Hot Flashes in Men: Causes & Treatments

Most people know that women frequently experience hot flashes during menopause, but hot flashes in men are less talked about. Please continue reading to learn more.

What are hot flashes?

Hot flashes are a sudden feeling of warmth or intense heat, particularly in the face, neck, and upper body. They are often accompanied by reddening of the skin and intense sweating. Hot flushing is typically followed by breaking out in a cold, clammy sweat. A hot flush might be accompanied by other symptoms like irritability, anxiety, or palpitations. The episodes are usually brief, lasting a few minutes, but they can occur multiple times a day. Hot flashes and night sweats can also happen at night. Hot flash interference with sleep can lead to other problems like daytime drowsiness.

Why do hot flashes occur?

Hot flashes occur because the body’s thermal control center, the hypothalamus, sends signals to widen the blood vessels in the skin. This causes warmth and flushing, making you blush deeply. Your body counteracts the rapid rise in temperature by producing a cold sweat.

Is it normal for men to have hot flashes?

It is not common for men to have hot flushes. Unlike women, in whom there is a sharp drop in estrogen levels at the time of menopause, men have only a slight fall in testosterone levels with age. Therefore, a male hot flash is not common.

At what age do men get hot flashes?

Some men in their 40s and 50s can experience symptoms such as irritability, mood swings, depression, changes in body fat distribution, low sex drive, loss of muscle mass, insomnia, lethargy, and problems with memory and concentration. However, the term “male menopause” can be misleading because, as mentioned, testosterone levels do not fall sharply in men with age. In fact, testosterone levels show a steady decline of only around 1% a year after age 40. Most men maintain high enough levels of testosterone to prevent hot flashes. Therefore, low-T is not usually a cause of hot flashes in men.

What would cause hot flashes in a man?

Medical reasons can cause hot flashes in men. Men who receive androgen deprivation therapy for prostate cancer treatment frequently experience hot flashes. Testosterone stimulates the growth of prostate cancer cells. Therefore, treatment for prostate cancer consists of blocking the action of this hormone in the body.

Androgen deprivation treatment with medications such as goserelin (Zoladex), leuprolide (Lupron), and bicalutamide (Casodex) suppresses testosterone production or blocks the effects of the hormone to prevent prostate cancer growth. Sometimes, androgen suppression is given as neoadjuvant therapy to boost the effects of radiation treatment.

However, low testosterone levels due to androgen suppression can trigger hot flashes in men. Up to 80% of men who receive prostate cancer treatment with androgen deprivation therapy report experiencing hot flashes.

What medications help male hot flashes?

Hot flash symptoms in men typically go away 3-4 months after androgen deprivation therapy is stopped and testosterone recovery occurs. However, men taking long-term androgen deprivation therapy often continue to experience hot flashes. Fortunately, treatment options are available to relieve hot flashes in men.

Hormone therapy

Men with prostate cancer cannot take testosterone. However, the female hormone estrogen can be used to treat hot flashes in men. Studies have shown that over 80% of men get relief from hot flashes after taking small doses of estrogen. However, estrogen treatment can cause hormonal changes and side effects such as male breast enlargement and breast tenderness. It is unclear whether taking estrogen increases cardiovascular risk in men.

Other treatments consist of female hormones like progesterone, for example, medroxyprogesterone (Provera) and megestrol (Megace). These can also reduce hot flashes by 80-90%. However, they can cause bloating and weight gain as side effects.

Bioidentical hormone replacement therapy uses plant-derived hormones to manage symptoms such as hot flashes. There are some FDA-approved bioidentical hormones. However, compounded bioidentical hormones have not been studied for safety or efficacy. Always consult a healthcare provider before taking any hormonal therapy for hot flushes.

Antidepressants

Antidepressant drugs such as selective serotonin reuptake inhibitors (SSRIs) like paroxetine (Paxil) and citalopram (Celexa) or serotonin norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor) and desvenlafaxine (Pristiq) are effective in lowering the incidence of hot flushes in men and women. Side effects of these medications in men include low sex drive and erectile dysfunction. They can also cause high blood pressure.

Lifestyle changes

The following tips can help in preventing hot flashes:

Avoid triggers for hot flashes, such as caffeine and alcohol intake, spicy foods, smoking, a warm room temperature, and tight-fitting clothing. These are the most common causes of hot flashes that do not have a medical reason. Limit your caffeine and alcohol consumption, keep your room cool, and take a lukewarm shower rather than a hot shower.
Talk to your doctor about taking a vitamin D supplement. Studies have shown that low vitamin D levels can increase the risk of hot flashes during menopause in women. The same may be true for hot flashes in men.

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