Managing Hot Flushes

Hot flushes (sometimes called hot flashes) and sweats are caused by the changing levels of hormones in the body. They are a very common side effect of hormone therapy for prostate cancer.

You are less likely to have hot flushes if you are taking anti-androgen drugs such as bicalutamide. Hot flushes are more likely if you are taking LHRH agonists such as zoladex. They can range from mild, where your face feels warm, all the way to severe, where you experience heat and sweats that affect your whole body. You may also experience heart palpitations (feeling your heart beating faster) and feelings of irritability. Hot flushes tend to last for around four-to-five minutes but may last for up to a few hours.

Some people find that their hot flushes begin to improve as their treatment progresses, becoming shorter and happening less often. However, others have hot flushes throughout their hormone therapy.

There are ways to manage hot flushes and treatment options are available. You will be able to speak to your doctor to decide which approach or treatment is the most suitable for you.

Hot flushes can be triggered by certain food and drink – including spicy foods, tea, coffee and alcohol – so you may want to avoid or limit these.

It’s also important to ensure that you are drinking enough water (the current recommendation is six-to-eight glasses per day). You may also find having cold drinks can help you to cope with hot flushes.

You should maintain a healthy weight or take steps to lose weight if you need to. Keeping active and eating a healthy, balanced diet will help with this.

If you currently smoke, you should try to stop as this can also reduce hot flushes.

Keep your room cool. For example, you can open windows or use a fan. It may also help if you wear layers of thin clothing or use layers of bedding so that you can remove them if you get too hot. If you are able to, choose natural fabrics such as cotton or silk for clothing and bedding.

Some people find it helpful to keep a record of when they have hot flushes. You can track what you have been doing when the hot flushes happen so that you can learn what triggers them. This enables you to avoid these triggers in the future.

There are medications available on prescription to manage hot flushes. You will be able to speak to your doctor about the different options available. You and your GP will decide which medicine is best for you, based on your personal experience and any other health conditions you may have.

Medroxyprogesterone is usually the first choice of treatment but if this medication doesn’t work for you, you may be offered a drug called Cyproterone. Certain antidepressant drugs have been shown to help with hot flushes – for example, venlafaxine and paroxetine – but make sure you speak with your doctor about any other side effects these drugs may have. In rare cases, your doctor may prescribe other medicines such as Gabapentin or a type of medicine called a progestogen.

There is some indication that there are complementary therapies that may help with hot flushes and sweats. There have been very few studies looking at this link, so more research is needed to fully understand their role in managing these side effects. Speak to your GP before trying complementary therapies as some of them may impact on your cancer treatment. They may also be available on the NHS, in which case your doctor may be able to help you to access them.

Acupuncture is one type of complementary therapy used to help hot flushes. It involves inserting thin needles into specific places on someone’s body. Some people find that it makes hot flushes more manageable.

There is also some evidence that cognitive behavioural therapy (CBT), a type of talking therapy that focuses on changing negative thought patterns, could be used to manage hot flushes.