Dear Alice,

This may sound weird, but I feel like I am having hot flashes. I start to feel very warm, even when the room is not. The feeling lasts about an hour, then goes away, and returns, sometimes several times a day. Can a guy in his twenties, or any guy for that matter, have them?

Dear Reader,

If you're not so cool with those personal heat waves, you're not alone. While you might typically associate hot flashes with 50-somethings going through menopause, the truth is that there are a host of reasons that anyone — males and females, old and young — might feel their temperature rising. Basically, hot flashes fall under the huge umbrella of "flushing" conditions. Flushing can happen in two ways: (1) though the autonomic nervous system (the brain system in charge of keeping your bodily processes running smoothly), which is the case in menopause, or (2) though chemical signals that affect the muscles in charge of dilating your blood vessels, caused by things such as medications, foods, or androgen changes in males (more on that below). It's understandable that you're not so keen on experiencing these mini-summers every few hours. Working with your health care provider to take stock of related symptoms and triggers, as well as testing out some preventive or management measures, may help sort out the cause behind your hot flashes. 

The range of possible causes for hot flashes in 20-something males is longer than you might expect. Hot flashes could possibly be caused by:

  • Emotional triggers, like nervousness or stress
  • Hyperthyroidism (an overactive thyroid)
  • Nervous system conditions, like a spinal cord injury or Parkinson's disease
  • Reactions to foods, such as sugar (a symptom of hypoglycemia)
  • A fever from an underlying illness
  • Low blood pressure
  • Medications for blood pressure or erectile dysfunction
  • Male breast cancer
  • Hypogondism, also known as andropause

That last item on this list — andropause — is sometimes a cause of hot flashes for adult males with none of the other pre- or co-existing conditions in the list above. Essentially, andropause — or late-onset hypogonadism — is a condition in which testosterone levels start to drop off. This sometimes happens due to an infection (such as mumps), exposure to radiation or chemotherapy, long-term opioid usage (which can include pain management medications), or just natural declines in testosterone production over time with age (yes, even for 20-somethings!). Other physical signs of low testosterone levels in males include decreased beard growth, increased fat, decreased muscle and bone mass, and breast enlargement or tenderness. 

If feeling physically hot is getting you emotionally bothered, fret not. People sometimes make hot flashes seem like only a "female issue" or something worthy of shame, but they happen to all sorts of people. In fact, some people may simply be more sensitive to room temperature changes than others, with no underlying medical explanation. Some stints with hot flashes may be temporary or may last throughout a person’s life. Whatever the case, there's no need to feel ashamed or embarrassed; consulting with a health care provider may help you to get to the bottom of this heated situation. In the meantime, consider these prevention and management tips when your body feels flushed:

  • Avoid external triggers that you can control, like spicy foods, hot beverages, or alcohol. 
  • Try relaxation techniques or getting a bit of fresh air when you feel that mercury start to rise.
  • Wear loose clothing or removable layers. 
  • Keep track what seems to be associated with your hot flashes (e.g., potential triggers or conditions) and what times of day they tend to occur. This information can help your health care provider determine any patterns in your experience and appropriate next steps.
  • Practice self-acceptance and positive thinking with regard to your condition; feeling embarrassed or ashamed might only exacerbate it.

Hope this helps you to keep your cool!

Alice!

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