What Does This Mean for Men Living With “Male Menopause”?
- Experiencing “male menopause” during prostate cancer treatment can feel isolating and frustrating.
- Many men feel unprepared for how much hormone therapy can affect their bodies and emotions.
- But a new research offers something many patients have been missing: hope and validation.
- Oxybutynin, a medication that has been used for decades, might be a treatment option for men who are struggling.
- Men taking oxybutynin reported much greater improvements in how hot flashes interfered with their daily activities and improvements were especially noticeable with the higher dose.
- While oxybutynin may not be right for everyone, this study gives doctors solid evidence to discuss it as a treatment option for men who are struggling.
These experiences are often described as “male menopause,” a term many patients use to explain what happens when testosterone levels drop very low during hormone therapy for prostate cancer.
“They Put Me Into Menopause — And Nobody Told Me What That Meant”
Read MoreGary’s experience is not unusual. Studies show that up to 80% of men receiving androgen deprivation therapy (ADT) experience hot flashes. For many, they occur multiple times a day and night, disrupting sleep and daily routines.
But for Gary, the physical symptoms were only part of the story.
Gary Schobel is the focus of a new SurvivorNet original documentary film, “A Firefighter’s Biggest Fight”, part of SurvivorNet’s ongoing landmark film series, “Men Beating The Odds”, highlighting men surviving a prostate cancer diagnosis with new passion and purpose.
When Hormone Changes Affect Emotions and Identity
Testosterone does more than fuel prostate cancer growth. It plays a role in mood regulation, emotional resilience, sexual desire, and a man’s sense of self. When levels fall rapidly, the emotional effects can be startling.
Hoping his story would help other men understand just how real these changes are, Gary shared something deeply personal:
“I’ve never cried so much,” he said. “At one point I told my wife, ‘I’ve got to get some testosterone. This is crazy. I’m just crying all the time.’”
Many men on hormone therapy report increased emotional sensitivity, sadness, or tearfulness… feelings they may never have experienced before. For men who have spent a lifetime being taught to suppress emotion, this shift can feel confusing or frightening.
And when these changes aren’t explained ahead of time, they can strain relationships.
“Do You Even Love Me Anymore?”
One of the most painful aspects of male menopause for many couples is the impact on intimacy and connection. Loss of sexual desire is common during ADT, but the emotional distance that can accompany it often comes as a surprise. Gary has been maried woth Christine for over 30 years and he recalls:
“Where would your relationship be with your spouse if intimacy was absent, gone? You don’t even have those thoughts anymore. And I didn’t see this coming.”
“It’s going to change the way you are as a man,” Gary said candidly.
For Gary and Christine, the changes raised questions neither of them expected.
“Nobody told me about this,” Gary said. “And I was grateful when my wife asked me, but I was puzzled when my wife asked me one morning, ‘Gary, do you even love me anymore?’”
These moments can be heartbreaking, not because love is gone, but because hormones are quietly reshaping how love is expressed and felt.
But new research is helping doctors find better ways to treat these undesired side effects.
A recent clinical study has brought encouraging news for men struggling with hot flashes during hormone therapy. The study found that a medication called oxybutynin, which doctors have used safely for many years for other conditions, can significantly reduce hot flashes and improve quality of life for men receiving ADT for prostate cancer.
New Research Offers Hope for Managing Hot Flashes
For years, men like Gary were told that hot flashes were simply something they had to endure. While some medications existed, options were limited and not always effective.
A recent clinical study offers new hope.
In a carefully designed randomized trial, researchers studied oxybutynin, to see if it could help men experiencing hot flashes during hormone therapy for prostate cancer.
Men in the study were having frequent hot flashes (at least 28 per week) and were given either oxybutynin or a placebo for six weeks.
What the Study Found
Fewer Hot Flashes
Men who received oxybutynin had greater reductions in the number of daily hot flashes than those who received placebo. The higher dose led to the largest improvement.
On average:
- Men taking placebo had about 2 fewer hot flashes per day
- Men taking the lower dose of oxybutynin had nearly 5 fewer hot flashes per day
- Men taking the higher dose had almost 7 fewer hot flashes per day
Less Severe Symptoms
Hot flashes didn’t just happen less often — they were also less intense. Men reported meaningful reductions in how severe their hot flashes felt, and these improvements often began within the first week of treatment.
Meaningful Improvement for Many Patients
A particularly important finding was how many men experienced a major improvement.
By the end of the study:
- About one-third of men on placebo had their hot flashes reduced by at least half
- More than half of men on the lower dose of oxybutynin achieved this level of improvement
- Nearly 80% of men on the higher dose experienced at least a 50% reduction
For many patients, this level of improvement can be life-changing.
Better Quality of Life, Not Just Fewer Symptoms
The study also looked at how hot flashes affected daily life: including sleep, mood, relationships, enjoyment of life, and overall well-being.
Men taking oxybutynin reported much greater improvements in how hot flashes interfered with their daily activities compared with those taking placebo. Improvements were especially noticeable with the higher dose.
This matters because managing symptoms isn’t just about numbers. It’s about:
- Sleeping through the night
- Feeling less exhausted during the day
- Being more present with family
- Regaining a sense of normalcy
Was the Medication Safe?
Safety is especially important for men undergoing cancer treatment, many of whom are older and may already be dealing with other health concerns.
In this study:
- No serious side effects caused by oxybutynin were reported
- The most common side effect was dry mouth, which is well known with this medication
- Urinary symptoms did not worsen overall
- Men did not report meaningful short-term problems with memory or concentration during the study period
These findings are reassuring, especially given oxybutynin’s long history of use in clinical practice. One leading prostate cancer specialist, Urologic Oncologist Dr. Leonard G. Gomella from Philadelphia’s Thomas Jefferson University, is embracing the new data with enthusiasm, telling SurvivorNet, “we currently do not have a standard treatment for this annoying condition. The new research just reported has nicely demonstrated that a readily available and well-studied medication, oxybutynin, can provide men with an effective option for hot flush relief.”
Why This Matters for Men and Families
For men like Gary Schobel, these findings validate something patients have long known: hot flashes and emotional changes during hormone therapy are real, disruptive, and deserving of treatment.
They also offer something equally important — options.
Talking to Your Doctor
If hot flashes are affecting your sleep, mood, or daily life, it’s important to talk openly with your care team. You don’t need to suffer in silence.
You might ask:
- Are my symptoms typical for hormone therapy?
- Could oxybutynin be an option for me?
- What dose would make sense to start with?
- What side effects should I watch for?
- Every patient is different, and decisions should always be made together with your healthcare provider.
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