Potential Treatment for Hot Flashes in Men
Hot flashes in men are not as uncommon as most people think they are, and they often are also more severe than those in women. Although few treatment options are available for hot flashes in men, new research suggests an alternative approach that may work.
Hot flashes in men
One thing that both men and women have in common concerning hot flashes is that they are associated with hormones. In women, the hormone is estrogen; in men, testosterone. In both sexes, a significant decline in the levels of these hormones can result in hot flashes.
While the drop in hormones in women is related to perimenopause, premature menopause and either natural or induced menopause, the decline in testosterone in men is typically only about 1 percent per year after age 40, which is not enough to lead to hot flashes.
However, the majority of men who undergo androgen deprivation therapy (hormone therapy) or castration for prostate cancer experience hot flashes. In addition, men who have a condition called hypogonadism (when the body does not produce enough testosterone) also may experience this symptom.
New treatment for hot flashes in men
According to a new study, seven weeks of hypnotic relaxation therapy significantly reduced uncontrolled hot flashes in a 69-year-old man who had undergone removal of his prostate because of prostate cancer. Before trying hypnosis, the patient had experienced as many as 160 hot flashes per week and severe sleep problems.
After the seven weeks of hypnotic relaxation therapy, which included sessions with trained therapists as well as self-hypnosis, he reported a 94 percent reduction in hot flashes (to about 15 per week) and an 87 percent improvement in sleep quality.
Other treatments for hot flashes in men
Other treatments for hot flashes in men who have prostate cancer include the following medical options. Men should discuss all of the possible therapies with their healthcare provider and fully understand the risks and benefits of each.
- Cyproterone acetate (Androcur), an antiandrogen hormone therapy
- Medroxyprogesterone acetate (Gestoral, Provera) or megestrol (Megace), progestin hormone therapy, which is associated with weight gain, bloating, and possible increases in prostate-specific antigen (PSA) levels
- Venlafaxine (Effexor LP), an antidepressant
- Estradiol, a type of estrogen, which is associated with a high incidence of breast tenderness and swelling
- Gabapentin (Neurontin), an antiseizure medication
A double-blind study evaluated the use of medroxyprogesterone, venlafaxine, and cyproterone in men who were experiencing hot flashes associated with hormone therapy for prostate cancer. The authors found that cyproterone and medroxyprogesterone were significantly more effective than the antidepressant. However, since cyproterone can interfere with hormone therapy, medroxyprogesterone could be a better choice.
Another possibility is acupuncture. A recent review of six studies of acupuncture in the treatment of hot flashes in men with prostate cancer and in women with breast cancer noted the following among 172 patients:
- Average reduction in hot flashes from baseline to the end of acupuncture treatment (range, 5-12 weeks) was 43.2 percent
- At a mean of 5.8 month follow-up after the end of treatment, the reduction in hot flashes from baseline persisted at 45.6 percent in 153 of the 172 patients who were follow up
The bottom line
Until recently, most of the studies of hypnosis and hypnotic relaxation therapy for hot flashes have been conducted in women, especially postmenopausal women or those with breast cancer, and the results have been positive for the most part. This latest study supports the use of hypnosis as an option for hot flashes in men.
Elkins GR et al. Hypnotic relaxation therapy for treatment of hot flashes following prostate cancer surgery: a case study. International Journal of Clinical and Experimental Hypnosis 2014; 62(3): 251-59
Frisk JW et al. How long do the effects of acupuncture on hot flashes persist in cancer patients? Supportive Care in Cancer 2014 May; 22(5): 1409-15
Irani J et al. 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, randomized trial. Lancet Oncology 2010 Feb; 11(2): 147-54