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Hot flushes and sweats in men

Hot flushes are sometimes a side effect of having low levels of hormones. Read about the causes, tips for coping and the possible treatments.

Some cancer treatments can lower the levels of sex hormones in the body. The sex hormones are oestrogen and progesterone in women, and testosterone in men. The cancer treatments include hormone treatments for prostate cancer.

Prostate cancer needs testosterone to grow. Hormonal treatments aim to:

  • stop the testicles from making testosterone
  • stop testosterone reaching cancer cells

How hot flushes may feel

It can start as a feeling of warmth in your neck or face. 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 (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. The flushes usually last for a few months but for some people they carry on for longer. 

They can be very disruptive. They might make sleeping difficult, impacting on your quality of life. 

Causes of hot flushes

Research suggests that low oestrogen in women can cause low levels of a hormone called norepinephrine. This hormone is found in the brain (area called the hypothalamus) and helps your body to regulate its own temperature. Low levels of norepinephrine may lead to increases in core body temperature. This increase in temperature can cause a hot flush.

Doctors need more research in men to see if low testosterone in men has the same role in causing hot flushes.

Some treatments such as goserelin (Zoladex) cause hot flushes in most men. Treatments called anti andogen drugs (such as bicalutamide) are less likely to cause hot flushes but can do so for some men.

For many people, hot flushes gradually get better over several months. For some people the flushes last as long as they are having treatment, although they do tend to happen less often over time.

Tips to help with hot flushes

Environment

  • 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
  • Have a lukewarm shower or bath instead of a hot one
  • Put a towel on your bed if you sweat a lot at night
  • Cooling pads can help to keep you cool
  • Try to stay calm under pressure as heightened emotions can cause a hot flush to start

Diet

  • Cut out coffee, tea and nicotine
  • Drink alcohol only in moderation
  • Sip cold or iced drinks

Treatment for hot flushes

Medroxyprogesterone

National guidelines advise medroxyprogesterone 20mg per day as the first choice of treatment. Your doctor should review this medication after 10 weeks.

Cyproterone

Your doctor may offer cyproterone 100mg per day if the medroxyprogesterone has not worked for you.

Cyproterone is used to stop the adrenal gland from making testosterone. It can also reduce hot flushes in men. This medicine may not be suitable for everyone.

A study completed in 2010 compared cyproterone with medroxyprogesterone and venlafaxine. It suggested medroxyprogesterone and cyproterone were the most effective in controlling hot flushes.

Antidepressant medicines

Research shows that these drugs can be helpful in treating hot flushes in men with prostate cancer. Examples are venlafaxine and paroxetine.

Gabapentin

US studies have shown that Gabapentin can be helpful in controlling hot flushes.

Other progestogens

Your doctor may consider these medicines for very severe hot flushes if other treatments have not helped you.

Complementary therapies for hot flushes

There is limited scientific evidence that complementary therapies can help hot flushes in men with prostate cancer.

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.

Last reviewed: 
26 Sep 2016
  • Comparison of physical interventions, behavioural interventions, natural health products, and pharmacologics to manage hot flashes in patients with breast or prostate cancer : Protocol for systematic review incorporating network meta analysis
    B Hutton and others
    Systematic reviews, 2015. vol 4, No 114, 1-7

  • Course and Moderators of Hot Flash Interference during androgen deprivation therapy for prostate cancer: A Matched Comparison
    B Gonzalez and others
    The Journal of Urology, 2015. Vol 194, No 3, 690-695

  • Efficacy of venlafaxine, medroxyprogesterone acetate, and cyproterone acetate for the treatment of vasomotor hot flushes in men taking gonadotropin-releasing hormone analogues for prostate cancer: a double-blind, randomised trial 
    J Irani and others
    Lancet Oncology, 2010. Vol 147-154

  • Gabapentin for the Management of Hot Flashes in Prostate Cancer Survivors: A Longitudinal Continuation Study – NCCTG Trial N00CB
    A Moraska and others
    Journal of Supportive Oncology, 2010.Vol 8, No 3, 128-132

  • How long do the effects of acupuncture on hot flashes persist in cancer patients?
    J Frisk and others
    Supportive care in cancer, 2014. Vol 22, No 5, 1409-1415

  • Randomized trial to assess the impact of venlafaxine and soy protein on hot flashes and quality of life in men with prostate cancer
    M Vitolins and others
    Journal of clinical oncology, 2013. Vol 31, No 32, 4092-4098

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