Management of ADT hot flashes?

Hot flashes are not a result of ADT. They are a result of low or absent testosterone, which is the reason for ADT. I was on ADT (Lupron, Abiraterone and Prednisone) for three years and had 6-8 hot flashes a day and 3-4 per night. I have been off ADT for 11 months, but am still experiencing hot flashes, although not quite as severe. My testosterone has reached 100 now, but the hot flashes are still a constant companion. I find that keeping the bedroom cool at night helps the nighttime hot flashes somewhat. I have tried black cohosh, ground flax seeds and other “remedies”, but haven’t noticed any improvement. I rather put up with the hot flashes than take drugs with all their side effects and potential interactions. I am willing to take drugs that will stop or slow the progression of my cancer, but I am unwilling to take drugs to combat the side effects of the drugs, other than calcium and Alendronate to prevent bone loss and iron to help red blood cells. When I was on ADT, I also needed Lisinopril to lower my blood pressure because ADT drugs raise blood pressure.

True, ADT doesn’t directly cause hot flashes. Basically, ADT (androgen deprivation therapy) hormone therapy leads to the pituitary gland downregulating its response resulting in a decrease in testosterone from the testicles. (See attached diagram,) This decrease in testosterone has significant metabolic side-effects, including (unfortunately) hot flashes. (Note that testosterone is an “androgen.”)

Lupron is an ADT (along with Eligard, Prostap, Camcevi, Lucrin, Zoladex, Trelstar, Pamorelin, Decapeptyl, Firmagon, and Orgovyx.)

Abiraterone (Zytiga) is not an ADT, Though it is a hormone therapy, it’s actually an ARPI (androgen receptor pathway inhibitor) - along with Erleada (apalutimide), Xtandi (enzalutimide), and Nubeqa (darolutamide).

Prednisone is a steroid used to control cortisol levels that are affected by the Abiraterone (Zytiga).

Depending on what your baseline testosterone level was, and how long you were on ADT, they say to not expect full recovery from the side-effects for 50% longer than you were on ADT. (Some men never fully recover depending on their age and how many years they were on ADT.). There are documented ways to minimize the side-effects of hormone therapy - including the hot flashes - without using other pharmaceuticals.

You mentioned bone loss. Did you have a baseline DEXA scan prior to start treatments?

I had very severe hot flashes nine years ago when I started Lupron. I would feel a lot of fatigue just as the hot flash would hit. After a year, my oncologist recommended I get a depo-provera shot. It almost completely stopped my hot flashes. I was good for a year and a half until I became castrate resistant and had to start Zytiga. It brought back the hot flashes, even though I was on depo-provera.

Then we come back to today as I Sit here getting a hot flash. I’ve been on Orgovyx For two years now, and I’m still getting about eight hot flashes a day. I had a depo-provera Shot about a month ago And the intensity of the hot flashes is quite a bit less. I’ve been on 1800 mg of gabapentin for at least five years and it makes no difference at all with my hot flashes.

Most people don’t get the intense hot flashes I get.

I have an embrlabs.com wave product (wave 2). I’ve used it for Over five years now. It’s like a refrigerator that looks like a watch and sits on the inside of your wrist. You could set up one of the buttons for their night mode . Hit the button twice and It Produces cold waves at measured times during the night and prevents hot flashes and night sweats. They used to bug me, before I got this device . When you start to feel a hot flash coming on, you hit another one of the buttons twice and it sends cold chills through your arms and it reduces the intensity, shortens the life and can stop the hot flashes if hit quickly enough. The device doesn’t work for everybody, but the night mode makes a significant difference for people that have night sweats and night hot flashes.
https://embrlabs.com/

Big big fan of the embrlabs.com wave product (wave 2) “watch’’ I find it works really well and has helped me sleep much better. Also great during the day if you catch the hot flash, hit the button twice and within a minute or so the hot flash quickly fades. Works better for me than a fan. I was pretty bothered by them but didn’t want to mix another drug into the mix. The battery needs to be charged every day, but this is a small price to pay for the relief the device gives. As a bonus I purchased it when it was on sale for $100 off so for a bit over $200 it was definitely worth it. Best to all of you, what a long, strange trip it’s been!

Big big fan of the embrlabs.com wave product (wave 2) “watch’’ I find it works really well and has helped me sleep much better. Also great during the day if you catch the hot flash, hit the button twice and within a minute or so the hot flash quickly fades. Works better for me than a fan. I was pretty bothered by them but didn’t want to mix another drug into the mix. The battery needs to be charged every day, but this is a small price to pay for the relief the device gives. As a bonus I purchased it when it was on sale for $100 off so for a bit over $200 it was definitely worth it. Best to all of you, what a long, strange trip it’s been!