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Question answered:23/01/07 Warning! this question is over two years old.
The SPCs for Soltamox [1] and Nolvadex [2] failed to mention impotence as a side-effect. The American drug website RxList has a section on side-effects [3]. For ‘Male Breast Cancer’ it reports the following:
“NOLVADEX is well tolerated in males with breast cancer. Reports from the literature and case reports suggest that the safety profile of NOLVADEX in males is similar to that seen in women. Loss of libido and impotence have resulted in discontinuation of tamoxifen therapy in male patients. Also, in oligospermic males treated with tamoxifen, LH, FSH, testosterone and estrogen levels were elevated. No significant clinical changes were reported.“
The UK health charity Cancer Back Up has a Q&A section that covers your question [4], they state:
“Generally speaking impotence does not seem to be a problem for men who are taking tamoxifen as part of their treatment for breast cancer. But it may occur very occasionally.
Usually if a man takes tamoxifen the levels of the male hormone, testosterone increase. But rarely, the drug has the opposite effect, reducing testosterone levels and causing impotence. Nobody is quite sure why this happens.
If a man develops impotence due to tamoxifen stopping the drug should solve the problem. Other drugs, called aromatase inhibitors, may be used as an alternative to tamoxifen. If impotence develops as a result of tamoxifen substituting an aromatase inhibitor may help.”
Finally, the American National Cancer Institute has a Q&A section on tamoxifen [5], stating:
“Men who take tamoxifen may experience headaches, nausea and/or vomiting, skin rash, impotence, or a decrease in sexual interest.”
References
1) http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=7948
2) http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=3709
3) http://www.rxlist.com/cgi/generic/tamox_ad.htm
4) http://www.cancerbackup.org.uk/QAs/BreastcancerQAs/AllQAs/related_faqs/QAs/34272016
5) http://www.cancer.gov/cancertopics/factsheet/Therapy/tamoxifen
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