Male hot flashes can come with drop in testosterone

Answer: The term “male menopause” is sometimes used to describe the symptoms that may happen to men in middle and older age as testosterone levels decrease. “Menopause” is incorrect: It means literally the cessation of monthly menstruation, and the alternative “andropause” suggests that one stops being a man when hormone levels decrease, so I will just refer to these symptoms as due to low testosterone.

Symptoms of low testosterone include less energy and vigor; decreased sexual interest; higher risk of depression; and less body hair and muscle mass. The faster and further the testosterone level drops, the more prominent the symptoms are likely to be.

Hot flashes generally happen only when the testosterone drop is sudden and extreme, such as in surgery (removal of both testicles) or with hormonal treatment of prostate cancer (Lupron is the most common). The fact that you have had prostate cancer and had surgical loss of a testicle raise my suspicion.

Your doctor already may have checked your testosterone level; if not, you probably should talk to her about it. If your testosterone is very low, treatment may solve your hot flashes, provided that your prostate cancer expert feels it is safe to do so. If you can’t get testosterone, there are other treatments available, such as venlafaxine or gabapentin.

If your issue isn’t testosterone, then I’d be concerned about alternate causes of hot flashes, such as periodic release of chemicals from tumors that can raise blood pressure (pheochromocytoma) or dilate blood vessels (carcinoid). Hot flashes in men are not common and deserve a more thorough evaluation than it seems you have had.