Management of Hot Flashes in Men on Androgen Deprivation Therapy

Pharmacological Management

The National Comprehensive Cancer Network recommends alternative hormonal options for treating hot flashes in men on ADT, including estrogen and cyproterone acetate 1, 2, 3
Non-hormonal pharmacological alternatives include SSRIs/SNRIs such as venlafaxine (37.5 mg/day) or paroxetine (10 mg/day) 4
Gabapentin (300-900 mg/day) has shown moderate efficacy in randomized controlled trials for treating hot flashes in men on ADT 1

Androgens (testosterone) are contraindicated in men with advanced prostate cancer on ADT 1, 2
Vitamin E supplements should be used with caution as there are concerns they may increase prostate cancer risk 1

The National Comprehensive Cancer Network suggests non-pharmacological treatments that can be tried concurrently, including acupuncture 1, 2
Exercise/physical activity and yoga may also be effective in managing hot flashes in men on ADT 1, 2
Lifestyle modifications and weight loss if overweight may help alleviate hot flashes in men on ADT 1, 2
Cognitive behavioral therapy (CBT) has been shown to reduce the perceived burden of hot flashes in men on ADT 1, 2