Currently one month into a 24-month sentence of ADT (Orgovyx + Nubeqa) for my node-positive PCa. IMRT starts early January. My side effects are milder than expected, mainly hot flashes in the evening and overnight. However I am quickly growing tired of waking several times a night as these hot flashes occur. I usually return to sleep after a short while, but the thought of this fitful sleep over the next two years as my new normal has me concerned.
While I hesitate to add another medication/patch/gel to my ADT doublet, I would gladly do so if I could “dose up” after dinner to get me through the next 10-12 hours with less sweating in the evenings and better sleep at night. No need for a 24 hour solution unless that’s unavoidable.
I see my MedOnc in two weeks so it’s a conversation I’d like to have with him.
Thanks…
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Veozah has worked miracles for me. I was having 20+ very strong hot flashes a day. Since starting Veozah I'm down to a few in the evening that I barely notice. I feel them coming on but they just fizzle out. It's been life-changing.
I've only filled it once. It cost me around $30 out-of-pocket but insurance didn't cover it. I'm not sure why it cost so little. The pharmacy didn't hesitate to fill it.
My naturopath recommended magnesium glycinate for hot flashes. I take 400 mg at bedtime. It doesn’t completely eliminate the hot flashes but they are definitely less frequent and not as intense when I take it.
Veozah is only approved for post-menstrual women but is good stuff if you can get it. Other things for which there's evidence: acupuncture, estrogen patches (I'd take with tamoxifen transdermal gel), Megace, Oxybutynin, venlafaxine.
I kept it simple and free when I was hot flashing. Firstly, be as fit as I could and eat less. Better circulation and low body fat help as much as anything. I tried a few of the drugs but they did nothing but add side effects.
A fan can do wonders, even if only for short intervals. Living where there is a reasonably cold winter obviously helps in that part of the year also.
It may sound flippant, but if you are only a month into ADT, hot flashes is the side effect that commonly appears first, so they’re commanding your attention. When the probable fatigue and brain fog set in, the flashes may well get pushed to the back of your mind . Or you may luck out and not experience those. If you’re not so lucky, here again exercise makes a dramatic difference.
I echo this. I exercise quite hard - 5 classes a week, and eat moderately with no UPF or sugar and limited meat. Also my last meal is at 5pm. I've never had a hot flush despite being a year into my 2 year sentence 🤞.
I agree with the use of a simple fan. I stopped ADT in July '24 and still use a fan every night. I turn it on when I go to bed and off when I get up. The one that works well for me is a cheap little fan from Amazon that sits on the nightstand running on it's lowest speed. This is the one I've been using for the last year or so. I keep it plugged into a low power usb charger all the time. amazon.com/gp/product/B0CYG...
My MO suggested Black Cohosh capsules which helped greatly. Also I found online a small bedside fan with remote control, built in shut off timer and very quiet operation that helped. The flashes have now faded away over time and seem like only triggered by occasional stress.
My husband was diagnosed in 2019 and is on Zytiga and Pednisone. He also takes allergy, blood pressure, and cholesterol medication, so he has no desire to take any other pills.
So, my Sister-in-law who is going through menopause told us about the Chili-Pad for her bed. She said it was a game changer for her hot flashes and night sweats, so I got one for his side….they can either cover the whole bed or just one side.
It isn’t pretty and it does make a noise at night, but it has worked great for him and helped him to sleep without the sweating as much.
As time has passed he has less hot flashes overall, but the pad does help at night.
This is their website if you want to test it out. They aren’t cheap, but it has worked well for my husband.
My menopausal wife and menopausal sister as well as myself on ADT have stopped our hot flashes in a matter of 3-4 days using Norwegian Kelp. It's inexpensive and can be purchased on Amazon.
That herb helps with the thyroid health so it is possible that similar results could be achieved by foods that provide iodine for the thyroid. Such foods include tuna, cod, shell fish, sea weed.
As others mentioned Black Cohosh, I sleep with a fan directly on me. I also take magnesium. I think after few months on Orgo Nubeq my hot flahes and sweats diminished . The fan helped me a lot. I wonder if the Low Dose Naltrexone I take for neuropathy may be helping as well?
Exercise. Walking 6 miles a day and weights four or five times a week reduced my sparks by 90 per cent. Early on they were really bad. Stay away from meds if you can help it. It just invites an unwanted complication.
I tried all of the usual methods. Finally started Veozah. Instead of hot/soaking flashes every 2 hours all day long. They are 95% gone.
Yes I pay out of pocket as insurance has denied it. My thought process.....if someone stood at the foot of my bed every morning and asked for $18 to get the flashes to stop, I would hand over the cash in heart beat!
I.m not sure why no one here hs suggested low dose topical estradiol to replace the nomral estradiol lost with ADT. RCT data supporitng this ere published two years ago. See:
Randomized Controlled Trial Eur J Endocrinol
. 2022 Nov 1;187(5):617-627. doi: 10.1530/EJE-22-0318.
Effects of oestradiol treatment on hot flushes in men undergoing androgen deprivation therapy for prostate cancer: a randomised placebo-controlled trial
Nicholas Russell, Rudolf Hoermann, Ada S Cheung, Jeffrey D Zajac, Mathis Grossmann
PMID: 36806623 DOI: 10.1530/EJE-22-0318
Abstract
Objective: Most men undergoing androgen deprivation therapy (ADT) for prostate cancer experience hot flushes. Current treatments have low or limited evidence of efficacy. It is likely that oestradiol depletion is the mediator of these hot flushes, and transdermal oestradiol might be an effective treatment.
Design: This is a 6-month randomised, placebo-controlled trial with the hypothesis that oestradiol would reduce hot flush frequency and intensity and improve quality of life (QoL).
Methods: Seventy-eight participants receiving ADT were randomised to 0.9 mg of 0.1% oestradiol gel per day or matched placebo. Hot flush frequency and severity were assessed by 7-day diary at baseline, month 1, month 3, and month 6. QoL was assessed by validated questionnaire.
Results: Oestradiol reduced daily hot flush frequency, with a mean adjusted difference (MAD) of -1.6 hot flushes per day (95% CI: -2.7 to -0.5; P = 0.04). The effect on weekly hot flush score was non-significant, with a MAD -19.6 (95% CI: -35.5 to -3.8; P = 0.11). On per protocol analysis, E2 significantly reduced daily hot flush frequency, with a MAD of -2.2 hot flushes per day (95% CI: -3.2 to -1.1; P = 0.001), and weekly hot flush score, with a MAD of -27.0 (-44.7 to -9.3; P = 0.02). Oestradiol had no significant effect on QoL.
Conclusion: We confirmed our hypothesis of a clinical effect of assignment to oestradiol to reduce hot flush frequency in men with castrate testosterone due to ADT. Transdermal oestradiol could be considered for men with burdensome hot flushes in whom other treatments have failed as long as the risk of breast effects and fat gain are considered.
I have tested the Kulkuf (similar but even colder bracelet) and have found it’s too disruptive to wear it in bed: you have to push a button to turn it on, the cold is rather harsh and there’s a fan whoosh, both of which interfere with sleep.
Megace reduced my hot flashes about 75%. During my 1st 3 years on Lupron. Worse though, was loss of bone density, also due to loss of natural estrogens resulting from no T.
Due to recurrence, I had an orchiectomy over 5 years ago (my choice for simple permanent T suppression).
I’ve been on estradiol since for hot flashes, fatigue, bone health. I feel great!
exercise exercise exercise, cut my hot flashes to a minimum, however sleep deprivation is real for me particularly after my 28 rounds of IMRT. I get up 3 to 4 times a night to pee.
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