Medical Oncologist
Hormone therapy
Endocrine therapy in men with breast cancer
Most breast cancers in men are hormone-sensitive, so hormone therapy is central to treatment. Tamoxifen is the standard tablet; aromatase inhibitors are usually combined with testosterone-lowering injections in men. This page explains, in general terms, the options, side effects and what it can mean for family.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
On this page
- How is hormone therapy used in men with breast cancer?
- Hormone therapy options for men, in general terms
- Side effects men most often mention
- The vocabulary, in plain language
- What we know, and what is still being learned
- Being a man with breast cancer
- What male breast cancer can mean for relatives
- Managing sexual side effects on hormone therapy
- Staying well through years of treatment
- What people assume about hormone therapy in men
- Common questions about hormone therapy in men
The short answer
How is hormone therapy used in men with breast cancer?
Most breast cancers in men are hormone receptor positive, so hormone therapy is a central part of treatment. Tamoxifen is the standard hormone tablet for men after surgery, usually taken for at least five years. It blocks oestrogen from reaching cancer cells. Aromatase inhibitors, which are widely used in postmenopausal women, work less reliably in men on their own, because the testes keep producing hormones that the body can convert to oestrogen. In men, they are generally combined with testosterone-lowering treatment when used.
Why hormone therapy matters so much in men
Because male breast cancers are so often hormone-sensitive, hormone therapy lowers the chance of recurrence substantially and is part of almost every man's plan.
What treatment usually involves
A daily tablet for several years, regular follow-up appointments, and attention to side effects that can affect men in particular ways, such as changes in libido or erectile function.
When tamoxifen may not be suitable
Men with a history of blood clots, or who cannot tolerate tamoxifen, may be offered an aromatase inhibitor together with injections that lower testosterone. This combination is also used in some cases of metastatic disease.
This page gives general information only. Your treatment plan is decided with your oncologist.Side by side
Hormone therapy options for men, in general terms
Tamoxifen
Aromatase inhibitor with testosterone lowering
The standard choice for most men
An alternative when tamoxifen is unsuitable
A daily tablet
A daily tablet plus regular injections
Small risk of blood clots
Bone thinning and joint pain more common
May affect libido and mood
Greater effect on libido and energy
Longest evidence in men
Less studied in early male breast cancer
Side effects
Side effects men most often mention
Men sometimes stop tamoxifen early because of side effects. Most can be discussed and many can be eased.
Changes in sexual function
Lower libido and difficulty with erections are reported by some men. These are worth raising, as help is available.
Hot flushes
Hot flushes and sweats can affect men on tamoxifen, just as they do women.
Often ease over time.Weight gain and mood
Some men notice weight gain, tiredness, irritability or low mood. Exercise and support can help.
Blood clots
A small increased risk. Leg swelling or pain, or sudden breathlessness, needs urgent attention.
Report promptly
- Leg pain or swelling
- Chest pain or breathlessness
- Changes in vision
Words you will hear
The vocabulary, in plain language
- Hormone receptor positive
- A cancer that uses hormones to grow. Most male breast cancers are.
- Tamoxifen
- A hormone tablet that blocks oestrogen from reaching cancer cells.
- Aromatase inhibitor
- A hormone tablet that lowers oestrogen production in body tissues.
- GnRH agonist
- An injection that lowers testosterone production by the testes.
- Adjuvant therapy
- Treatment after surgery to lower the chance of recurrence.
- BRCA2
- An inherited gene change linked with male breast cancer.
Being straight with you
What we know, and what is still being learned
Male breast cancer is uncommon, so most treatment evidence comes from studies in women, with smaller studies in men. The general principles apply well, but some details, such as the best alternatives to tamoxifen, are less certain in men.
Staying on treatment matters
Studies suggest a significant share of men stop tamoxifen early, often because of sexual side effects. As in women, completing treatment is linked with better outcomes, so it is worth discussing problems openly rather than stopping.
Talking about sexual health can feel awkward
Many men find it hard to raise erectile or libido problems, especially in a breast clinic. Doctors are used to these conversations, and there are treatments and practical approaches that help.
Genetic testing is important
Men with breast cancer have a higher chance of carrying a BRCA2 or similar gene change, which matters for their own health and their family.
What this page cannot tell you
It cannot tell you which option suits you. Ask your oncologist why they recommend a particular hormone treatment.
Talk to our team
Have a question about your situation?
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
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Living with it
Being a man with breast cancer
Many men are surprised to learn that men can get breast cancer at all, and some feel embarrassed or isolated. These feelings are common and understandable.
Information designed for women
Most leaflets, waiting rooms and support groups are aimed at women. Ask your team for information relevant to men, and whether any men's support networks exist.
Telling family and friends
Some men keep the diagnosis private. Sharing it with trusted people often brings more support than expected, and it matters for relatives who may need genetic advice.
Body image after surgery
A mastectomy scar on the chest can affect confidence, particularly when swimming or changing in public. Time, support and sometimes scar treatments help.
Your family
What male breast cancer can mean for relatives
Because inherited gene changes are more common in men with breast cancer, a diagnosis can have implications for the wider family.
Daughters and sisters
If a BRCA2 or similar change is found, female relatives may have a higher risk of breast and ovarian cancer and may be offered testing and extra screening.
Sons and brothers
Male relatives may carry the same gene change, which can raise the risk of breast and prostate cancer. Genetic counselling helps them decide about testing.
Sharing the information
A genetic counsellor can help you explain results to relatives in a way that is clear and supportive.
Sexual health
Managing sexual side effects on hormone therapy
Changes in desire, erections or ejaculation are among the most common reasons men give for stopping tamoxifen. They are also among the least discussed, which means many men struggle without help that is readily available.
Raise it early
Mention any change at your first review after starting treatment. Your oncologist can check whether other medicines, low mood, tiredness or health conditions such as diabetes are playing a part, and suggest practical steps.
Treatments that may help
Some medicines for erectile difficulty can be used safely alongside hormone therapy after checking with your team. A referral to a urologist or sexual health specialist may be offered if problems continue.
Involving your partner
Talking openly with your partner about what is happening, and why, often eases pressure on both of you. Counselling for couples can help if intimacy has become a source of tension.
Long-term health
Staying well through years of treatment
Hormone therapy continues for years, so looking after your general health makes treatment easier and supports your recovery.
Stay active
Regular walking, strength exercises or sport help control weight, improve energy and mood, and protect bones and heart health.
Watch your heart and blood sugar
Keep up checks of blood pressure, cholesterol and blood sugar with your regular doctor, as these matter for long-term health alongside cancer follow-up.
Check the other side
Men who have had breast cancer have a higher chance of a new cancer in the other breast. Report any new lump or nipple change promptly.
Commonly believed
What people assume about hormone therapy in men
Hormone therapy is only for women.
Most male breast cancers are hormone-sensitive, and hormone therapy is a key part of treatment for men.
The same tablets work the same way in men and women.
Tamoxifen works well in men. Aromatase inhibitors alone are less reliable in men and are usually combined with testosterone-lowering injections.
Sexual side effects just have to be accepted.
They are worth discussing, because treatments and practical approaches can help.
My diagnosis does not affect my family.
Inherited gene changes are more common in men with breast cancer, so relatives may benefit from genetic counselling.
Questions we are asked
Common questions about hormone therapy in men
How long will I take tamoxifen?
Usually at least five years, sometimes longer for higher-risk cancers. Your oncologist will review this with you over time.
Will tamoxifen affect my erections?
Some men notice changes. Tell your team, as help is available and adjustments may be possible.
Can I take an aromatase inhibitor instead?
Usually only with testosterone-lowering injections, because on its own it works less reliably in men.
Do I need genetic testing?
It is generally recommended for men with breast cancer. Ask your team for a referral.
Does tamoxifen interact with other medicines?
Some antidepressants and other medicines can reduce how well it works. Tell your team everything you take.
What follow-up will I need?
Regular clinic reviews and imaging of the other breast if advised. Report new lumps or symptoms promptly.
Are there support groups for men?
They are fewer, but some exist, including online. Ask your team what is available.
Where can I read about my own treatment?
Your oncology team will give you written information about your hormone therapy. Use that as your main reference.
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Sources
- American Society of Clinical Oncology — Management of male breast cancer guideline
- National Cancer Institute — Male breast cancer treatment (PDQ)
- Cancer Research UK — Male breast cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.