Hot Flashes in Men: Understanding the Causes, Symptoms, and Solutions

By Dr. David Samadi

When we think of hot flashes, menopause is typically the first thing that comes to mind. Yet, hot flashes aren’t just for women—many men also experience these sudden waves of heat and sweating. Each year, over 25 million men in the U.S. and more than 408 million men worldwide seek treatment for this surprising condition.

What Are Hot Flashes?

A hot flash has been described as a sudden feeling of warmth that isn’t due to external temperature. Men and women experience them similarly: they often start with a quick, intense heat, especially around the face and chest, followed by skin redness and sometimes significant sweating. 

Although brief—usually lasting around 4 minutes—a hot flash can leave behind a clammy, cold feeling as it passes. While some people have infrequent and mild hot flashes, others might experience them multiple times a day, often accompanied by sensations like anxiety, heart palpitations, and irritability.

What Causes Hot Flashes in Men?

Hormonal changes are the primary trigger of hot flashes in both men and women. Women typically encounter hot flashes during menopause when estrogen levels drop sharply. Men’s testosterone levels decline more gradually, usually about 1% per year after age 40, which usually doesn’t cause hot flashes. However, specific prostate cancer treatments that lower testosterone can trigger hot flashes in men.

A main treatment for prostate cancer is androgen deprivation therapy (ADT). While it’s effective for treating prostate cancer, unfortunately, often leads to hot flashes in men. This therapy reduces testosterone to prevent cancer growth and can be used alongside radiation for increased effectiveness. ADT typically involves injections with intent to either minimize testosterone production or block its effects on the body. Between 70% and 80% of men undergoing ADT experience hot flashes, likely due to the hypothalamus—the brain’s temperature regulator—sending signals that widen blood vessels, causing flushing and then a cooling sweat.

Other symptoms that may accompany hot flashes in men include changes in mood, decreased libido, and erectile dysfunction.

Tips for Reducing and Managing Hot Flashes

If hot flashes are affecting your daily life, here are some practical steps to reduce their frequency and intensity:

• Maintain a cool environment: Keep your room cool, use fans, and consider cooling pads or pillows for comfort.
• Dress in layers: Choose light, breathable fabrics like cotton or silk that can be easily removed if you overheat.
• Stay hydrated: Sip on cold or iced drinks throughout the day to keep your body temperature down.
• Limit triggers: Reduce or avoid alcohol, caffeine, smoking, and spicy foods, to reduce hot flash flare-ups.
• Manage stress: High emotions or stress can sometimes trigger hot flashes, so practicing relaxation techniques may help.

Treatment Options for Hot Flashes in Men

In addition to lifestyle modifications, certain medications and therapies can help manage hot flashes. Here are some standard options:

• Hormonal medications: Medroxyprogesterone and cyproterone acetate, types of progestogen, are often first-line treatments for hot flashes. Medroxyprogesterone is typically prescribed at 20 mg per day for 10 weeks, while cyproterone acetate may be used if medroxyprogesterone isn’t effective.
• Antidepressants: Certain antidepressants like venlafaxine and paroxetine have shown effectiveness in reducing hot flashes in men undergoing prostate cancer treatment.
• Gabapentin: Though primarily used for epilepsy and nerve pain, gabapentin may also help control hot flashes in rare cases.
• Complementary therapies: Acupuncture and cognitive behavioral therapy (CBT) have been linked to reducing the severity of hot flashes. Acupuncture can offer relief from extreme hot flashes, while CBT focuses on managing thoughts and stress responses.

Tracking Hot Flashes

Keeping a diary of your hot flashes, noting triggers such as specific foods, drinks, or activities, can help you and your healthcare provider find the best management strategy.

Considerations for Complementary Therapies

If you’re interested in exploring alternative options, talk to your doctor about complementary therapies like acupuncture, herbal remedies, or CBT. Though scientific evidence is still limited, some men report improvements with these approaches.

Hot flashes can be an unexpected experience for men, particularly those undergoing prostate cancer treatment. Understanding the causes and management options can make coping with and reducing their impact on daily life easier. If you’re experiencing hot flashes, consulting a healthcare professional can be the first step toward finding relief.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer Now What? A Practical Guide to Diagnosis, Treatment, and Recovery and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911.