Androgen deprivation therapy has been used for years and its use has increased recently in the treatment of locally advanced and metastatic prostate cancer patients. Frequent side effects of androgen deprivation therapy are hot flashes, neuropsychological, sexual dysfunction, anemia and physical and metabolic changes. The most concerning ones are an increase risk of diabetes, cardiovascular disease, fractures and in some cases a possibly increase in mortality. Since not every patient with prostate cancer will die due to their disease the benefit and risk of androgen deprivation therapy should be discussed. We encourage in these patients to have routine surveillance and control of their glucose, modification of cardiac risk factors and to have preventive measures and treatment of osteoporosis.