Calcium and vitamin D are non-negotiables, but they’re not the whole story. You also need:
- 1,200 to 1,500 mg of calcium daily from food sources like dairy, leafy greens, and fortified foods
- 800 to 1,000 IU of vitamin D daily, often requiring supplementation
- Regular weight-bearing exercise like walking or light resistance training
- Adequate protein to support bone matrix
Your oncologist should monitor your bone density with DEXA scans and may prescribe medications like bisphosphonates or denosumab if needed.
Mood Changes and Depression
Hormone changes affect brain chemistry, which means mood swings, anxiety, and depression are common side effects. You’re not “just being emotional” because your hormones genuinely influence neurotransmitters that regulate mood.
As your Oncology Dietitian, what I help survivors understand is that while you can’t control hormone fluctuations, you CAN support your mental health through nutrition and lifestyle. This includes:
- Omega-3 fatty acids that support brain health
- B vitamins from whole grains and leafy greens
- Regular physical activity to boost endorphins
- Adequate sleep for emotional regulation
- Professional support through therapy or counseling
Cognitive Changes (Brain Fog)
Many survivors experience memory problems, difficulty concentrating, and mental fog during hormone therapy. While we call this “chemo brain,” hormone therapy alone can cause these symptoms.
As your Oncology Dietitian, I’ve seen how frustrating this can be when you’re trying to manage work, family, and treatment all at once. That’s why I work with my clients on specific evidence-based strategies to reduce brain fog through nutrition and lifestyle changes.
This includes eating antioxidant-rich berries and leafy greens, getting healthy fats from avocados and nuts, staying well hydrated because even mild dehydration affects cognition, and maintaining regular meal timing to keep blood sugar stable throughout the day.
If you’re ready for expert, personalized support, apply here for: VIP 1:1 Cancer nutrition & Lifestyle Coaching with me today so you don’t waste another month stuck guessing what’s right for your body.
One of the most common questions I hear is, “When will I feel like myself again?”
The answer varies for everyone, but here’s what research and years of working with survivors tells us.
Short-term side effects like mild nausea or early hot flashes usually improve within 3 to 6 months as your body adjusts to new hormone levels.
Longer-term effects, such as gradual bone changes or shifts in sexual health, can last through treatment but often stabilize with the right nutrition, movement, and medical support.
Here’s the encouraging part: many people start feeling more like themselves again within 6 to 12 months after completing therapy. Some changes, like bone density, may need ongoing care – but with the right guidance, your strength, energy, and confidence can absolutely return.
Permanent vs. Temporary Side Effects
Let me be honest with you about what might be permanent and what will likely improve:
Usually Temporary (Improve After Stopping Treatment)
- Hot flashes and night sweats
- Fatigue
- Some mood changes
- Most cognitive changes
- Weight gain (though requires active management)
May Be Permanent or Long-Lasting
- Bone density loss
- Some sexual function changes
- Some vaginal atrophy in women
- Reduced fertility
- Muscle mass loss (without intervention)
Managing Side Effects: What Actually Works
After working with hundreds of cancer survivors, I’ve learned what strategies actually make a difference. Here’s what I teach in my programs that gets real results:
Nutrition Strategies That Support Your Body
What I’ve seen with my clients is that when they fuel their bodies properly, side effects become more manageable. This isn’t about restriction or perfection. It’s about giving your body what it needs to function well despite hormonal changes.
My clients consistently report feeling better, having more energy, and managing side effects more effectively when they implement my 5-pillar approach: balanced plates with vegetables and lean proteins, consistent meal timing to stabilize energy and blood sugar, adequate hydration to support every body function, anti-inflammatory foods to reduce pain and discomfort, and bone-supporting nutrients from food-first sources.
I have spent years developing and refining these strategies specifically for cancer survivors, and you can see how powerful nutrition becomes when applied correctly during treatment to help manage even the most challenging side effects.
Exercise and Movement
Research consistently shows that regular exercise is one of the most effective ways to manage multiple hormone therapy side effects at once. Exercise helps with weight management, bone health, fatigue, mood, cognitive function, and sleep quality.
What I recommend to my clients:
- Aim for 150 minutes of moderate activity weekly
- Include resistance training 2 to 3 times per week
- Start where you are because even 10 minutes counts
- Choose activities you actually enjoy
Medical Management Options
Your healthcare team has several tools to help manage side effects:
- For hot flashes: Certain antidepressants, gabapentin, or other medications
- For bone loss: Bisphosphonates or denosumab
- For vaginal dryness: Low-dose vaginal estrogen (when appropriate)
- For joint pain: Physical therapy, acupuncture
- For depression: Antidepressants and therapy
Get Expert Support to Manage Hormone Therapy Side Effects
You don’t have to figure this out alone. While your medical team manages your cancer treatment, I’m here to help you manage the side effects and feel your best throughout your journey.
If you’re looking for comprehensive support that addresses all aspects of cancer nutrition during hormone therapy, my Cancer Prevention Bundle gives you instant access to evidence-based strategies for managing side effects, maintaining weight, supporting bone health, and reducing your risk of recurrence.
This bundle includes my most popular masterclasses on nutrition for hormone-sensitive cancers and sustainable weight management tailored specifically for cancer survivors on hormone therapy.
Get the Cancer Prevention Bundle now and start feeling better today.
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Living Well on Hormone Therapy: A Realistic Approach
Here’s what I want you to know after working as your Oncology Dietitian with cancer survivors for years: hormone therapy side effects are real, but they don’t have to control your life. The survivors who do best aren’t the ones who ignore their symptoms or push through without support. They’re the ones who acknowledge challenges, implement practical strategies, and get expert guidance when they need it.
In my VIP 1:1 Cancer Nutrition & LIfestyle Coaching Program, I work with survivors to create personalized nutrition plans that address their specific side effects while supporting overall health and cancer prevention. We don’t just talk about what you “should” do. We focus on what actually works for your life, your preferences, and your body’s unique needs.
References
- National Cancer Institute: Hormone Therapy for Prostate Cancer Fact Sheet (2024)
- American Cancer Society: Hormone Therapy Side Effects (2025)
- Breastcancer.org: Side Effects of Hormonal Therapy for Breast Cancer (2024)
- UPMC Hillman Cancer Center: Hormone Therapy Side Effects (2024)
- PMC: Adverse Events Associated with Hormonal Therapy for Prostate Cancer
- Susan G. Komen: Side Effects of Aromatase Inhibitors (2025)
- Fred Hutchinson Cancer Center: Hormone Treatment Side Effects (2023)
