Androgen deprivation therapy
Also called: ADT
What it means
Androgen deprivation therapy (ADT) is a prostate cancer treatment that lowers testosterone to very low levels. It's effective against cancer but causes rapid bone loss and higher fracture risk.
ADT can accelerate bone loss faster than early menopause, so your bones need a plan alongside your cancer care.
Androgen deprivation therapy suppresses testosterone to castrate levels as part of prostate cancer treatment. Testosterone normally supports bone formation directly, and some of it converts into estrogen in the body, which gives extra bone protection. When ADT removes both of these, bone loss speeds up considerably — often several per cent in the first year, which is faster than the bone loss typically seen in early menopause. Lean mass declines too, and fracture risk goes up.
The cancer treatment itself isn't in question — it's about whether the skeleton is being monitored while it happens. Standard oncology guidance includes checking baseline bone density, making sure vitamin D and calcium intake are adequate, assessing fracture risk, encouraging resistance and loading exercise, and considering bone-protective medication for higher-risk men. In practice, these steps are frequently overlooked, so it helps to ask your care team directly whether a bone plan is in place.
A similar situation happens in women on aromatase inhibitor therapy for breast cancer, which suppresses estrogen production and also accelerates bone loss. Anyone in either of these groups is encouraged to have an explicit, monitored bone plan. Decisions about starting, adjusting, or stopping these medications belong with your prescribing physician.
How sure is this?
Graded Strong Clinical Evidence: Supported by multiple well-designed clinical studies in humans. Read each study with its grade in mind. One study is a piece of the picture, not the whole of it.
Where the Academy teaches it
This page is the short version. The lessons teach it in full, with the context around it and a quiz to lock it in.
Questions people ask about this
Yes, it's possible — a number of common medications can affect bone, so it's a smart question to ask. This doesn't mean you should change anything on your own; it just means it's worth reviewing your full medication list with your prescriber to understand whether bone monitoring makes sense for you.
Read the full answer →Yes. Men absolutely can get osteoporosis — in fact, roughly a third of all hip fractures happen in men, and men who fracture a hip have higher mortality afterward than women do. The decline is more gradual than the sharp drop women experience at menopause, but it's real and often overlooked.
Read the full answer →Related words
Testosterone is a male hormone that supports bone formation directly and indirectly, partly by being converted into…
An aromatase inhibitor is a medication that blocks the enzyme aromatase, which the body uses to make estrogen. It's…
Estrogen is a hormone that protects bone by keeping bone-removing cells in check. Falling estrogen, especially at…
Menopause is when your periods stop and estrogen levels drop sharply, which speeds up bone loss because the cells…
A fragility fracture is a broken bone caused by a fall or bump that normally wouldn't break a healthy bone, often at…
A hip fracture is a break at the femoral neck, the narrow part of bone connecting the hip joint ball to the thigh…
Education only, not medical advice. Decisions about tests, medications and treatment belong with your own doctor. OsteoStrong does not diagnose, treat or cure any disease.
