Hot flushes are sometimes a side effect of having low levels of hormones.
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
- 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
- Cut out coffee, tea and nicotine
- Drink alcohol only in moderation
- Sip cold or iced drinks
Treatment for hot flushes
National guidelines advise medroxyprogesterone 20mg per day as the first choice of treatment. Your doctor should review this medication after 10 weeks.
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.
Medroxyprogesterone and cyproterone are the most effective in controlling hot flushes.
Anti depressant medicines
Research shows that these drugs can be helpful in treating hot flushes in men with prostate cancer. Examples are venlafaxine and paroxetine.
US studies have shown that Gabapentin can be helpful in controlling hot flushes. This is not licensed in the UK.
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.
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.