You’re seated when a sudden wave of intense warmth hits your body, followed by embarrassing sweating and a racing heart. At first, you waved it off as a hot day or thought it was because you ate too much hot sauce. But then it happened again a few times, including nights when piquant wasn’t on the menu. Perhaps it’s time you consider hot flashes in men as the reason behind this uncomfortable flushing. 

Hot flashes aren’t solely a women’s issue. Here’s why men experience them and what you can do to beat the heat.

The Science Behind the Sweat

There are several causes of hot flashes in men. Understanding them helps determine the most suitable approach to managing these symptoms. They include:

1. Hormonal Imbalances and Andropause

As men age, testosterone levels naturally decrease at 1% per year. While this process is gradual, a rapid drop in testosterone triggers the brain’s hypothalamus, which is responsible for regulating body temperature. It signals blood vessels to expand, resulting in a sudden surge of internal heat.

Low testosterone levels can also lead to fatigue, mood swings, weight gain and decreased libido. Fortunately, only 10 – 25% of older men have testosterone levels considered low enough to instigate male menopause — also known as andropause. A blood test will determine if low testosterone is contributing to your symptoms.

This also applies to people assigned female at birth (AFAB). Researchers discovered that over two-thirds of transgender men in the perimenopause or menopausal age bracket experience hot flashes, including those who’ve undergone a hysterectomy — where the ovaries are surgically removed.

2. Testosterone Replacement Therapy Withdrawal

Men undergoing testosterone replacement therapy (TRT) may experience hot flashes if they stop treatment abruptly. When external testosterone is introduced into the body, the natural production of the hormone slows down. When TRT is discontinued, it can take time for the body to regain balance, causing hormonal fluctuations that result in hot flashes.

Gradually tapering off TRT under medical supervision can help minimize withdrawal-related hot flashes.

3. Stress and Anxiety

Mental health plays a significant role in triggering hot flashes. Wondering how? Stress and anxiety activate the “fight or flight” response, stimulating the body to release adrenaline and increase heart rate. This results in an internal surge of heat and excessive sweating.

Most people afflicted by Generalized Anxiety Disorder (GAD) are constantly in this hyper-aware state. They experience physical symptoms of GAD, such as abrupt body temperature changes, excess sweating and irregular heart palpitations — characteristics of hot flashes.

4. Some Medications

Certain therapies and medicines interfere with the body’s natural processes of hormone regulation and temperature control, leading to hot flashes. Studies looking to establish the occurrence of hot flushes and their bedtime equivalent, night sweats, in cancer patients underscore the following culprits:

• Cancer treatments.
• Hormone therapy with gonadotropin-releasing hormone or estrogen, including gender-affirming regimens.
• High blood pressure medicines.
• Antidepressants.
• Opioids and pain medications.
• Steroids and corticosteroids.
• Surgery to remove one or both testicles for the treatment of prostate cancer.

If you suspect your prescription is causing hot flashes, consult your doctor before changing your regimen.

5. Medical Conditions That Trigger Hot Flashes

Several underlying health conditions induce male hot flashes, particularly:

• Hormonal imbalances.
• Hyperthyroidism, where an overactive thyroid increases metabolism, causes excessive heat production and sweating.
• High blood pressure affects circulation, potentially leading to temperature dysregulation.
• Diabetes. Unstable blood sugar levels can trigger sweating episodes and heat surges.
• Some cancers, particularly those that target the prostrate and blood.
• Viral infections like COVID-19, HIV and even the common cold.
• Bacterial infections like tuberculosis.
• Neurologic conditions, specifically those characterized by damage to nerves that regulate heat-generating functions like blood pressure, heart rate and respiration.
• Digestive illnesses, such as gastroesophageal reflux disease (GERD) and acid reflux, are linked more to night sweats than daytime hot flashes.
• Mental health illnesses, such as GAD and depressive disorders.
• Substance abuse of alcohol and drugs like cocaine, heroin and meth.

Managing these conditions with appropriate medical guidance can help alleviate hot flashes.

6. Lifestyle Factors and Environmental Triggers

While most hot flashes happen randomly and at any time, others are motivated by everyday stimuli, such as:

• Spicy foods and alcohol. Your favorite hot wings might be betraying you. These dilate blood vessels and can make you feel even hotter.
• Caffeine overload. Overconsumption of coffee or energy drinks may overstimulate the nervous system, raising the body’s temperature.
• Overdressing in hot environments. Overheated rooms, tight clothing and excessive bedding can contribute to night sweats and hot flashes.
• Smoking. Nicotine affects circulation, increases blood pressure and exacerbates sweating, factors that exacerbate hot flashes — yet another reason to quit.

Keeping a log of when hot flashes occur can help you identify and avoid your specific triggers. Making small adjustments to your lifestyle can significantly reduce the frequency of episodes.

Signs You’re Experiencing Hot Flashes

Hot flashes in men often show up as:

• A sudden feeling of intense warmth, primarily in the upper body.
• Profuse sweating.
• Chills afterward, as your body overcorrects for the heat surge.
• Heart palpitations or a racing heartbeat.
• Night sweats, which can disrupt sleep and leave you feeling exhausted.

Many men feel embarrassed about experiencing hot flashes, but acknowledging them is the first step to better management. Recognizing these symptoms early can help you pinpoint triggers to seek effective treatments.

How to Manage and Reduce Hot Flashes

1. Master the Art of Layering

Since hot flashes come without warning, dressing in light, breathable layers make it easier to shed heat when needed. Avoid synthetic fabrics that trap heat and moisture. Moisture-wicking fabrics are effective in keeping sweat under control.

2. Try Stress-Relief Techniques

Stress is a major trigger for hot flashes. Practices like meditation, deep breathing and progressive muscle relaxation can help keep your nervous system calm and cool. Engaging in hobbies, socializing or even practicing gratitude can lower stress levels and minimize the likelihood of experiencing hot flashes.

3. Keep a Cool Drink Handy

As people age, they begin losing the ability to preserve optimum body fluid levels. During a hot flash, you sweat to cool down. If you don’t refill these reserves, dehydration sets in — quicker if you experience several flush episodes.

A cold glass of water or herbal tea can help bring your core temperature down quickly. Staying hydrated keeps your system running smoothly. Experts recommend that people over 50 consume at least two liters of water daily. Some of this comes from the meals you consume. So, include foods with high water content in your diet. Watermelons, tomatoes, berries, leafy greens and cucumbers are viable options. Also, avoid excessive caffeine or alcohol, as they can aggravate dehydration and initiate a hot flash.

4. Mind Your Diet

Some foods and drinks worsen vasomotor symptoms or are risk factors for conditions that trigger them, like obesity. Besides spicy meals, refined grains, highly saturated fat foods and sweet desserts are risk factors for hot flashes.

Additionally, fluctuating hormonal levels in people 50 and over cause a weight gain of about 1.5 pounds yearly. The Extra bulk insulates heat, making it harder for the body to cool down naturally.

Keep a food diary to identify your triggers and prioritize wholesome choices that are filling yet cause little to zero upswings in your body mass index. Avoiding ultra-processed foods, excess sugar and fried foods may also help stabilize blood sugar levels, reducing the likelihood of sudden hot flashes.

5. Exercise, But Do It Smartly

Regular exercise helps regulate hormones and reduce stress, but overheating during workouts can worsen things. Opt for lower-intensity activities like swimming, yoga or brisk walking instead of high-intensity interval training (HIIT) in a hot gym. Working out in a cooler environment or during chillier times can prevent overheating.

6. Consider Hormonal Therapy — With Caution

For men with significantly low testosterone, TRT might help — but it’s not always the best option. Some men may benefit from natural hormone-balancing strategies, while others prefer modern medical intervention. Talk to your doctor to weigh the benefits and risks.

Hot Flashes in Men — Nothing to Worry About

Hot flashes in men are a manageable issue. Many men feel isolated in their experience, but the reality is that hot flashes are more common than you think. The key is to understand what’s causing them and make small interventions to keep your cool. Open discussions with healthcare providers, partners and peers can help lessen the stigma and encourage better management techniques.