Hot flushes in men

Hormone therapy for prostate cancer can change the levels of sex hormones  in your body. This can cause hot flushes. 

This page is about hot flushes in men with prostate cancer. But some of the tips on how to cope with hot flushes are also applicable to men who have hot flushes for other reasons. 

How does hormone therapy cause hot flushes?

Hormones occur naturally in your body. They control the growth and activity of normal cells. Testosterone is a male sex hormone mainly made by the testicles.

Prostate cancer usually depends on testosterone to grow. Hormone therapy blocks or lowers the amount of testosterone in the body. 

Different types of hormone therapy cause different side effects. Some hormone treatments can cause hot flushes in most men. Other drugs are less likely to cause hot flushes.

For many men, hot flushes gradually get better over time. For others, the flushes last as long as they are having treatment. 

How hot flushes may feel

Hot flushes can vary from one person to another. They can start as a feeling of warmth in your neck, face, chest or back. This often spreads to other parts of your body. You might have:

• reddening of the skin

• light or heavier sweating

• feelings of your heart beating in your chest - these are called palpitations 

• feelings of panic or irritability 

Hot flushes can last between 2 to 30 minutes. You may have a few a month or more often. They might happen suddenly without warning. Or there might be triggers such as stress, a hot drink, or a change in the temperature. They can be disruptive and might make sleeping difficult.

The hot flushes can last for as long as you are having treatment. But for some men, they get better over time. If your hot flushes are mild or don’t bother you, you may not need treatment. But speak to your doctor or specialist team if you find them disruptive or difficult to deal with. 

Tips to help with hot flushes

Some of the following tips might help to reduce the frequency or intensity of flushes.

• Keep your room cool – use a fan if necessary.

• Wear layers of light clothing so you can easily take clothes off if you overheat.

• Have layers of bedclothes to remove as you need to.

• Wear natural fibres such as silk or cotton instead of synthetic (artificial) fabrics.

• Spray your face with a cool water in a spray bottle, use a cold gel pack or use a handheld fan.

• Have a lukewarm shower or bath instead of a hot one.

• Put a towel on your bed so you can easily change it if you sweat a lot at night.

• Cooling pads or pillows can help to keep you cool.

• Try to stay calm under pressure as heightened emotions can cause a hot flush to start.

• Sip cold or iced drinks.

• Cut out or reduce alcohol and caffeine drinks such as tea and coffee.

• Reduce or stop smoking (nicotine).

• Cut out or reduce the spicy foods you eat.

• Deep breathing and relaxation techniques

• Being physically active, such as returning to work or keeping busy with hobbies, can distract you from hot flushes and may make you less aware of them.

• Hot flushes caused by hormone treatment may be helped by changing the time you take the medication. Switching to taking it before bed instead of first thing in the morning can help you to sleep through symptoms.

• Always check with your healthcare team before taking any herbal supplements to relieve hot flushes. Some herbal supplements can interact with your cancer treatment.

Treatment for hot flushes

There are different drugs that can help with hot flushes. Your doctor may also suggest you try complementary therapies such as acupuncture. 

Keeping a diary

Hot flushes are often triggered by certain foods or drinks. Some people find that keeping a diary of their hot flushes can help them manage this problem. You can show the diary to your doctor or specialist nurse. 

Drug treatments for hot flushes

Medroxyprogesterone

Medroxyprogesterone is a type of drug called progestogen. This is usually the first choice of treatment. You take 20 mg per day for 10 weeks. After 10 weeks your doctor should review this medication. 

Cyproterone

Your doctor may suggest you take cyproterone acetate if medroxyprogesterone hasn't worked for you. You usually take 50 mg every day but your doctor can increase the amount to 150 mg if you need. 

Antidepressant medicines

Research has shown that certain antidepressant medicines can be helpful in treating hot flushes in men with prostate cancer. Examples are venlafaxine and paroxetine.

Gabapentin

Gabapentin is a medicine used to treat epilepsy and nerve pain. It can also be helpful in controlling hot flushes but this is rare. 

Other progestogens

Your doctor may consider other types of progestogens if other treatments haven't helped you. An example of this is megestrol acetate (Megace). 

Complementary therapies for hot flushes

There is limited scientific evidence that complementary therapies can help hot flushes in men with prostate cancer. Talk to your cancer doctor, GP, or specialist nurse if you're considering using any complementary or alternative therapies. 

Acupuncture

Small studies suggest people experience less extreme hot flushes whilst having acupuncture.

Cognitive behavioural therapy

This treatment suggests there is a link between your thoughts and actions. It focuses on calming your body and mind and keeping a positive outlook. This may help with hormonal symptoms such as hot flushes.

Deep breathing

Some people suggest breathing techniques to help with hot flushes. Slow, deep breaths from the tummy (abdomen) can help you relax. This is also called diaphragmatic breathing.  

Coping with prostate cancer

It can be difficult coping with prostate cancer and its treatment. There is support available.