Ask Dr. K: 'Low T' often cause of men's hot flashes

Written by Dr. Michael White, Published on February 13th, 2012
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Ask Dr. K

Anthony Komaroff

Q I'm a 75-year-old man who recently underwent prostate cancer surgery. I've begun to have what I think are hot flashes. I'm baffled, because I thought hot flashes were a female problem. Could I be having male hot flashes?

A In short, the answer is yes. As with hot flashes in women, sex hormones are to blame.

Women get hot flashes at menopause, when their estrogen levels drop. In men, the problem is testosterone, a type of hormone called an androgen. More specifically, declining testosterone levels can lead to hot flashes in men.

In women, estrogen levels drop dramatically after age 50. But for men, declining testosterone levels start as early as age 30 and slowly fall throughout a man's life.

By age 70, more than half of men are testosterone-deficient.

This deficiency is responsible for menopause-like symptoms in some men, and these can include hot flashes. It's difficult to predict which men will have these symptoms, though.

Some men with what appear to be low levels of testosterone don't have symptoms, although many men with low testosterone levels have hot flashes.

Other symptoms besides hot flashes are caused by low levels of testosterone -- sometimes called "low T."

If in addition to the hot flashes you also have little energy, low sex drive, poor-quality erections and your muscles seem to be shrinking, you may have low T.

As a prostate cancer patient, you're at higher risk for hot flashes.

This is especially true if you are receiving androgen deprivation therapy as part of your treatment, because it lowers your testosterone levels.

Testosterone spurs the growth of many prostate cancer cells. Therefore, treatments that lower testosterone levels are often given to men with prostate cancer.

Your doctor can measure the testosterone in your blood to see if your hot flashes are caused by low testosterone or some other condition.

If it turns out that they are due to low testosterone, there are a few treatments that might help you.

Testosterone replacement therapy can restore normal levels and reduce hot flashes. However, this is not an option for you. Because testosterone encourages prostate cancer cell growth, it should be used only by men without prostate cancer.

A possible option for men like you with prostate cancer is female hormones. That may sound weird, but research shows they are highly effective.

Write to Anthony Komaroff via his website,, or c/o Universal Uclick, 1130 Walnut St., Kansas City, MO 64106.

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Ask Dr. K: 'Low T' often cause of men's hot flashes

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