For some men, the onset of drug-induced menopause can trigger severe emotional problems such as depression or psychosis. In my practice, I have a gentleman who experienced a serious allergic reaction to Lupron that precludes further therapy with this agent. Finally, there are quite a few men who find the cost of combined androgen blockade prohibitive. DES does not cause menopausal symptoms, it is safe in patients allergic to Lupron or Zolodex and it is much less expensive. All estrogen-like drugs used to treat prostate cancer cause an increase in breast enlargement and tenderness.
Estrogens induce the release of proteins from the liver that cause high blood pressure.
Renin and angiotensin act at the level of the kidney to then cause the body to retain salt and water. Estrogen increases the production of angiotensin by the liver. The extra salt and water can cause edema and high blood pressure. By reducing the dose, all of these side effects may be reduced to a minimum. Also, diuretics and blood thinners such as Coumadin can be used to treat these side effects.