Understanding how hormonal therapy works, why it is used, and how supportive care can help
Hormonal therapy is an important treatment used for several types of cancer, particularly breast and prostate cancers.
Unlike chemotherapy, which directly attacks rapidly dividing cancer cells, hormonal therapy works by reducing or blocking the hormones that certain cancers depend upon to grow.
For many people, hormonal therapy is taken for months or even years after primary treatment. While it can play a crucial role in reducing the risk of cancer recurrence, it may also create physical, emotional and quality-of-life challenges that can affect day-to-day wellbeing.
Understanding how hormonal therapy works and what to expect can help patients feel more informed and better prepared throughout treatment.
Understanding Hormonal Therapy
What Is Hormonal Therapy?
Some cancers use naturally occurring hormones as growth signals.
Hormonal therapy works by:
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Reducing hormone production
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Blocking hormone activity
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Preventing hormones from stimulating cancer cells
By removing or blocking these signals, cancer growth may be slowed or stopped.
Hormonal therapy is most commonly used in:
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Breast cancer
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Prostate cancer
but may also be used in certain other hormone-sensitive cancers.
Why Is Hormonal Therapy Used?
Hormonal therapy may be recommended:
After Primary Treatment
To reduce the risk of cancer returning after surgery, chemotherapy or radiotherapy.
Before Surgery
To shrink hormone-sensitive tumours.
For Advanced Cancer
To help control cancer growth and progression.
Alongside Other Treatments
As part of a broader treatment plan.
For many patients, hormonal therapy is one of the longest phases of their cancer journey.
How Does Hormonal Therapy Work?
Different hormonal therapies work in different ways.
Reducing Hormone Production
Some treatments reduce the body's production of hormones.
Examples include:
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Aromatase inhibitors (Anastrozole, Letrozole, Exemestane)
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LHRH agonists used in prostate cancer
Blocking Hormone Receptors
Other treatments prevent hormones from attaching to cancer cells.
Examples include:
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Tamoxifen
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Fulvestrant
Suppressing Ovarian Function
In some women, treatments may temporarily or permanently reduce ovarian hormone production.
Which Cancers Can Be Treated With Hormonal Therapy?
Hormonal therapy is most commonly used for:
Hormone-Receptor Positive Breast Cancer
Many breast cancers depend upon oestrogen for growth.
Hormonal therapy may significantly reduce the risk of recurrence.
Prostate Cancer
Prostate cancer is often driven by testosterone.
Reducing testosterone levels can slow or control disease progression.
How Is Hormonal Therapy Different From Chemotherapy?
Many patients are surprised to learn that hormonal therapy is not chemotherapy.
Chemotherapy Hormonal Therapy
Directly damages cancer cells Alters hormone signals that cancer cells depend upon
Usually given over a defined number of cycles Often taken for months or years
Side effects often occur during treatment cycles Side effects may develop gradually over time
Often causes hair loss and low blood counts More commonly affects energy, mood, joints and hormone-related
functions
Acts broadly on rapidly dividing cells Acts on hormone pathways
Although hormonal therapy is often perceived as gentler than chemotherapy, its long-term effects can still have a significant impact on quality of life.
Why Do Side Effects Occur?
Hormones influence many normal body functions.
When hormone levels change, a wide range of physical and emotional symptoms may occur.
The type and severity of side effects varies according to:
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The treatment being used
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Duration of treatment
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Age
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General health
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Individual biological factors
Not everyone experiences the same challenges.
Common Side Effects of Hormonal Therapy
Fatigue
Many patients report persistent tiredness or reduced energy levels.
Fatigue may affect:
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Work
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Exercise
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Motivation
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Daily activities
Hot Flushes and Night Sweats
Particularly common in breast cancer treatments that reduce oestrogen levels.
These symptoms may disrupt sleep and daily comfort.
Joint and Muscle Pain
Aromatase inhibitors are frequently associated with:
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Joint stiffness
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Muscle discomfort
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Reduced mobility
These symptoms may affect quality of life and treatment adherence.
Sleep Disturbance
Hormonal changes may influence sleep quality and recovery.
Mood Changes
Some individuals experience:
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Anxiety
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Low mood
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Irritability
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Reduced confidence
These changes can be influenced by both treatment and the broader cancer experience.
Cognitive Difficulties
Some patients describe:
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Reduced concentration
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Memory difficulties
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Mental fatigue
These symptoms may resemble those experienced after chemotherapy.
Reduced Bone Health
Long-term hormonal therapy may increase the risk of:
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Bone thinning (osteopenia)
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Osteoporosis
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Fractures
Your oncology team will monitor this when appropriate.
Changes in Sexual Health and Intimacy
Hormonal treatments may affect:
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Libido
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Vaginal dryness
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Erectile function
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Intimacy and relationships
These challenges are common but often under-discussed.
Weight and Body Composition Changes
Some patients notice:
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Weight gain
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Changes in body composition
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Reduced muscle mass
particularly during prolonged treatment.
When Should You Contact Your Oncology Team?
Always follow the advice provided by your oncology team.
Contact your oncology team if you experience:
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Severe or worsening symptoms
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Significant mood changes
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Persistent pain
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New neurological symptoms
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Any side effect affecting your ability to continue treatment
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Any symptom that causes concern
Early communication often allows symptoms to be managed more effectively.
Why Early Support Matters
Because hormonal therapy is often prescribed for long periods, small side effects can gradually accumulate and have a significant impact on quality of life.
Many patients discontinue treatment prematurely because symptoms become difficult to manage.
Supportive care introduced early may help individuals:
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Adapt to treatment
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Maintain daily function
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Improve treatment tolerance
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Support emotional wellbeing
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Maintain physical activity
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Develop practical self-management strategies
The goal is not simply to manage symptoms, but to help patients remain engaged with treatment whenever possible.
Treatment Adherence Matters
Hormonal therapy is often prescribed to reduce the risk of cancer recurrence.
For this reason, helping patients remain on treatment when medically appropriate can be an important part of supportive care.
By addressing factors that affect quality of life, comfort and day-to-day functioning, supportive care may help reduce some of the barriers that make long-term treatment difficult.
This is one of the reasons why early, proactive support can be valuable.
How Rowan Health Supports Patients Receiving Hormonal Therapy
At Rowan Health, support is organised around personalised hormonal therapy support protocols rather than standardised treatment packages.
Our goal is not only to support patients who develop treatment-related difficulties, but wherever possible to anticipate challenges and introduce supportive strategies before they significantly affect quality of life.
Step 1 – Understanding the Treatment Pathway
We begin by understanding:
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The cancer diagnosis
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The hormonal therapy being received
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Previous treatments
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Current symptoms
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Recovery goals
Different hormonal therapies are associated with different patterns of side effects and recovery needs.
Step 2 – Identifying Areas of Vulnerability
We assess factors commonly affected during treatment, including:
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Fatigue
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Sleep quality
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Joint and muscle health
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Physical activity levels
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Cognitive function
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Emotional wellbeing
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Bone health
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Quality of life
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Treatment adherence challenges
Our aim is to identify potential difficulties early and support patients proactively whenever possible.
Step 3 – Building a Personalised Support Protocol
Depending on the individual's needs, the protocol may combine:
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Symptom management
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Rehabilitation
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Recovery support
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Education
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Self-management strategies
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Selected therapeutic interventions
These may include:
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Rehabilitation and manual therapy
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Acupuncture
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Neuro-coaching
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Lifestyle and recovery support
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Medical homeopathy
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Herbal medicine
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Fatigue-management strategies
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Sleep support
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Survivorship planning
The emphasis is always on selecting the right combination of support for the right person at the right time.
Step 4 – Monitoring, Adapting and Supporting Recovery
Hormonal therapy often continues for many months or years.
Protocols are reviewed regularly and adapted as symptoms, priorities and recovery goals evolve over time.
Support may change considerably between the start of treatment and long-term survivorship.
Our Goal
Our objective is not simply to respond to symptoms as they arise.
It is to provide proactive, coordinated support that helps individuals:
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Maintain function and independence
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Strengthen resilience
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Reduce the burden associated with treatment
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Improve quality of life
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Facilitate recovery and rehabilitation
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Support treatment adherence where medically appropriate
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Navigate survivorship with confidence
By understanding the treatment pathway, anticipating likely challenges and adapting support over time, we aim to help patients navigate treatment and recovery as successfully as possible.
Areas We Commonly Support During Immunotherapy
Fatigue and Reduced Energy
Fatigue is one of the most common side effects associated with hormonal therapy and can affect individuals in different ways. Unlike ordinary tiredness, it may persist despite adequate rest and can have a significant impact on daily life.
Many people report reduced stamina, slower recovery after physical activity, difficulty concentrating and a general sense of reduced energy. Fatigue may fluctuate over time and can continue throughout treatment.
Because hormonal therapy is often prescribed for several years, managing energy levels becomes an important aspect of maintaining quality of life during and after cancer treatment.
Joint Pain and Stiffness
Joint and muscle symptoms are common during hormonal therapy, particularly with treatments that reduce oestrogen levels.
Individuals may experience aching joints, stiffness after periods of rest, muscle discomfort or reduced flexibility. Symptoms are often most noticeable in the hands, wrists, knees, hips and feet and may be more pronounced in the morning.
The severity of symptoms varies considerably between individuals. While some experience only mild discomfort, others may find that joint symptoms affect mobility, exercise and everyday activities.
Sleep Difficulties
Sleep disturbances are frequently reported during hormonal therapy and may arise for a variety of reasons.
Changes in hormone levels, hot flushes, night sweats, physical discomfort and emotional stress can all contribute to difficulties falling asleep or maintaining restful sleep throughout the night.
Poor sleep may affect energy levels, concentration, mood and overall wellbeing. For some individuals, sleep difficulties can become one of the most challenging aspects of long-term treatment.
Hot Flushes and Night Sweats
Hot flushes and night sweats are among the most commonly reported side effects of hormonal therapy.
A hot flush is a sudden sensation of heat that may affect the face, neck and upper body and is often accompanied by sweating and skin flushing. Night sweats are similar episodes that occur during sleep.
The frequency and intensity of these symptoms vary considerably. Some individuals experience occasional mild episodes, while others may have frequent symptoms that affect sleep quality, comfort and daily activities.
Cognitive Difficulties
Some people notice changes in memory, concentration and mental clarity while receiving hormonal therapy.
Common experiences include forgetfulness, difficulty focusing, reduced mental stamina and a feeling of "brain fog". These symptoms are usually subtle but can sometimes affect confidence, work performance and everyday tasks.
Cognitive changes may result from a combination of factors, including hormonal changes, fatigue, sleep disruption and the broader physical and emotional effects of cancer treatment.
Emotional Wellbeing
A cancer diagnosis and the experience of long-term treatment can affect emotional wellbeing in many ways.
Individuals may experience periods of anxiety, uncertainty, frustration, sadness or reduced confidence. Concerns about recurrence, future health, family responsibilities and returning to normal life are common.
Hormonal changes associated with treatment may also influence mood and emotional resilience. Emotional responses vary greatly between individuals and may change throughout the treatment journey.
Physical Activity and Recovery
Maintaining physical function is an important consideration during hormonal therapy and recovery after cancer treatment.
Fatigue, joint discomfort, reduced fitness and changes in confidence may affect a person's ability to remain active. Some individuals find that activities they previously performed with ease require greater effort or recovery time.
The effects of treatment can vary significantly, and recovery often continues long after active cancer treatment has ended
.
Long-Term Survivorship
Hormonal therapy is frequently prescribed for several years and forms part of the broader survivorship journey experienced by many people after cancer treatment.
While completing surgery, chemotherapy or radiotherapy is often seen as a major milestone, many individuals continue to face physical, emotional and practical challenges long afterwards. These may include ongoing fatigue, changes in physical function, concerns about recurrence, alterations in personal relationships and adapting to life after cancer.
Survivorship focuses on living well beyond cancer, addressing the long-term effects of treatment and supporting health and wellbeing throughout the years that follow.
Understanding Treatment, Recovery and Support
Explore our detailed guides:
Cancer Treatments
➡ Understanding Cancer & Cancer Treatments
➡ Understanding Antibody-Based Therapies
➡ Understanding CAR-T Cell Therapy
Treatment challenges
➡ Why Side Effects Happen
➡ Cancer-Related Fatigue
➡ Chemo Brain
➡ Peripheral Neuropathy
➡ Xerostomia (Dry Mouth)
➡ Mucositis
➡ Skin and Nail Changes During Cancer Treatment
➡ Sleep Difficulties
Recovery & Support
➡ Cancer Support & Survivorship
➡ Carers' Wellbeing
➡ Recovery After Cancer Treatment
Need Support?
Every hormonal therapy journey is different.
If you would like to discuss supportive care during treatment or recovery, Rowan Health offers personalised consultations designed around your diagnosis, treatment pathway, symptoms and recovery goals.