ADT: How long until I can expect the hot flushes to kick in?

It depends….. Did your doctor recommend that you start a robust resistance-training program prior to starting hormone therapy to minimize side-effects?

I had only mild warm flashes.

Read up on the benefits of resistance-training exercises.

It takes a few weeks while the testosterone winds down to almost zero. The flashes are due to the low T. Other symptoms start to kick in at that time. Fatigue, libido impact and hot flashes are the big 3.
After 10 months in with Eligard, for me stomach weight gain, swollen ankles, and fatigue are what I am experiencing. The hot flashes have tended to get fewer. The good news is PSA is undetectable so the bad guy is sleeping. I had EBRT radiation (20) that, at this point, (after 3 months) have offered no side effects. I didn't have Erleada prescribed but Casodex was initially for 30 days to help with a T flare that is associated with initial administration of ADT.
Wishing you well as to navigate this path you are on.

Not everyone gets hot flashes, I had really strong ones The second time I had Lupron 2 1/2 years after the first time. They did tell you to start taking calcium twice a day as well as vitamin D? It is a sexual to keep your bones strong while you Are on ADT.

When I had my first 6 month shot of Lupron (same ingredients as Eligard) I didn’t have any side effects at all. It was given to me two months before I had radiation, similar to your situation.

Did they give you Casodex for two weeks before you started ADT? That really is mandatory since you get a testosterone Spike which makes things worse if you don’t get Casodex. If they didn’t give you that I would be a little suspicious about the place I was being treated, It is considered standard of care to do it.

Due to their different mechanisms of action. ADT which includes Orgovyx, Firmagon, Lupron, Eligard, Prostap, Camcevi, Lucrin, Zoladex, Trelstar, Pamorelin, and Decapeptyl can cause numerous side effects. Actually due to a lack of testosterone.
Hot flashes
Fatigue
Muscle deterioration
Bone weakening
Brain fog
Depression
Weight gain
Joint pain
Difficulty in breathing

Not all of these side effects occur to everyone on the drugs. Most of them are just things you have to be aware of and circumvent. I run on the track twice a day, 1 mile at least, to help prevent bone weakening, fatigue and muscle deterioration. I also go to the gym three days a week (usually) and spend an hour with all different types of weight exercises. One thing that happens is people get a beer belly from the muscle deterioration, I do a lot of sit-ups to offset that.

Some people get depression but it is not common. It is easily treatable, according to people that have reported it on here and on Online Meetings I have participated in. If he has that problem Come back and ask for help, Or see a psychiatrist about doing something to relieve the depression. Believe it or not doing exercises and running or walking can help relieve the anxiety and depression.`

Some people get no hot flashes at all. Others only have a few hot flashes and they are very minor. I had severe hot flashes for the first year on Lupron. As a hot flash was hitting I would feel a lot of fatigue. After a year, my oncologist prescribed a depo-provera shot every three months and it really stopped those hot flashes on Lupron. There are other hormones that can do this, speak to your doctor.
I know one person that says eating tofu every day really controlled his hot flashes, another person in this forum said the same thing. Tofu does have properties similar to endocrine hormones but a lot weaker. Can’t hurt to try it. Seems they ate it daily.

According to a doctor that spoke to a recent webinar, many people on ADT should be taking bone straighteners if they are staying on ADT for an extended period or have become castrate resistant. I took Fosamax for six years and I’m now on Zometa. That along with calcium taken daily helps keep your bones strong. Ask your doctor about this.

It's an individual thing. I had one grade 1 hot flash in 6 months. Removed sweater a couple of time and that was about it.

I was fortunate to have minimal occurrences of modest hot flashes while on ADT treatment.

I began Orgovyx in Feb 2023, and walked almost daily in central PA (read "cold") and my hot flashes would occur during my walk. I would think "wow, I am warm"; followed by "yo, dummy, that's a hot flash".
So off went a jacket, or sweatshirt or knit cap (or all of the above) and I would be walking in pretty cold temps with relatively few clothes. And laughing at myself.
Best wishes for mild side effects.

@brianjarvis Hi Brian,
No - he never mentioned it but he knows I work out 5-6 per week and just told me “keep doing what you’re doing.” Hopefully I keep the energy when they start zapping me! I’ve done strength training (not body building) all my life so hopefully that plays in my favor. Prayers and blessings for journey, sir!

@michaelcharles I live in South Florida, so I’d have to look long and hard for a coat and knit cap! haha
I think I may have had one or two, but I’m sure I’ll know it when it hits!
Thanks for the reply. Sending prayers for you - keep winning!

@jeffmarc Yes - I am on Erleada and remain on that. I took it for a month to try to lessen the spike.
Eligard I got two weeks ago - so far so good. Dietician says all sounds good and some guys get them bad while others don’t. I might still be early in the fight. I’m just ready to start radiating some cancer next week! Good luck and prayers for your fight!!

@gpc100866 There has been much reported on the physical benefits of exercise while on ADT. Here are just a few that I’ve bookmarked:

> Drs. Sholz and Moyad talking about exercise and hormone therapy: https://m.youtube.com/watch

> A paper on The Benefits of Exercise During Hormone Therapy: https://static1.squarespace.com/static/54c68ac6e4b06d2e36a4b8c9/t/55cb7275e4b0d97ae7ff60af/1439396469154/The+Benefits+of+Exercise+During+Hormone+Therapy_Insights+August+2015_PCRI.pdf

> A study about the benefits of exercise to counteract the adverse effects of ADT: (They describe a good resistance-training exercise program): https://journals.lww.com/acsm-msse/fulltext/2023/04000/resistance_exercise_training_increases_muscle_mass.2.aspx

If you do what it takes, you’ll do very well with the hormone therapy - it’ll just be an annoyance.

As said, everyone is different. In my case, hot flashes began about 4 weeks in. They were pretty severe for about 2 months and then backed off a little and then disappeared. I get surprised by one every now and then but could go weeks in between. My biggest SE is the fatigue and muscle weakness. I try to combat that through a daily 2 mile walk and resistance band training, but I have to force myself to do that. I continuously have that "Jello leg" feeling and I buy cat litter in 20-pound bags instead of 40's so I don't have to lift them. But...I've learned that prostate cancer comes with ever changing new normals and I'm still looking at the green side of the grass, so all is well. Hang in there, my friend.