Suppressing Hot Flashes Caused By ADT, A Head to Head Evaluation

Hormone treatment (ADT) leads to hot flashes, one of the more unpleasant, but most common side effects we experience. Approximately 80% of men on ADT experience some hot flashes. There are numerous treatments, but their effectiveness is inconsistent, some of us even feel they are ineffectual. They range from various drugs to acupuncture to standing on our head ( I don’t actually recommend this treatment.) Even in the best cases, the treatments rarely do more than partially reducing their intensity and their frequency.

For a reason unknown to me, there has not been any studies that I have been able to locate, that actually compares the effectiveness (or should I say ineffectiveness) of any of these treatments against each other.

In a study published in The Lancet Oncology, researchers in France evaluated, in a head to head evaluation, the effectiveness of three hot flash medications, cyproterone, medroxyprogesterone (pronunciation: meh-DROX-ee-pro-JESS-tur-own), brand Name(s): Amen, Cycrin, Provera), and the antidepressant venlafaxine, in men who had 14 or more hot flashes per week after six months of hormonal prostate cancer treatment.

The 311 men participating in the study were divided randomly into three groups and treated with one of the three hot-flash treatments for 12 weeks. Participants self reported the frequency and severity of hot flashes at weeks four, eight, and twelve during the study.

The results showed all three drugs reduced the frequency of hot flashes. The hormonal treatments, cyproterone and medroxyprogesterone, were more effective than venlafaxine at combating hot flashes throughout the study. The median reduction in number of daily hot flashes after four weeks of treatment was 47% for venlafaxine, 95% for cyproterone, and 88% for medroxyprogesterone.

Cyproterone, is also a potential ADT type treatment in its own right for prostate cancer. It functions as an antiandrogen, suppressing the actions of testosterone (and its metabolite dihydrotestosterone) on tissues by blocking the androgen receptors from binding to the prostate cancer cells. It also suppresses luteinizing hormone (which in turn reduces testosterone levels). Using Cyproterone might be considered as long as it does not interfere with the other ADT drugs you are using. However, if it would interfere with the ADT, medroxyprogesterone should be considered as a good choice to control hot flashes.

How cyproterone, and medroxyprogesterone stack up against the other hot flash treatments still needs to be evaluated.

Joel T Nowak MA, MSW

Bookmark to