Why Do Men Get Hot Flashes? Doctors Explain
Hot flashes can happen to anyone, and for guys in particular, they could be signaling low T.
Hot flashes can happen to anyone, and for guys in particular, they could be signaling low T.
When you hear the term “hot flashes,” it’s likely connected to menopausal women, who experience surges of heat due to hormone changes as estrogen levels drop. But they’re not the only ones opening windows and throwing the covers off in the middle of the night. Hot flashes in men are also a thing.
“Hot flashes in men can occur when hormonal changes, such as a decline in testosterone, disrupt the body’s temperature regulation,” says hormone specialist Yoshua Quinones, M.D. “These hormonal shifts cause men to experience sudden sensations of warmth and sweating.”
If you’re noticing drastic temperature changes, here’s what might be going on—and what to do about it.
Yoshua Quinones, M.D., an internist with Medical Offices of Manhattan in New York. He specializes in internal medicine, hormonal health, hypertension, diabetes, obesity, mental health, and overall well-being.
Natalie Kunsman, M.D., an integrated health advisor and physician at Broad Health, Hone Health’s partnered medical practice. She specializes in family medicine, anti-aging and regenerative medicine, and hormonal health in Colorado Springs, CO.
Although lifestyle factors and medical conditions (more on those in a minute) can contribute to hot flashes in men, the main driver tends to be hormone changes, particularly low testosterone, says Natalie Kunsman, M.D., a specialist in hormone health and anti-aging and regenerative medicine.
“Hormones allow the body to respond to changing environmental conditions and maintain a stable internal temperature, a process known as thermoregulation,” says Kunsman.
Both testosterone and estrogen (men need this hormone, too) influence the way the hypothalamus—the part of the brain regulating temperature—controls blood flow and heat distribution throughout the body (1).
“Testosterone binds to androgen receptors at the hypothalamus, which sets off a chain of events to turn on gonadotropin-releasing hormone,” Kunsman says. For context, gonadotropin-releasing hormone helps your testicles (or ovaries) function properly. This interaction leads to the production of more testosterone (2).
When there’s decreased T, though, it prompts changes in the hypothalamus that makes regulation more difficult, she adds. Most notably, it breaks or weakens that chain of events, so your hypothalamus releases less gonadotropin-releasing hormone. Overall, that can lead to effects like erectile dysfunction, reduced sex drive, hot flashes, depressed mood, and other issues. (2)
Lifestyle factors—having high stress levels, drinking alcohol excessively, and smoking tobacco—contribute to hormonal imbalances that may also be linked to hot flashes in men, says Quinones (3, 4).
“Maintaining a healthy lifestyle with regular exercise and a balanced diet can help mitigate these factors,” he says. Other lifestyle components include not getting quality Zs and carrying excess chub, Kunsman adds.
Androgen deprivation therapy (ADT), which is used in prostate cancer treatment, is a known cause for hot flashes. It lowers the production of testosterone as a way to stop the growth of cancer cells—since those cells use testosterone as fuel to keep replicating (5).
Research found in The Journal of Urology estimated that up to 80 percent of men undergoing this type of therapy have hot flashes—sometimes for years (6). Of those, about 25 percent report that hot flashes are the most distressing part of ADT, even more so than other side effects.
That’s because hot flashes tend to interfere with daily life, and particularly with sleep quality, the study noted.
There are some other conditions that might cause hot flashes as well, says Kunsman, such as thyroid problems and diabetes. That’s because both of those issues can lead to challenges with hormone regulation, she adds (7, 8).
The main symptom of a hot flash is just what it sounds like: A sudden surge of full-body heat that feels like you stepped into a sauna while wearing a winter coat. According to research, other symptoms can include (9):
The good news is that hot flashes tend to be short, averaging less than five minutes and often even shorter. The bad news is that they happen frequently (as much as 10 times) throughout the day and during the night (10).
She explains that hot flashes in men are often confined to the upper body. “It may feel like a wave of heat that causes flushing of the face, armpit sweating, internal heat, and the need to strip a layer of clothes off. Some people may even experience a raise in heart rate. Afterward, there may be a sensation of coldness as the body resets itself.”
Both medical interventions such as medications to treat thyroid issues or diabetes, and lifestyle changes can ease hot flashes in men, says Quinones. For the latter, that might mean making shifts in your daily routine such as picking up meditation, ditching cigarettes, cutting back on booze, eating nutrient-dense foods, and hitting the gym regularly.
Treatment can also incorporate hormone therapy such as testosterone replacement therapy, adds Kunsman.
“This is one of the mainstays for treating hot flashes because you’re replenishing hormonal losses,” she says.
If you’re looking for a cheat sheet about hot flashes, here are some FAQs and their answers:
According to Kunsman, there’s no universally accepted age when a man gets hot flashes, since testosterone levels can begin to drop as you age (11). However, hot flashes are more likely as you get older, since testosterone levels gradually keep going down as you enter later stages of life (12).
Low testosterone is the main culprit, and that can be prompted by issues like diabetes and thyroid problems. Prostate cancer treatment can also lead to hot flashes.