Does anyone else that has been on ADT drugs for years have trouble with tears or crying for no real reason? I tear up anymore at just the thought of something sad. It’s a major pain in the ass, not to mention embarrassing because I am still employed. Wondering if there is a solution other than stopping ADT all together ? I have about had it with the feminizing effects of ADT drugs….
ADT and crying: Does anyone else that... - Advanced Prostate...
ADT and crying
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joeguy
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You might consider an anti depressant if you're not already on one. I'm on Lexapro 10mg...works real good dealing with the lows.
I have considered that, but I really think this has much more to do with the messed up stuff ADT does to our hormones, rather than any type of depression. I don’t seem to have any other signs of depression, I just tear up for no real reason.
Just giving my experience..every man gets toake his own decisions. Good luck
I agree that the tears and the depression are two different phenomena. I had them both in spades. Antidepressants helped with the depression, but not with the tears.
Dr put me on an anti depressant. when I wasn't getting teary eyed I was fighting in bars. All good now
ADT made you get into bar fights ?
Getting emotional seems to common, with tearing up. Some people on ADT get the opposite, where they get angry and even confrontational. One person i know has had to fight road rage ever since he started on ADT - never an issue prior.
Since being on ADT, I've been much more emotional. Tearing up during movies etc. In other ways, I've become more calm, as in traffic.
ADT did make me cry more and more often. That is to be expected since your hormones are out of whack from their natural state. Kind of how women cry more during their time of month. Add to that that you are probably feeling miserable from how ADT makes you feel, you got good reasons to cry. 
good answer. i didn't actually cry but i became more emotional and "feminine", more willing to listen. but the greater imminence of death also makes me less patient especially dealing with assholes. so it all sort of balanced out for me. i am very nice up to a point, then "fuck you" i have better ways to spend my remaining hours.
People react differently. This happened exactly with my dad - exactly like you're experiencing. He was a man's man, quite a tough person and ADT brought him to his knees with uncontrollable crying and a lot worse. He was extremely embarrassed about it too. The truth is, there's nothing to be embarrassed about. It's just it's playing havoc with your hormones.
Personally, I wouldn't try to fight it or take anything to counteract it. Hormones are extremely powerfull. He tried his best to fight it, and it defeated him every time which made it worse because he found any form of defeat hard to accept. He never quit on anything in his life - ever.
I would just try to accept it and go along with the situation. If you explain it to people what's happening, they'll understand. Try to make light of the situation if you can.
Hope that helps you.
Yes, definitely an ADT side effect. Currently off ADT for almost a year but T is still at castrate levels though up from undetectable . My emotional lability has improved along with my irritability. If have to go back on ADT I will try an antidepressant.
How long were you on ADT? I have been on 1 year but will stop next month. Hoping my T recovers but stories like yours are worrying.
I have been on ADT for 7 yrs. Minus a 1 year break I took at about the 3 yr mark. Since I have wide spread metastatic PC, I get ADT for life. I am now castrate resistant so the drugs no longer do much, but they have kept me alive so far
joeguy wrote -- " ... I get ADT for life... "
For LIFE for ME -- was via an ORCHIECTOMY
^^^^ the above rhymes for a reason, it's my KISS solution (Keep It Simple Stupid) and since 2015 I've had MINIMAL SE's.
Orchiectomy for me too. Lifelong ADT for G9 recurrence? Yeah, no "holidays" from ADT would be worth the risk. So, permanent ADT, by a lifelong series of shots or medications? Nah, take the simple, one-and-done solution. Jettisoned the boys a few years ago, and am very pleased. Undetectable PSA ever since.
I also take estradiol to offset the bad side effects of missing testosterone. It stabilized my emotions, my memory's good, no hot flashes, good energy. This path isn't for everyone, but I'm really satisfied.
VHRguy wrote -- " ... I also take estradiol to offset the bad side effects of missing testosterone. It stabilized my emotions, my memory's good, no hot flashes, good energy .. "
👍👍
curious as I also had localised G9 (4+5) and RT finished 22 dec 2022 - been on goserelin (zoladex) now for 14 monhs (including 2 months pre RT) - you stopping next month rather than going for the 24 months - is that because of side effects or oncologist suggestion?
I can’t excercise due to being wheelchair user from years ago and with my PSA at 0.01 since RT my onc saying I could stop now … I’m a little nervous as research say at least 18 months from start of RT ?
Just wondering what your feelings are, have been ? The ADT is getting harder - but then keen to try and maximise no return for as long as possible!
I am stopping because I believe the potential added benefits of another year do not outweigh the potential long term detrimental effects of having no testosterone.
You are correct standard SOC is 24 months but after watching some of the more recent PCRI videos on treating localized G8 and G9 and talking with my RO we are comfortable at one year.
Thanks - I think that’s where I’m going - and my RO seems to be suggesting the same for me. It’s all a balance I guess and the almost zero T can be pretty not great long term.
SimMartin and OldTVGuy….. similar to your stories. G9 pathology post RP, 2yrs later reoccurrence, Salvage Radiation and 18 mths of Lupron. It ended in Nov, and was supposed to be 24 mths but then my doctor at MSK decided no more benefits from an add’l 6!mths. I’ll either find out that I’m cured or not in the future. The side effects have been very bothersome, not debilitating but definitely bothersome. Here’s hoping my “T” bounces back. Yes, one of the side effects was a wide swing of emotions (sad and anger) on the most benign things.
I had the same problem about tearing up. Couldn’t watch a Hallmark movie without tearing up. I balled at the end of Sergeant York when he was given the house at the end of the movie. Also would tear up when a sad thought crossed my mind. Along with the hot flashes and weight gain, I have a whole new perspective on women. I apologized to my wife for the way I overlooked parts of our relationship through the years. Drew me closer to her. I now feel that every man should go through ADT to help them better understanding what a woman goes through. Men in my opinion are such jerks when T controls them.
Best of luck.
youtube.com/watch?v=3vCYHpK...
One of the funnier scenes from Sleepless in Seattle (a chick flick), when the guys claim to start crying every time they see the end of The Dirty Dozen.
Hilarious
yes, I tell my wife I have been transformed into a menopausal woman
I guess we all react differently. However, to put you at ease I too feel I am more susceptible to tearing than I was before ADT and now Orchiectomy. We need to take it in our stride.
First I want to say I’m also „closer to water“ than before, getting more emotional than before. E.g. when watching films and also when I experience touching evenings like Christmas. But for these are tears of joy mainly and I’m glad that I can experience these feelings now, too.
Before taking meds I recommend that you try some kind of meditation or attention and relaxation exercise. You find tons of videos on Youtube. Chose the one where you like to voice and the words. I do this regularly, to relax and self-reflect. Over time it will give you more emotional control and it feels really good lying or sitting down with a totally relaxed body.
Yep ! Me as well, seems quite a common thing, as one said, hormones are very powerful things and even before i was sentenced to this, i believed that hormones have shaped mans history as well as individual lives, just take what we was all like in our 20's chasing women getting into trouble, now it's changed again, ya don't need antidepressants, think we just have to learn to live with it or stop ADT, rock and hard place springs to mind 😉
would appear the common denominators for ADT evolve around fatigue, run away emotions, and a host of other side effects that come on as quickly as they disappear. Add in a touch of stress and uncertainty with each passing lab work and you have a recipe for lots of sleepless nights. I’m 69 years old and have certainly shed my share of tears brought on by this disease over the past several years since diagnosis. Lots of hiking, biking and plenty of mediocre golf has helped me through the low times. I’ve also found that journaling the best parts of everyday living does wonders for recalibrating my thought processes. Speaking for myself, I haven’t any more room in my pillbox for ant additional medications, but I certainly wouldn’t find fault with anyone suffering from this to add antidepressants to the mix. Stay strong and our thoughts are with you.
There may be more to your tears than just random bouts of crying. There may be an emotional trigger that would not ordinarily cause that response. The response als may modulate over time. I found it it did for me.
Bigger picture...it's allowing you to live longer! Discuss this with your doctors and maybe there's a work around for some of it. The days of what was normal are behind you. You need to realize your world has and will continue to change with changes in your condition and meds.
Don't get angry and upset that you're being "feminized". If you accept there will be challenges like this, you may be able to figure out how to minimize the side effects while continuing to live your life.
Well I haven't changed, always been prepared to tear up if the situation warrants it. I always said my wife broke me and that caused it. But she passed 6 years ago now, so nup, all me. We are just ageing and we must accept we are very clearly closer to our maker than we were ever before, that we understood anyway. It does cause a different view of the world, including tears. Sad things do impact more than when young and 'well'. So cry away, I say! All good. If you want to blame the ADT ok, that's as good as anything else.
There are some good replies here to your post. I've been on ADT for ten years, the emotional roller coaster can at times be very demanding.
I think I'm less patient, but thats mainly due to my inability, but tears are a pain in the butt. I'm worse towards the end of the 3 monthly Lupron jab cycle. It is embarrassing and difficult to control.
Whatever you do, don't stop your treatment, that's the wrong thing to do. Others say that we're being feminised, but I've met some bloody hard women in my time, most had beard's too 😱. I've tried to work on it, some self control, its better now.
I didn't cry at the end of " A Wonderful Life " this Christmas, so I must be getting better.
It might be time to tell your work mates the reason why it happens, you only have to say" its the cancer treatment I'm on " I think they will understand, but if they sympathise don't cry.
Take care and keep at it 💪
I have exactly the same problem, Joe. And I totally understand how you’re feeling about it.
I don’t think there really is a medical solution.
What I do is let everyone know I’m fighting prostate cancer and I’m on ADT and when I’m done crying, I laugh about it.
Others laugh with me. Often they’ll pat me on the shoulder and say something like, ‘You got this.”
In my experience, people are mostly very accepting and supportive.
Was it mark twain who said.. ." Man......i feel like a woman "..?
Maybe the cowardly lion didnt need courarage....just get off ADT.........hey he was symptomatic....the courage....da nerve..boo hooo.,.😪
I knew a guy from Hawaii, a former air traffic controller, who wrote cryptic stuff like that on the Healingwell forum. Is that you, logos?
I have been taking Goserelin (Zoladex) injections since 2008 with addition of Xtandi and Nubequa fom 2019. I get really emotional at times, there are songs I cannot sing and texts I cannot read without my voice breaking and tears welling up.
Also I still have hotflushes, mostly at night and when I am trying to sleep. Immediately before I get a hotflush, I get what I call a 1 minute depression. Suddenly I will feel very low, but it passes quickly.
I wish I could stop the ADT, but I guess I would not be alive today with out them. I did stop the Zoladex for 2 years once and it did not work out to well.
I am not taking any anti depressants as I am also a recovering alcoholic (33 years) and a very addictive person.
I get that way, usually due to too much thinking about friends lost to cancer and stress can add to it. Even fell apart in front of my oncologist once, never had a doctor hug me before that. I've gotten good at hiding it, usually walking outside alone until it subsides.
yes. Even after 7 years I think it’s the load we are carrying on our shoulders. The blues come on pretty easy , but we’re on the right side of the grass so I’ll put up with it . 😢
Hey Joe, I was on ADT for 2 years and cried a lot. Many people here and elsewhere say the same thing. I was on Lexapro which helped incrementally. Two things helped me with ADT:
Weight training. It made a big difference. Didn't eliminate the crying, but helped it and my fatigue.
Ritalin. There's some evidence that Ritalin helps the fatigue of ADT. It definitely helped me! My doctor read the paper and agreed to prescribe it. pubmed.ncbi.nlm.nih.gov/246...
I've been off ADT for 2 years now. Other than the time I was fired from my job about 13 years ago, ADT was the hardest experience in my life.
"Hey Joe, where you goin' with that gun in your hand?" Sorry Hendrix popped into my head. Take care Joe!
I have the opposite reaction to crying ... I have uncontrollable laughing and have never cried once. I started laughing about 4 weeks after starting ADT and it got to the point where I would be laughing at nothing. I laughed while driving, shopping, etc anytime and anywhere. It sounds like it might be fun but it was embarressing and I started having downers after laughing. For every laughing fit I would have a downer or angry periods. Not to mention panic attacks and other mental health issues which I didn't have previously. I ended up on anti-depressants which reduced laughing and anger problems but didn't stop them. I get angry for no reason plus I get the usual hot flushes and am growing a good set of breasts which I hate. Add sleeping issues, memory problems, incredible fatigue, weight gain, muscle loss and other issues to the mix.
Yes, I went through a period of around 12 months when I'd laugh very much uncontrollably for little or no reason. Great entertainment for the rest of the family, but I just couldn't stop it. All good now.
My husband has been on ADT nine years, and the bouts of uncontrolled weeping and sudden rage were startling. On the plus side it surfaced things that it was good for him to deal with, which he chose to do. No meds, but he did see a therapist. He has become a much more caring and peaceful person as a result.
I too have bouts of crying. Been on ADT for about 9 months. It’s now the worst part of the side effects other than ED. Having problems with my wife now doesn’t help. Going back to work in a few weeks. I deal with the public a lot. I worry about breaking down in front of customers. Don’t want to go on medication for it though. I am going to gym every other day and take long walks on the other days . Seeing a therapist too. That seems to help. I have at least another 15 months to go but it appears to be working as my psa is <.1 since September . KFG.
You're describing depression. IMHO, depression isn't caused or made worse by ADT. I've been depressed my entire life but during my ADT I stopped taking the anti-depressant because I don't think it was working. (And I'm not sure I need it.)
I'm not going to mention the name of the anti-depressant because everyone is different and the one I used might backfire on someone else.
Also only IMHO, lowering of testosterone might lead to a lesser experience of these symptoms. Nothing seems to be nearly as urgent anymore.
After the hot flashes, the tearing up, and getting a pair of little titties (about a year), I believe I became a more sensitive, caring, and better person.
Only time the ADT causes me to cry is if I get to the front door and look down and notice my purse and shoes don't match😭
Ive been on ADT for 12 years, crying and the uncontrollable emotions have always been an issue. Now after all these years Ive somewhat learned to control it. I take a little pause and tell myself that its the drugs and the messed up chemistry making me do it and Im not going to allow myself to be manipulated by it. I know it may seem strange but it works.
I’ve been on ADT for 18 months. It’s turned me into an old woman, (sorry ladies). I was an emotional wreck and would cry at the drop of a hat. I fought it for months until my Onc recommended Paxil. It has stopped the crying very effectively. I can still get emotional however, but it takes a lot to trigger it. That’s my experience. I do feel much better now.
I have been on Lupron and Nubeqa for 32 months - Eligard failed. Had been on that for a year. 2015 diagnosed G9, psa 20.6. IGMR 25 sessions, two sessions of HDR Brachy, 24 months Lupron. 2 yrs no treatments the psa doubled twice in three months to over 2.0 Will be taking a holiday from meds starting next month. PSA has been <0.02 for over 30 months. Now will be 76 in early Feb - energy OK, push myself. Only issue recently has been a major infection, replaced knee, in late Aug that took me down big time. Slowly recovering but feel good. I my case heart, circulation, are great. Not diabetic either. Never smoked so lungs are clear.
My suggestion: Attitude! Think Positive! Don´t expect problems because you will get them.
You're right Joe. I stopped after a year and half and have loved my last 10 months of running 10 K ( and having sex again) but now my PSA is starting to climb. But it was a wonderful 10 month reprieve. The tearing up stuff for me only happened when I added single malt whiskey to a good marijuana buzz.
I have been on Venlafaxine for 11 years. It almost completely stopped the emotional swings and crying plus helped with hot flashes. Rarely does it happen and if so, minimal. It was causing problems for me as a supervisor and in my daily home life. Darndest thing. I would breakout at stupedest thoughts, movies, etc. My wife thanked me for taking it. Started at 75mg and after many years, now at 150. Yes like everything you might have side effects but it has givin me much better QOL. There's no need to suffer with this. It's all about QOL for me.Best of luck.
Oh heck yeah. I can watch action movies and chick flicks with equal enthusiasm
I'm right there with you. Started ADT almost 3 years ago and have most of the side effects under control, but this is one of those things that I never really recognized as a side effect until now. I have had a career as a victim advocate and have always been empathetic, but this definitely seems more intense now. Maybe this explains the reason I broke down and cried in front of the judge and the court when I was reading a victim impact statement for a family in a tragic case. I couldn't understand why I couldn't stay under control. Now it makes sense. But if this is what it takes to stay alive, I got this. I hope you can make peace with it, too.
Joe, we need to think about getting a big group together next November/December to watch Hallmark movies. I'll bring a truckload of tissues. Mood swings are not unusual. While on ADT my wife changed my name to "Dick". Venlafaxine helped that and hot flashes. Even off ADT now for 18 months I am still more sensitive.
Yes, much more emotional now. Surprised to hear that ADT can cause anger issues. But, on the positive side... I sure can shop for shoes now!!!🙄
We are grieving our loss of what was. It is real grief and we need to deal the all the stages we experience until we have accepted our loss. Live for each day.
I can fully sympathize with you. After 7 years on Lupron I was at the point where I could walk across my living room and start crying, then all of a sudden be mad at the air. It was driving me crazy. So I did what no one really wants to talk about: castration. I could be all polite and sh*t and say orchiectomy but then I have to explain what it means anyway.
After years of ADT my balls were completely atrophied and useless so getting rid of them was not an issue. There are fake ones now that mimic the feel of real (except when you wrack yourself there's no pain) so your partner isn't as freaked out.
Bottom line I am feeling much saner and happier now that I'm off the ADT.
Used to be some sort of bone problems, back in the day, from castration but that's been well taken care of by drugs like Xgeva.
Ask around, there are a number of us eunuchs here and we all seem to be very happy with the procedure. You may have to be aggressive with your doctor to get him to agree, since it is a huge hit to pharmacy and visit fees when you are no longer getting the monthly/quarterly/semi-annual injections.
As always YMMV
I have been castrate resistant for a few years, Im not sure they recommend snipping guys that are mCRPC…
mCRPC was not an issue in my case. I started out metastatic and was castrate resistant within a year. My urologist, who diagnosed me, offered castration at the beginning and he was a very smart urologist.
Lupron and other ADT drugs eliminate testosterone, so castration does the same thing without the side effects.
The only thing is that castration is not reversible whereas you can stop ADT. However I have not heard any reports on what happens next, except the cancer takes off and then the inevitable (you die).
According to a 2021 study available through the NIH, men with good insurance don't tend to get castration. It is mostly poor people on Medicaid, apparently. Did you know that pharmacies get a kickback based on the price of the drugs they dispense? All my oncologists get their drugs from their pharmacy -- just sayin'
But (emphasis added and footnote numbers removed) "Surgical castration for metastatic prostate cancer is used less frequently than medical castration, yet costs less, requires less follow-up, and may be associated with fewer adverse effects...
"Despite low use, surgical castration is also associated with better non-oncologic outcomes. In a retrospective analysis of SEER-Medicare, surgical castration was associated with lower risks of fractures (HR 0.77), peripheral arterial disease (HR 0.65), and cardiac events (HR 0.74) compared to medical castration. Similarly, a population-based study from Denmark suggested while medical castration was associated with increased risk of myocardial infarction (HR 1.31, 95% CI 1.16–1.49) or stroke (HR 1.19, 95% CI 1.06–1.35), surgical castration was not. Additionally, although both forms of ADT have been found to be similar in terms of costs within the first year of PCa treatment, a previous analysis suggested surgical castration was more cost-effective per quality-adjusted life years over time, reflective of the upfront costs of surgery compared to the compounded costs of additional medication dosage with GnRH analogues. The cumulative costs of medical castration will become more relevant as men with metastatic PCa live longer with recent advances in therapeutics."
See ncbi.nlm.nih.gov/pmc/articl...
I've read some of those articles, too. When hubby first learned he had PCa this past June and was going on a short course if ADT, he told me that should he ever need a long course of ADT he was going to have the surgical castration, no doubt about it. We even looked at the photos of the silicone replacement testicles and decided on the "go big or go home" model.
Wow, this is very interesting. On ADT 2015-2017 and Feb 2023 I was finally ‘sentenced to Life on ADT’. Bummer, what did I do to deserve that!! But hey, the other option not so best. Read somewhere that ADT (Zoladex) can cause depression (or elements thereof such as sadness, tiredness, weakness, anger, frustration, blah, blah, blah). For a while I thought I was the only person who got irritated/annoyed, sad, etc, etc. I find my mind, which granted is somewhat tiny anyway, thinking a lot of swear words (such as FO) towards people, particularly those who stand in the middle of the grocery isle with their cart blocking the way…..and did I say inconsiderate and/or idiot drivers or just inconsiderate and rude people. Also, my wife tells me that I have ‘foggy brain.’ Also, she likes Hallmark movies and if I don’t watch them she’ll think I’m being rude…..watery eyes hello. Just writing this feels cathartic!
Remember this Gentlemen and Gentlewomen:
THE MORE YOU CRY, THE LESS YOU PEE......
Good Luck, Good Health and Good Humor.
j-o-h-n Thursday 12/28/2023 6:30 PM EST
Is " ... THE LESS YOU PEE ..."
in Quantity
in Frequency
in Quality of FLOW
or ALL of ABOVE ???
it DEPENDS......
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 12/29/2023 1:11 PM EST
Being someone that has bipolar and has had to regularly take antidepressants, specifically SSRI's which prolong the QT interval,a word of warning to those considering adding an antidepressant to their ADT:
"GENERALLY AVOID: Long-term androgen deprivation therapy (ADT) can prolong the QT interval. Coadministration of ADT with other agents that may prolong the QT interval could also result in additive effects and an increased risk of ventricular arrhythmias including torsade de pointes and sudden death. The risk may be increased in patients with certain underlying risk factors like congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). Studies in young men have shown that endogenous serum testosterone levels are inversely associated with QTc (QT interval corrected for heart rate) duration. Clinical trials in men with low serum testosterone levels have reported testosterone administration being associated with a shortening of QTc. Likewise, studies using ADT have shown that it may prolong the QT interval; however, this effect may vary by drug, dose, or even each drug class that can be used to reduce testosterone levels. A clinical study comparing abarelix to a luteinizing hormone-releasing hormone agonist plus nonsteroidal antiandrogen therapy found that both therapies prolonged the mean Fridericia-corrected QT interval (QTcF) by more than 10 msec from baseline. Approximately 20% of patients in both groups had either changes from baseline QTc of >30 msec or end-of-treatment QTc values >450 msec. Similarly, a study comparing degarelix to leuprolide found that approximately 20% of patients on each drug had QT/QTc intervals >450 msec after 1 year of treatment. From baseline to end of study, the median change in QTcF was 12.3 msec for degarelix and 16.7 msec for leuprolide. Some drugs used to lower testosterone levels may also have other side effects that can predispose a patient to QT prolongation and torsade de pointes. For example, inhibitors of 17 alpha-hydroxylase/C17,20-lyase (CYP17) like abiraterone may cause hypokalemia as a result of increased mineralocorticoid levels. Clinical data on ADT prolonging the QT interval in women and children are lacking.
MANAGEMENT: The benefits of androgen deprivation therapy (ADT) should be carefully assessed against the potential risk in patients receiving other drugs known to prolong the QT interval. Electrolyte abnormalities should be corrected prior to initiating therapy, and monitoring of electrocardiograms and electrolytes may be advisable. The manufacturer's labeling as well as current clinical guidelines should be consulted for monitoring recommendations."
None of the three consultants I saw had a clue of this interaction.Only because I did my due deligence was able to realise this interaction and point it out to the consultants.It's not to say don't take an antidepressant but make sure you are monitored and checked prior and during the period of taking them.
Before I started ADT, I always cried at the end of Rudy. I cry at a lot more movies now.
everyone without testosterone feels like that. It’s not magic. For me way down there at >3 it was tearing up at anything remotely sad.
ADT makes me cry easily… However the he emotions are jumbled.
The capacity to be aggressive hasn’t been diminished, however I may cry whilst settling your hash ( so to say).
The whole journey has been disturbing, I may get acclimated to it.
However, for me, to survive I must endure.
Not how I envisioned being retired.
Fuq Cancer
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