In the United States today, more than 2 million women live as breast cancer survivors. As the number of cancer survivors grows, the unique long-term side effects of cancer treatment and aging play an increasingly prominent role in the routine care of these patients. Of special concern are the short- and long-term effects of sex hormone deprivation. This article reviews current issues surrounding the acute and late effects associated with hormone deprivation in breast cancer survivors and summarizes the scientific and therapeutic discoveries to date to identify optimal nonestrogenic treatments for symptom control in individual patients.