Adult Urology| Volume 55, ISSUE 1, P97-101, January 2000

Download started.


Transdermal estrogen in the treatment of hot flushes in men with prostate cancer


      Objectives. To assess the effectiveness and tolerability of transdermal estrogen in men with hot flushes after hormonal therapy for prostate cancer.
      Methods. Twelve men with moderate to severe hot flushes were randomized to receive either low-dose (0.05 mg) or high-dose (0.10 mg) estrogen patches applied twice weekly for 4 weeks. After a 4-week washout period in which no treatment was given, each patient received the alternative dose for 4 weeks. Treatment response was assessed by daily logs and questionnaires completed every 4 weeks that included a visual analog assessment. Serum luteinizing hormone, follicle-stimulating hormone, testosterone, and estradiol levels were also measured every 4 weeks during the study.
      Results. There was a significant reduction in the overall severity of the hot flushes seen in patients with both the low and high-dose estrogen patch. A significant reduction in the daily frequency of the hot flushes was seen with the high-dose patch only. Overall, 10 (83%) of 12 men reported either mild, moderate, or major improvement in symptoms with either the low or high-dose patch. Mild, painless breast swelling or nipple tenderness was noted in 2 (17%) and 5 (42%) of 12 men treated with the low and high-dose estrogen patch, respectively. FSH levels decreased significantly with both the low and high-dose patch. Estradiol levels increased from 12.1 to 16.4 pg/mL and 26.9 pg/mL with the low and high-dose patch, respectively. There was no significant change in serum testosterone or luteinizing hormone levels.
      Conclusions. Transdermal estrogen appears to be a promising, well-tolerated therapy for men with hot flushes after endocrine treatment for prostate cancer. Further study in larger groups of patients is necessary to assess the relative effectiveness and morbidity of this treatment.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Landis S.H
        • Murray T
        • Bolden S
        • et al.
        Cancer statistics, 1999.
        CA Cancer J Clin. 1999; 49: 8-31
        • Clark J.A
        • Wray N
        • Brody B
        • et al.
        Dimensions of quality of life expressed by men treated for metastatic prostate cancer.
        Soc Sci Med. 1997; 45: 1299-1309
        • Sharifi R
        • Knoll L.D
        • Smith J
        • et al.
        Leuprolide acetate (30-mg depot every four months) in the treatment of advanced prostate cancer.
        Urology. 1998; 51: 271-276
        • Soloway M
        • Sharifi R
        • Wajsman Z
        • et al.
        • Lupron Depot Neoadjuvant Prostate Cancer Study Group
        Randomized prospective study comparing radical prostatectomy alone versus radical prostatectomy preceded by androgen blockade in clinical stage B2 (T2bNxM0) prostate cancer.
        J Urol. 1995; 154: 424-428
        • Karling P
        • Hammar M
        • Varenhorst E
        Prevalence and duration of hot flushes after surgical or medical castration in men with prostatic carcinoma.
        J Urol. 1994; 152: 1170-1173
        • Schow D.A
        • Renfer L.G
        • Rozanski T.A
        • et al.
        Prevalence of hot flushes during and after neoadjuvant hormonal therapy for localized prostate cancer.
        South Med J. 1998; 9: 855-857
        • Miller J.I
        • Ahmann F.R
        Treatment of castration-induced menopausal symptoms with low dose diethylstilbestrol in men with advanced prostate cancer.
        Urology. 1992; 40: 499-502
        • Smith Jr, J.A
        A prospective comparison of treatments for symptomatic hot flushes following endocrine treatment for carcinoma of the prostate.
        J Urol. 1994; 152: 132-134
        • Parra R.O
        • Gregory J.G
        Treatment of post-orchiectomy hot flashes with transdermal administration of clonidine.
        J Urol. 1990; 142: 753-754
        • Loprinzi C.L
        • Goldberg R.M
        • O’Fallon J.R
        • et al.
        Transdermal clonidine for ameliorating post-orchiectomy hot flashes.
        J Urol. 1994; 151: 634-636
        • Quella S.K
        • Loprinzi C.L
        • Sloan J.A
        • et al.
        Long term use of megestrol acetate by cancer survivors for the treatment of hot flashes.
        Cancer. 1998; 82: 1784-1788
        • Loprinzi C.L
        • Michalak J.C
        • Quella S.K
        • et al.
        Megestrol acetate for the prevention of hot flushes.
        N Engl J Med. 1994; 331: 347-352
        • Eaton A.C
        • McGuire N
        Cyproterone acetate in treatment of post-orchidectomy hot flushes.
        Lancet. 1983; 1: 1336-1337
        • Hammar M
        • Frisk J
        • Grimas O
        • et al.
        Acupuncture treatment of vasomotor symptoms in men with prostatic carcinoma.
        J Urol. 1999; 161: 853-856
        • Atala A
        • Amin M
        • Harty J.I
        Diethylstelbestrol in treatment of postorchiectomy vasomotor symptoms and its relationship with serum follicle-stimulating hormone, luteinizing hormone, and testosterone.
        Urology. 1992; 39: 108-110
        • Bailar III, J.C
        • Byar D.P
        • Veterans Administration Cooperative Urological Research Group
        Estrogen treatment for cancer of the prostate.
        Cancer. 1970; 26: 257-261
        • Steingold K.A
        • Laufer L
        • Chetkowski R.J
        • et al.
        Treatment of hot flashes with transdermal estradiol administration.
        J Clin Endocrinol Metab. 1985; 61: 627-632
        • Townsend P.T
        • Dyer G.I
        • Young O
        • et al.
        The absorption and metabolism of oral oestradiol, oestrone and oestriol.
        Br J Obstet Gynecol. 1981; 88: 846-852
        • Powers M.S
        • Schenkel I
        • Darley P.E
        • et al.
        Pharmacokinetics and pharmacodynamics of transdermal dosage forms of 17 beta-estradiol.
        Am J Obstet Gynecol. 1985; 152: 1099-1106
        • Dollery C
        in: Boobis A.R Burley D Davies D.M Therapeutic Drugs. Churchill Livingstone, Edinburgh1991: 04-09
        • McCallum K.A
        • Reading C
        Hot flushes are induced by thermogenic stimuli.
        Br J Urol. 1989; 64: 507-509
        • Smith Jr, J.A
        Management of hot flushes due to endocrine therapy for prostate carcinoma.
        Oncology. 1996; 10: 1319-1322
        • Casper R.F
        • Yen S.S.C
        Neuroendocrinology of menopausal flushes.
        Clin Endocrinol. 1985; 22: 293-296
      1. Radlmaier A, Bormacher K, and Neumann F: Hot flushes: mechanism and prevention. EORTC Genitourinary Monograph 8: Treatment of Prostatic Cancer—Facts and Controversies, 1990, pp 131–140.

        • Sartor O
        • Eastham J.A
        Progressive prostate cancer associated with use of megestrol acetate administered for control of hot flashes.
        South Med J. 1999; 92: 415-416