Hot flushes in men: prevalence and possible mechanisms

Abstract

In men treated with castration because of prostatic carcinoma hot flushes are as common as in women after menopause. Flushes also occur in normal ageing men, but the prevalence is unknown. Hot flushes are probably caused by an instability in the thermoregulatory centre, because of decreased sex hormone concentrations. Calcitonin gene-related peptide (CGRP) is involved in menopausal hot flushes in women and possibly in men with castrational therapy. Serotonin may also be implicated. Alternative treatments for hot flushes are needed, since men with prostatic carcinoma may not be treated with testosterone, and oestrogen therapy in men has many draw-backs. Therefore, development of a CGRP-antagonist may be useful. In conclusion vasomotor symptoms are common in men with castrational therapy and also exist in normal, ageing men. Since CGRP, serotonin and a decrease in sex steroids seem to be involved in hot flushes, the mechanisms behind hot flushes in men and women may be similar.