Hot Flashes

[Murph256]

I began taking 120 mg daily of Orgovyx last week and am already experiencing hot flashes. I know from my previous experience on Lupron that my hot flashes can be very uncomfortable and embarrassing. My MO prescribed Effexor to control the hot flashes, but upon learning it’s an anti-depressant, I am reluctant to take it. I already have enough issues without the potential side effects from an anti-depressant. So my question is, can anyone recommend a gentler but still effective treatment for hot flashes that is not going to further effect my mood and personality?

[LearnAll]

Effexor (venlafaxine) is a powerful antidepressant. It increases blood pressure in doses higher than 150mg a day. Men on ADT already have tendency to increasing blood pressure so effexor can multiply this bad effect. A natural substance called "Black Cohosh" is used by some to reduce hot flashes. interestingly, diet loaded with vegetables and fruits also was found to reduce hot flashes.

Daily vigorous physical exercise has been reported to cause decrease in hot flashes.

[Murph256 in reply to LearnAll]

Thank you. I am already being treated for high blood pressure, and that was before I began taking Orgovyx. My diet is pretty good, mostly plant based with some chicken and fish, and I get a good amount of exercise. I will order black cohosh.

[JPnSD in reply to Murph256]

I am also on oral antagonist Relugovix/Orgovyx after having started ADT with Firmagon initially. I find my hot flashes have varied over the course of a year....and diet, physical activity and emotions seem to play a part in the intensity. I tried the Black Cohosh and Calcium glycinate but they did nothing for me. My worst sweats from hot flashes occur with high intensity exercise...but then are lessened following those periods. Best of luck on your journey. We should all form a subgroup ADT Club on here and post notes under agonist and antagonist ADT for comparison

[Clotter1 in reply to LearnAll]

Ask your doc about a low dose of Oxybutyninn. It has worked well for me.

[Captsquid2u in reply to LearnAll]

I used to sleep like a baby outside in my zero gravity lounge chaiseIn low 30 degrees weather with my ski clothing and a warm blanket, probably not for everyone, but where I live I can do that. And it sounds crazy but it worked for me. Now just sleep with window open and heat almost off.

[mrscruffy]

I live in AZ so it is hot ALL the time. I didn't know I was having them until doctor asked about it. I am of no help to you, just thought I would share.

[Tall_Allen]

Acupuncture works well - they do it in the ear. Other medicines that help are estrogen patches (with tamoxifen), Megace, and oxybutynin.

[spencoid2 in reply to Tall_Allen]

nothing i have used so far helps much. Did Megace and others and am waiting for the insurance company to pre-approve patches. Calcium glycinate worked for about a week. Another hormone worked for maybe a week. Seems to be taking forever and I am having many interrupted sleep nights. will it be worth the wait and the constant pestering of my oncologist. Seems like a good doctor but getting prescriptions and answers when not seeing him is almost impossible. Not much in terms of options here but I am really tired of fighting for each prescription or answer. Another doctor got a pre-approval in one day. This is going on for weeks.

[E2-Guy in reply to Tall_Allen]

100% agree with TA regarding "patches"...same type of ADT as the tE2 gel that I have been using for 43 months. I don't even know what 'hot flashes' are like since I've never had one. If I've had any 'mood swings', no one has commented...perhaps I've been a jerk my entire life?

[maley2711 in reply to E2-Guy]

Did you decide to use those patches instead of Lupron, etc? And your Doc's reaction? Your T level with patches only? Reason they are not SOC?

[E2-Guy in reply to maley2711]

I have never used "patches"; however, the gel is essentially the same only in a different form. My T has been fluctuating between 13 and 99 with the exception of the latest one. No one can explain why since my gel usage has remained constant. Even though this last blood test was kinda crazy, my PSA is still low at 0.012. I will get tested again in about two months.

8/3/2018 - 96

10/3/2018- 72

8/10/2019 - 10

11/06/2019 - 91

2/11/2020 - 99

5/14/2020 - 25

2/16/2021 - 13

12/11/2021- 341

When I report my blood test results to my 'old docs', they just tell me to continue what I'm doing!

Why tE2 is not a commonly used therapy is a good question? Perhaps it is not as lucrative as trimonthly doctor visits and the nasty, exorbitantly priced injections. I haven't seen a doctor in 4½ years and my monthly gel cost (here in Thailand) is about $20.

[Break60 in reply to maley2711]

I switched to patches in early2019 after reading the PATCH trial and asking my urologist about them. I use three per week as adt but used just one when i was on Lupron to stop hot flashes. They’re SOC for doctors who understand how much better they are than Lupron etc. They’re much cheaper and natural so big pharma doesn’t promote them so docs don’t . It’s all about the $ as usual. Bob

[maley2711 in reply to E2-Guy]

Thanks for the humor!!!

[Clotter1 in reply to Tall_Allen]

A fee. Oxybutynin in. Low dose helped me a lot.

[joeguy in reply to Tall_Allen]

As you know, I have been using Tamoxifen with Nubequ monotherapy to control breast growth. I will be adding Orgovyx soon. Do you think the Tamoxifen will help with the hot flashes, or is it only used if one is using estrogen patches to control the breast issues? Thanks

[Tall_Allen in reply to joeguy]

Only for breast growth.

[Murph256]

Thank you. I’ll run those by my MO.

[GoBucks]

My MO wanted me to try venlafaxine and I resisted. I tried stuff I can't remember anymore. Nothing worked. I finally gave in and tried 37.5 mg of venlafaxine. While I still have hot moments I am 75+% better. I have no known side effects. And as added bonus my wife no longer calls me a Dick.

[spencoid2 in reply to GoBucks]

And why did she call you a dick before?

[Tommyemily in reply to spencoid2]

Maybe his first name is Richard

[GoBucks in reply to Tommyemily]

Haha. 4 years of Lupron and Zytiga can make me a little "testy". I'm calmer now.

[Murph256]

You and your wife sound very satisfied. 😊

[noahware]

Gabapentin also works for some. It is what my MO prescribed for my hot flashes, but has not worked well at the relatively low doses I've tried... so reluctantly considering upping the dose (some only get results with fairly high doses).

[spencoid2 in reply to noahware]

I have a ton of gaba here, used to use it for neuropathic pain but got over that. Does it really work for hot flashes?

[noahware in reply to spencoid2]

It does for many, but often not until doses are 900mg or more. I recall you were among those trying magnesium... did that work? That is up next for me!

[spencoid2 in reply to noahware]

not interested in taking that much gabapentin. magnesium glycinate seemed to work for a while and then stopped. i can't figure out if the hot flashes wake me up or if i have a hot flash because i wake up. any ideas on this?

[noahware in reply to spencoid2]

For me, I think they wake me up.

I've been thinking about taking a few forms of magnesium, upwards of 800 mg, but need to research a bit more.

[Chadsdad in reply to spencoid2]

I think in my case, waking up to pee causes me to have a hot flash. It happens every time which is 3 or 4 times each night. I also think that anything that agitates me will cause them. I take Megestrol which helps some. The reason I know is I stopped for about 10 days and almost caught fire one time.

[LearnAll in reply to noahware]

Gabapentin is much safer than Venlafaxine (effexor)...less side effects. Gabapentin doses can go to up to 4000 mg/day . Its a mood stabilizer and anti seizure medication. It also decreases anxiety. For hot flashes, results are mixed.

[London441]

Whatever remedy or remedies you choose, increasing exercise frequency and intensity will enhance it. Same with caloric restriction.

[Murph256 in reply to London441]

Great advice. Thanks.

[2dee]

Started Lupron in 2018 and hot flashes began. Added Xtandi in 2020 hot flashes continued. Dropped Xtandi after 15 mos and added Lynparza last 3 mos. Hot flashes finally subsided quite a bit.Still on Lupron which started them but must finally be acclimating after 3+ years?

2Dee

[dhccpa]

Why did you switch from Lupron to Orgovyx?

[Murph256 in reply to dhccpa]

I took Lupron for 9 months, before, during and after my salvage radiation. I had the whole range of side effects on it, most not only hot flashes, mood swings and depression. I also found the shots to be painful. My MO recommended Orgovyx as a gentler more convenient alternative. He claims Orgovyx has fewer side effects, and that it will be easier on my heart. Also, if we choose to try intermittent ADT, he claims my T levels should recover more quickly. I remember that it took a full 6 months for my T levels to recover after my last Lupron shot. I will report back my experience.

[dhccpa in reply to Murph256]

Thanks. I've had good results on Lupron (so far! three years now) with minimal side effects so haven't switched but always interested in others' experiences.

[fish7days]

20mg Megace

[larry_dammit]

The Effexor was a great help, both for my moods and the hot flashes. My daughter got on line and found me a portable fan that I carried for the first couple of years. And last night I received a set of fans that hang around my neck. I just need moving air and cloths that I can get off fast 🤪🤪🤪

[Hidden]

After trying most of the above suggestions I was finally prescribed Estradiol Patch 0.1mg once a week. That was 10 months ago. The HOT FLASHES were gone in less than a week and have not returned.

[Chazem in reply to Hidden]

Works for me too.

[john_in_pa]

I'm on Effexor 75mg. It has significantly reduced my hot flashes and as a bonus has profoundly improved my mood. I no long ruminate on negative thoughts and I feel positive. I've had no side effects, no high BP. But note that Effexor is a serious drug. Some people have a tough time getting off of it. I tried Black Cohosh and it didn't work for me. I think Effexor is worth a try, especially if you're high in negative emotions. Good luck bother!

[Murph256 in reply to john_in_pa]

Thank you. Admittedly, I do get negative concerning my cancer diagnosis and treatments.

[PSA680]

Hi Murph - I take Sage (the herb) supplements every morning & it seems to have reduced the intensity of Firmagon & Xtandi induced hot flushes. No science behind it but the NHS support nurse said a few people had found it useful. I also exercise a lot. Good luck my friend.

[dougnola]

Hi Murph, I’ll add on to this helpful stream that for me (and many others), this too shall pass. After about 6 intense months, mine gradually subsided and they were gone w/in two years. If anxiety-Induced sweating on top of hot flashes is part of your problem, I recommend regular mediation and, as the flash is happening, close your eyes and remind yourself that nobody gives a flying fig about your flash other than you. That helped me, anyway…flash subsided more quickly. Exercise helps too! ✌️ DougNOLA.

[Murph256 in reply to dougnola]

Good point! I’ll keep that in mind. 😊

[EdBar]

Estradiol patches work great and also help maintain bone health which ADT can have a negative effect on. I’ve been using them for around 7 years now. The patches don’t have the cardiac issues that pills do because they are absorbed through the skin and not through the liver. I add that in case your doc isn’t familiar with them.I used to get wicked hot flashes just about every hour, Snuffy Myers prescribed the patches back when I was seeing him, I’ve used them ever since.

Ed

[Chazem in reply to EdBar]

Ditto all of that.

[MateoBeach]

Effexor sent my blood pressure through the roof and it took a year and 3 BP meds to bring it back to normal after I stopped it. When nothing else works get the 0.1mg estradiol patch and you likely will feel great with zero hot flashes. Best thing this side of testosterone recovery.

[NewPotatoCaboose]

I started Orgovyx Oct. 11. I was very worried about hot flashes after reading reports here. While I've had some night sweats relieved by peeling the covers back, I've not really had issues. I'm doing intermittent fasting and trying to stay active. Not sure what my secret is, but I do use CBD, CBG and vaporize cannabis flowers daily.

[Break60]

One estradiol patch, .1mg. Changed twice weekly stops hot flashes.

[epfj3333]

This won't stop them but it sure helps. It's a small, hand-held fan with a USB rechargeable battery. I have four of them around the house. When you break out in a sweat, it cools you down quickly. Here's the link on Amazon:

amazon.com/HandFan-Portable...

Also, I carry a baby wash cloth in my pocket whenever I go out. It's very small and not bulky. It comes in handy when you're having a conversation with someone and break out in a sweat. They come in a 6-pack. Here's the Amazon link:

amazon.com/Gerber-6-Count-W...

[Metaldraft]

Our standard of care matters to our individual personalize care and because pharmaceutical don’t have proprietary ownership on estradiol it’s not one they advocate.Estrodial does what other adt agonist or anti agonist won’t do.it’s an anecdotal implementation that may be a preference or suggestion.

Finding peace with you and the journey

[carbide]

I take Venlafaxine. Have zero side affects.Give it a try, may or may not help hot flashes. You can always stop. Short half life.

Best luck.

[nuc1111]

Megace----It works for me--I'm on Lupron and Zytiga

[Atlantic77]

embrlabs.com/blogs/news/wav...

[Chazem in reply to Atlantic77]

This has helped me while I went off estrogen to get radiation to my breasts.

Going forward I don't expect to get tender beast buds when I go back on the patch.

[Exrunner]

I started Orgovyx on April 12, 2021. At the time I requested my Urologist, Oncologist and PCP to consider prescribing Estradiol patches to mitigate some of the side effects of ADT. (DEXA Scan showed osteopenia in right hip and spine) They would not...not SOC, patient be dammed! I am currently trying to get my VA PCP to consider the Estradiol patches. I will find out Dec 22,2021 if they will prescribe it.I have experienced many of the side effects. Complete loss of libido, more than normal bone and muscle pain, hot flushes and tiredness I did not previously experience.

I made the decision to use over the counter Estrogen BI-EST 5.0 cream. The use has reduced the hot flushes. Initially it increased my Estradiol from <5 to 14.8. but an Estradiol test on Dec 17 showed the Estradiol dropped back to 6.2. The difficulty in using the cream is getting the right amount each time you use it. I feel I was pretty consistent in applying the same amount each day but apparently it was not enough. Upping the dosage and will get another test to see if it raises the reading.

Not recommending it just explaining what I am doing.

I exercise three to four times a week, maintain my weight the same as it has been for the past 50 years and watch what I eat. No weight gain since I started Orgovyx.

[Bentot]

I must say that after I was prescribed Lyrica 50 mg x 2/day by Paliative Care for nerve pain from metastatic pain to my ribs pain, the hot flashes seem to have disappeared for the most part. Still love my portable fan. The neck fan at lowest speed is usually too much air, and often falls from my neck.

[Muffin2019]

After 4 years the summer is the worst, during the winter they subside somewhat, I just live with them considering the alternative, also joke about they being the women's curse, sorry about the joke to the women out there.

[j-o-h-n]

Move into a nudist colony....(leave the rest of the family at home).....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/19/2021 3:12 PM EST

[Boywonder56]

I like j.o.h.n.s id er...its better than his last one wich was to hold ice cubes between but cheeks.....wich i actually tried....😂

[Hidden]

I take cyproterone acitate and it stopped the flashes in their tracks. I only take 50 mg once a day. Everyone is different tho......all the very best travelling onwards bro....

[DennisCA]

I tried the estrogen patches and they worked great for the hot flashes. However, 2 MO's (one for my blood clotting disorder, Factor V Leiden, and Dr. Rettig at UCLA/VA for prostate cancer) told me to get off them immediately due to risk of clots. I went to Venlafaxine and it has helped, but not completely. Dr. Rettig just said to increase it to 75 mg (I was on 37.5 mg), which I try right after Christmas. Good luck.

[Mischa3]

I haven't seen this mentioned, but it's cheap & easy, and works for me: deep breathing for a few minutes. My PA recommended it, and I didn't try for quite awhile because it makes no sense, but my frequency of hot flashes made it ridiculous not to give it a shot.

At the 1st sign of a flash, relax, and take a slow, deep breath. Release just as slowly. For me at least, after about a minute or so of this, I start to cool down again.

this works every time for me, and I really don't want one more drug in me at this point!

good luck!