Why Do Men Get Hot Flashes? Doctors Explain
Hot flashes can happen to anyone, and for guys in particular, they could be signaling low testosterone.
Most people think of menopause when they hear the term hot flashes, but men can get hot flashes, too—usually for the same reason: hormones.1
Hot flashes in men are linked to a decline in testosterone that throws off the hypothalamus, the part of the brain that regulates body temperature. Sometimes, factors like existing medical conditions or treatments for prostate cancer can play a role in male hot flashes. Either way, the result is the same—sudden waves of heat and sweating that can feel equally intense, says hormone specialist Yoshua Quinones, M.D.
If you’re noticing drastic body temperature changes at night or during the day, here’s what may be causing those male hot flashes—and what you can do about it.
About the Experts
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.
At What Age Do Men Get Hot Flashes?
Men may get hot flashes as early as their 40s and 50s, when testosterone levels naturally begin to decline.2 As those levels continue to drop with age, the chance of experiencing hot flashes rises.3
While there isn’t consistent data on the percentage of men affected by hot flashes, they can occur whenever testosterone levels drop, triggering unpleasant symptoms of hormone imbalance. One eye-opening study of a single Swedish community found that up to 33% of men aged 55 to 75 experienced hot flashes at least once a week.4
What Causes Hot Flashes in Men?
Hot flashes in men are usually linked to sudden or significant drops in testosterone. These drops can happen during medical treatments that lower testosterone, such as prostate cancer therapy, but they may also occur with age-related hormone decline (sometimes called andropause or “manopause”). In these situations, low testosterone disrupts the brain’s ability to regulate body temperature, leading to those sudden waves of heat.5 Lifestyle factors may play a role, but hormone changes are the main driver.
According to hormonal health expert Dr. Natalie Kunsman, “Hormones help the body respond to environmental changes and keep its internal temperature steady, a process known as thermoregulation.” Both testosterone and estrogen influence how the brain controls blood flow and heat distribution throughout the body.6
Low testosterone and hormone changes
Low testosterone can cause hot flashes due to the hormone’s influence on the hypothalamus—the part of the brain that manages body temperature. Although the mechanisms are not altogether known, it appears that extremely low testosterone levels may confuse the hypothalamus into misinterpreting temperature signals from the body, and overreacting to what it perceives as overheating.
Without the stabilizing effects initiated by testosterone binding to androgen receptors in the hypothalamus, the body becomes more sensitive to minor changes in temperature, triggering the sudden bursts of sweating and flushing we know as hot flashes.
It may seem counterintuitive, but what makes us feel like we are “burning up” during hot flashes are really the body’s extreme methods of “cooling down”—flushing to release heat through the skin, and sweating to cause cooling through evaporation. Because of this, many people feel cold and clammy after a hot flash, and their bodies may shiver to generate heat.
Low estrogen may also play a role in hot flashes in men, just as it does in women. Because most estrogen in men comes from testosterone being converted by the aromatase enzyme, low testosterone often means low estrogen, too. This explains why men can experience hot flashes when taking aromatase inhibitors, even if their testosterone levels are normal. Supporting this idea, studies show that estrogen therapy can reduce hot flashes and other symptoms in men on androgen deprivation therapy (ADT), though its use is limited by side effects.
Androgen deprivation therapy (ADT)
Androgen deprivation therapy (ADT), a treatment used for prostate cancer, is a known cause of hot flashes in men. It lowers the production of testosterone to stop the growth of cancer cells—since testosterone triggers those cells to keep replicating.7 8
A 2024 study in The Journal of Urology found that up to 80 percent of men undergoing this type of therapy experience hot flashes—sometimes for years.9 10 Of those, about 25 percent report that hot flashes are the most distressing side effect of ADT, because hot flashes and night sweats in men tend to interfere the most with daily life.
Hot flashes and medical issues
Hot flashes in men are sometimes caused by medical conditions, such as thyroid disorders and diabetes. Imbalances in thyroid levels or blood glucose can disrupt the body’s ability to regulate temperature, leading to waves of heat and sweating, according to Kunsman. Longstanding diabetes also leads to abnormal regulation of the autonomic nervous system, which regulates sweating, flushing, and temperature control.
High blood pressure may also contribute to hot flashes in men by affecting blood vessel function and thermoregulation.11 12 In some cases, the medications used to treat these conditions can contribute to hot flashes as well, Quinones adds.
Anxiety
Anxiety and depression can sometimes accompany hot flashes—or even be the underlying cause. These conditions are especially common in men in their 40s and 50s who are going through andropause, a period of hormonal change marked by declining testosterone levels.
Lifestyle factors
High stress levels, excessive drinking, and smoking can exacerbate hormonal imbalances that may be linked to hot flashes in men.13 14 Poor sleep and carrying extra weight can tinker with testosterone levels, too. Dietary factors like excessive caffeine, sensitivity to food additives like MSG or sulfites, or use of diet supplements containing niacin or nicotinamide can also trigger or worsen the severity of hot flashes.
Lifestyle improvements like regular exercise and a balanced diet can help offset hot flashes in men, Quinones says.
Symptoms of Hot Flashes in Men
Besides the telltale feeling of excessive heat and flushing, hot flashes in men might be accompanied by the following symptoms:
Hot flashes also might be accompanied by other symptoms of low testosterone as well, including irritability, anxiety, and brain fog.
How long do hot flashes in men last?
Hot flashes tend to be short, averaging less than five minutes, but they often happen frequently (as many as 10 times) during the day and night.16
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,” Kunsman says. “Afterward, there may be a sensation of coldness as the body resets itself.”
Symptoms of male hot flashes in ADT patients
Hot flashes from androgen deprivation therapy (ADT) for prostate cancer can be slightly different than those from other causes of low testosterone like andropause.
With ADT, testosterone levels drop suddenly and almost completely, which makes hot flashes more frequent, intense, and disruptive. ADT hot flashes also typically persist as long as the therapy continues, with up to 50 percent of men reporting hot flashes up to five years, so you really can’t outwait them. In addition to hot flashes, ADT can cause other side effects like erectile dysfunction, loss of libido, fatigue, mood changes, and unintended weight gain.
Medication for male hot flashes
Treatment for male hot flashes caused primarily by low testosterone may include hormone therapy, such as testosterone replacement therapy (TRT). “This is one of the mainstays for treating hot flashes because you’re replenishing hormonal losses,” Kunsman says.
For men whose hot flashes stem from hyperthyroidism, thyroid medications may help regulate hormone levels and reduce symptoms.17
For those experiencing hot flashes as a side effect of androgen deprivation therapy (ADT), some research shows that certain medications—such as gabapentin, clonidine, and antidepressants like venlafaxine—can provide relief.18 19 In severe or treatment-resistant cases, progesterones like megestrol acetate or medroxyprogesterone acetate, as well as estrogens like diethylstilbestrol (DES) or transdermal, have also been effective.
Lifestyle changes for male hot flashes
These simple lifestyle changes may help ease hot flashes in men:
Do:
- Add stress-relieving activities such as yoga or meditation
- Stay physically active
- Eat nutrient-dense foods that support testosterone production—think healthy fats and quality protein
- Take vitamin D supplements if your levels are low, as vitamin D deficiencies can lead to lower testosterone
Don’t:
- Drink excessive amounts of alcohol or caffeine
- Eat spicy foods
- Spend time in hot environments, like saunas
- Wear tight clothing
- Skimp on sleep
If you’re wondering, do men’s hot flashes get worse at night? Yes, they can. To avoid overheating while you sleep, try keeping your bedroom temperature cool, wearing light, breathable layers of clothing, and setting up a fan by your bed.
The Bottom Line
Hot flashes in men are often caused by hormonal changes like low testosterone or by treatments like androgen deprivation therapy (ADT) for prostate cancer. Though not widely discussed, male hot flashes are common and treatable. Lifestyle changes and medications like testosterone therapy can help manage symptoms and improve quality of life.
World Health Organization (2024) Menopause
↑Cleveland Clinic (2022) Low Testosterone (Hypogonadism)
↑Stanworth, Roger D, Jones Hugh T (2008) Testosterone for the aging male; current evidence and recommended practice
↑Spetz, Anna-Clara E (2003) Hot flushes in a male population aged 55, 65, and 75 years, living in the community of Linköping, Sweden
↑U.K. National Health Service (2022) The Male Menopause
↑Padilla, Stephanie L et al (2019) A Neural Circuit Underlying the Generation of Hot Flushes
↑American Cancer Society (2023) Hormone Therapy for Prostate Cancer
↑Sarthak, Shah et al (2024) Bothersome Hot Flashes Following Neoadjuvant Androgen Deprivation Therapy and Stereotactic Body Radiotherapy for Localized Prostate Cancer
↑Sarthak, Shah et al (2024) Bothersome Hot Flashes Following Neoadjuvant Androgen Deprivation Therapy and Stereotactic Body Radiotherapy for Localized Prostate Cancer
↑Gonzalez, Brian D et al (2015) Course and Moderators of Hot Flash Interference during Androgen Deprivation Therapy for Prostate Cancer: A Matched Comparison
↑Johns Hopkins Medicine (n.d.) Thyroid Disorders
↑Gambineri, Alessandra (2018) Sex hormones, obesity and type 2 diabetes: is there a link?
↑Rachdaoui, Nadia, Sarkar, Dipak K (2013) Effects of Alcohol on the Endocrine System
↑Tweed, Jesse Oliver et al (2013) The endocrine effects of nicotine and cigarette smoke
↑Lugo, Tania, Tetrokalashvili, Maggie (2022) Hot Flashes
↑Spetz, Anna-Clara E (2003) Hot flushes in a male population aged 55, 65, and 75 years, living in the community of Linköping, Sweden
↑Lugo, Tania, Tetrokalashvili, Maggie (2022) Hot Flashes
↑Sarthak, Shah et al (2024) Bothersome Hot Flashes Following Neoadjuvant Androgen Deprivation Therapy and Stereotactic Body Radiotherapy for Localized Prostate Cancer
↑U.K. National Health Service (2023) Common Questions About Clonidine
↑
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The Edge upholds the highest standards of health journalism. We source research from peer-reviewed medical journals, top government agencies, leading academic institutions, and respected advocacy groups. We also go beyond the research, interviewing top experts in their fields to bring you the most informed insights. Every article is rigorously reviewed by medical experts to ensure accuracy. Contact us at support@honehealth.com if you see an error.
About the author
Meredith Bethune is a freelance journalist covering health, wellness, food, travel, and the outdoors for publications like New York Times, Outside, Wine Enthusiast, National Geographic, Travel + Leisure, Condé Nast Traveler, CNN, Vogue, and Eater. An avid hiker and adventurer, Bethune holds a degree in history from Tulane University in New Orleans, Louisiana.
About the reviewer
Dr. Steven D. Wise is board-certified in endocrinology, diabetes, metabolism, and internal medicine. He is a fellow of the American Association of Clinical Endocrinologists (FACE).
