Would you use fezolinetant for hot flashes for men on ADT?

I might consider it after trying the usual agents that will at least partially relieve symptoms in the majority of patients, such as low-dose megestrol or venlafaxine (there are others, but these are the ones with which I have had the most experience and success).

Fezolinetant is expensive and requi...

Start with medroxyprogesterone 20 mg daily.

“Medroxyprogesterone could be considered to be the standard treatment for hot flushes in men undergoing androgen suppression for prostate cancer.”

Reference: Irani et al., PMID 19963436

Presently, I would not use Fezolinetant. First I try Effexor. It can be helpful. But in my experience, this works in a minority of men's bothersome hot flashes.

The next step, which is much more effective is low-dose estrogen patches. This has been studied in randomized clinical trials - Russell et a...