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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Hot Flashes and Hypogonadism Symptoms in Patients with Prostate Cancer Receiving Hormone Replacement Therapy

Hyun Hye Park1, Jeong Sook Park2
Korean Journal of Adult Nursing 2014;26(2):159-170.
Published online: April 30, 2014

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Corresponding author: Park, Jeong Sook College of Nursing, Keimyung University,1095 Shindang-dong, Dalsseo-gu, Daegu 704-701, Korea. Tel: +82-53-580-3907, Fax: +82-53-580-3904, E-mail: jsp544@kmu.ac.kr
• Received: August 22, 2013   • Accepted: April 4, 2014

© 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This research investigated the degree and predictors of hot flashes and hypogonadism symptoms in patients with prostate cancer receiving hormone replacement therapy.
  • Methods
    The subjects were 111 patients with prostate cancer receiving hormone replacement therapy in two university hospitals located in D city. The measurement tools included Hot Flash Diary and AMS (Aging Male's Symptoms rating scales). The data were analyzed using t-test, ANOVA, and binary logistic regression analysis.
  • Results
    The percentage of patients who experienced hot flashes among the participants was 14.4%. The predictors for hot flashes were eating irregularly, having coffee frequently and the types of hormone. The average score of hypogonadism symptom was 2.16 out of five-point scale and the highest score of hypogonadism symptom was the sexual symptoms (2.77 out of five-point scale). The predictors for hypogonadism symptom were eating habits and years of having the illness.
  • Conclusion
    These findings provide the information that irregularly eating habit was an important factor in hot flashes and hypogonadism symptoms of the participants. Therefore the development of a nutritional education encouraging regular meals is necessary for the given population.
  • Key Words: Prostate cancer; Hot flashes; Hypogonadism; Hormone replacement therapy
Table 1.
Characteristics of Prostate Cancer Patients Receiving Hormone Therapy with Hot Flashes (N=16)
Characteristics Categories n (%) or M±SD
Hot flush Yes 16 (14.4)
No 95 (85.6)
Hot flashes onset Before receiving treatment 4 (25.0)
When treated 9 (56.3)
After 3 months of treatment 2 (12.5)
After 6 months of treatment 1 (6.2)
How to relieve Yes 0 (0.0)
No 16 (100.0)
Hot flashes related daily interference in work (work outside the home and housework) Many times 0 (0.0)
Often 2 (12.5)
Sometimes 1 (6.2)
Not 2 (12.5)
Never 11 (68.8)
Many times 0 (0.0)
Hot flashes related daily interference in social activities (time spent with family, friends, etc.) Often 2 (12.5)
Sometimes 1 (6.2)
Not 2 (12.5)
Never 11 (68.8)
Hot flashes diary Hot flashes score 43.63±25.20
Hot flashes frequency (times/1 day) 2.88±1.82
Hot flashes duration (minutes/1 time) 4.38±4.08
Sweat score 41.50±31.76
Palpitation score 11.00±20.16
Table 2.
Characteristics of Prostate Cancer Patients Receiving Hormone Therapy with Hypogonadism Symptoms (N=111)
Categories Question n (%) or M±SD
Total average score   2.16±0.66
Psychological factor Irritability 1.64±0.98
Nervousness 1.80±1.06
Anxiety 1.62±1.04
Depressive mood 1.84±1.11
Feeling burnt out, having hit rock-bottom 1.89±1.04
Subtotal score 1.76±1.05
Somatovegetative factor Decline in your feeling of general well-being 1.90±1.00
Joint pain and muscular ache 1.88±1.01
Excessive sweating 2.00±1.25
Sleep problems 2.15±1.27
Increased need for sleep, often feeling tired 1.95±1.17
Physical exhaustion / lacking vitality 2.07±1.06
Decrease in muscular strength 2.18±1.13
Subtotal score 2.02±1.13
Sexual factor Feeling that you have passed your peak 2.39±1.19
Decrease in beard growth 1.66±0.96
Decrease in ability/frequency to perform sexually 3.28±1.53
Decrease in the number of morning erections 3.29±1.54
Decrease in sexual desire/libido 3.24±1.55
Subtotal score 2.78±1.52
Table 3.
Hot Flashes and Hypogonadism Symptoms according to General Characteristics in Prostate Cancer Patients Receivin Hormone Therapy (N=111
Characteristics Categories Hot flashes DTS
Yes (n=16) No (n=95) x2 (p†) M±SD t or F (p) Scheffé
n (%) n (%)
Age (year) 60~69 5 (31.2) 16 (16.8) 2.62 2.42±0.61 2.32
70~79 9 (56.3) 53 (55.8) (.263) 2.13±0.67 (.103)
80~89 2 (12.5) 26 (27.4)   2.02±0.65  
M±SD 75.2±6.71      
Body Mass Index Normal weight 8 (50.0) 41 (43.2) 0.43 2.15±0.60 0.72
Overweight 4 (25.0) 31 (32.6) (.888) 2.08±0.74 (.488)
Obesity 4 (25.0) 23 (24.2)   2.28±0.67  
Spouse Have 13 (81.3) 77 (81.1) 2.28 2.20±0.66 1.36
Have not 3 (18.7) 18 (18.9) (.319) 1.98±0.68 (.176)
Education lever ≤Elementary school 3 (18.7) 28 (29.5) 0.88 2.13±0.56 0.32
Middle school 6 (37.5) 28 (29.5) (.701) 2.11±0.73 (.720)
≥High school 7 (43.8) 39 (41.0)   2.22±0.69  
Religion Protestant & catholic 4 (25.0) 21 (22.1) 1.28 2.09±0.78 0.17
Buddhism 7 (43.8) 31 (32.6) (.510) 2.19±0.66 (.839)
None 5 (31.2) 43 (45.3)   2.17±0.62  
Smoking status Smoker 4 (25.0) 15 (15.8) 0.81 2.35±0.69 1.35
Nonsmoker 12 (75.0) 80 (84.2) (.471) 2.12±0.65 (.178)
Drinking status (1 week) Rare 9 (56.3) 66 (69.5) 1.61) 2.07±0.63 2.35)
≤1 time 5 (31.2) 18 (18.9) (.450) 2.41±0.75 (.100)
≥2 times 2 (12.5) 11 (11.6)   2.21±0.64  
Eating habits Regular 11 (68.8) 69 (72.6) 6.92 2.04±0.63 16.20
Average 2 (12.5) 24 (25.3) (.029) 2.34±0.64 (＜.001)
Irregular 3 (18.7) 2 (2.1)   3.16±0.30 a＞b, c
Nutrition Balance 10 (62.5) 36 (37.9) 3.14 2.09±0.67 1.75
Average 5 (31.3) 43 (45.3) (.217) 2.29±0.59 (.178)
Unbalance 1 (6.2) 16 (16.8)   1.98±0.80  
Feeding habit Vegetarian 9 (56.3) 34 (35.8) 2.41 2.33±0.66 -2.17
A meat-eater 7 (43.7) 61 (64.2) (.166) 2.05±0.63 (.032)
Taste preference Evenly among all 10 (62.5) 61 (64.3) 0.49 2.10±0.68 0.74
Sweetness 4 (25.0) 18 (18.9) (.855) 2.22±0.62 (.476)
The others 2 (12.5) 16 (16.8)   2.31±0.66  
Water intake (1 day) ＜1 L 5 (31.2) 36 (37.9) 1.78 2.22±0.58 2.73
1~2 L 7 (43.8) 47 (49.5) (.396) 2.03±0.68 (.070)
＞2 L 4 (25.0) 12 (12.6)   2.45±0.74  
Coffee intake (1 day) ≤1 cup 4 (25.0) 56 (59.0) 8.09 2.12±0.66 1.12
2 cups 5 (31.2) 24 (25.2) (.013) 2.09±0.71 (.329)
≥3 cups 7 (43.8) 15 (15.8)   2.35±0.61  
Regular exercise (1 week) ＜3 times 5 (31.2) 25 (26.3) 0.16 2.05±0.58 -1.01
≥3 times 11 (68.8) 70 (73.7) (.762) 2.20±0.69 (.314)
Duration of treatment since diagnosis (year) ＜1 9 (56.3) 37 (38.9) 1.52 2.01±0.63 3.50
1~5 5 (31.2) 41 (43.2) (.457) 2.18±0.64 (.033)
＞5 2 (12.5) 17 (17.9)   2.48±0.70 a＜c
Duration of hormone therapy (year) ＜1 10 (62.5) 47 (49.5) 0.93 2.05±0.64 -1.84
≥1 6 (37.5) 48 (50.5) (.422) 2.28±0.68 (.068)
Kinds of hormones LHRH agonist 14 (87.5) 50 (52.6) 0.68 2.22±0.65 1.10
Antiandrogen 2 (12.5) 45 (47.4) (.012) 2.08±0.69 (.272)
Additional treatment No 10 (62.5) 56 (59.0) 1.69 2.21±0.69 0.50
Yes 4 (25.0) 16 (16.8) (.417) 2.04±0.65 (.606)
Operation radiotherapy y 2 (12.5) 23 (24.2)   2.13±0.61  

DTS=decreased testosterone symptoms; LHRH=luteinizing hormone releasing hormone.

†Obtained by Fisher's exact test.

Table 4.
Influencing Factors of Hot Flashes in Prostate Cancer Patients Receiving Hormone Therapy by Binary Logistic Regression Analysis (N=111)
Characteristics Categories B Wald OR (95% CI) p
BMI Obesity -0.36 0.21 1.44 (0.30~6.80) .643
Overweight -0.30 0.00 0.96 (0.20~4.52) .964
Normal weight     1  
Smoking status Smoker -0.40 0.26 0.66 (0.14~3.11) .606
Nonsmoker     1  
Eating habits Irregular 2.48 3.93 11.95 (1.02~138.90) .047
Average -0.31 0.12 0.73 (0.13~4.02) .719
Regular     1  
Coffee intake (1 day) ≥3 cups 2.18 7.12 8.89 (1.78~44.24) .008
2 cups 0.95 1.44 2.58 (0.54~12.18) .230
≤1 cup     1  
Regular exercise (1 week) ≥3 times 0.20 0.08 1.22 (0.30~4.92) .771
＜3 times     1  
Kinds of hormones LHRH agonist 2.03 5.70 7.61 (1.44~40.25) .017
Antiandrogen     1  

OR=odds ratio; CI=confidence interval; BMI=body mass index; LHRH=luteinizing hormone releasing hormone.

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    Hot Flashes and Hypogonadism Symptoms in Patients with Prostate Cancer Receiving Hormone Replacement Therapy
    Korean J Adult Nurs. 2014;26(2):159-170.   Published online April 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.2.159
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    Hot Flashes and Hypogonadism Symptoms in Patients with Prostate Cancer Receiving Hormone Replacement Therapy
    Korean J Adult Nurs. 2014;26(2):159-170.   Published online April 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.2.159
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    Hot Flashes and Hypogonadism Symptoms in Patients with Prostate Cancer Receiving Hormone Replacement Therapy
    Hot Flashes and Hypogonadism Symptoms in Patients with Prostate Cancer Receiving Hormone Replacement Therapy

    Characteristics of Prostate Cancer Patients Receiving Hormone Therapy with Hot Flashes (N=16)

    Characteristics Categories n (%) or M±SD
    Hot flush Yes 16 (14.4)
    No 95 (85.6)
    Hot flashes onset Before receiving treatment 4 (25.0)
    When treated 9 (56.3)
    After 3 months of treatment 2 (12.5)
    After 6 months of treatment 1 (6.2)
    How to relieve Yes 0 (0.0)
    No 16 (100.0)
    Hot flashes related daily interference in work (work outside the home and housework) Many times 0 (0.0)
    Often 2 (12.5)
    Sometimes 1 (6.2)
    Not 2 (12.5)
    Never 11 (68.8)
    Many times 0 (0.0)
    Hot flashes related daily interference in social activities (time spent with family, friends, etc.) Often 2 (12.5)
    Sometimes 1 (6.2)
    Not 2 (12.5)
    Never 11 (68.8)
    Hot flashes diary Hot flashes score 43.63±25.20
    Hot flashes frequency (times/1 day) 2.88±1.82
    Hot flashes duration (minutes/1 time) 4.38±4.08
    Sweat score 41.50±31.76
    Palpitation score 11.00±20.16

    Characteristics of Prostate Cancer Patients Receiving Hormone Therapy with Hypogonadism Symptoms (N=111)

    Categories Question n (%) or M±SD
    Total average score   2.16±0.66
    Psychological factor Irritability 1.64±0.98
    Nervousness 1.80±1.06
    Anxiety 1.62±1.04
    Depressive mood 1.84±1.11
    Feeling burnt out, having hit rock-bottom 1.89±1.04
    Subtotal score 1.76±1.05
    Somatovegetative factor Decline in your feeling of general well-being 1.90±1.00
    Joint pain and muscular ache 1.88±1.01
    Excessive sweating 2.00±1.25
    Sleep problems 2.15±1.27
    Increased need for sleep, often feeling tired 1.95±1.17
    Physical exhaustion / lacking vitality 2.07±1.06
    Decrease in muscular strength 2.18±1.13
    Subtotal score 2.02±1.13
    Sexual factor Feeling that you have passed your peak 2.39±1.19
    Decrease in beard growth 1.66±0.96
    Decrease in ability/frequency to perform sexually 3.28±1.53
    Decrease in the number of morning erections 3.29±1.54
    Decrease in sexual desire/libido 3.24±1.55
    Subtotal score 2.78±1.52

    Hot Flashes and Hypogonadism Symptoms according to General Characteristics in Prostate Cancer Patients Receivin Hormone Therapy (N=111

    Characteristics Categories Hot flashes DTS
    Yes (n=16) No (n=95) x2 (p†) M±SD t or F (p) Scheffé
    n (%) n (%)
    Age (year) 60~69 5 (31.2) 16 (16.8) 2.62 2.42±0.61 2.32
    70~79 9 (56.3) 53 (55.8) (.263) 2.13±0.67 (.103)
    80~89 2 (12.5) 26 (27.4)   2.02±0.65  
    M±SD 75.2±6.71      
    Body Mass Index Normal weight 8 (50.0) 41 (43.2) 0.43 2.15±0.60 0.72
    Overweight 4 (25.0) 31 (32.6) (.888) 2.08±0.74 (.488)
    Obesity 4 (25.0) 23 (24.2)   2.28±0.67  
    Spouse Have 13 (81.3) 77 (81.1) 2.28 2.20±0.66 1.36
    Have not 3 (18.7) 18 (18.9) (.319) 1.98±0.68 (.176)
    Education lever ≤Elementary school 3 (18.7) 28 (29.5) 0.88 2.13±0.56 0.32
    Middle school 6 (37.5) 28 (29.5) (.701) 2.11±0.73 (.720)
    ≥High school 7 (43.8) 39 (41.0)   2.22±0.69  
    Religion Protestant & catholic 4 (25.0) 21 (22.1) 1.28 2.09±0.78 0.17
    Buddhism 7 (43.8) 31 (32.6) (.510) 2.19±0.66 (.839)
    None 5 (31.2) 43 (45.3)   2.17±0.62  
    Smoking status Smoker 4 (25.0) 15 (15.8) 0.81 2.35±0.69 1.35
    Nonsmoker 12 (75.0) 80 (84.2) (.471) 2.12±0.65 (.178)
    Drinking status (1 week) Rare 9 (56.3) 66 (69.5) 1.61) 2.07±0.63 2.35)
    ≤1 time 5 (31.2) 18 (18.9) (.450) 2.41±0.75 (.100)
    ≥2 times 2 (12.5) 11 (11.6)   2.21±0.64  
    Eating habits Regular 11 (68.8) 69 (72.6) 6.92 2.04±0.63 16.20
    Average 2 (12.5) 24 (25.3) (.029) 2.34±0.64 (＜.001)
    Irregular 3 (18.7) 2 (2.1)   3.16±0.30 a＞b, c
    Nutrition Balance 10 (62.5) 36 (37.9) 3.14 2.09±0.67 1.75
    Average 5 (31.3) 43 (45.3) (.217) 2.29±0.59 (.178)
    Unbalance 1 (6.2) 16 (16.8)   1.98±0.80  
    Feeding habit Vegetarian 9 (56.3) 34 (35.8) 2.41 2.33±0.66 -2.17
    A meat-eater 7 (43.7) 61 (64.2) (.166) 2.05±0.63 (.032)
    Taste preference Evenly among all 10 (62.5) 61 (64.3) 0.49 2.10±0.68 0.74
    Sweetness 4 (25.0) 18 (18.9) (.855) 2.22±0.62 (.476)
    The others 2 (12.5) 16 (16.8)   2.31±0.66  
    Water intake (1 day) ＜1 L 5 (31.2) 36 (37.9) 1.78 2.22±0.58 2.73
    1~2 L 7 (43.8) 47 (49.5) (.396) 2.03±0.68 (.070)
    ＞2 L 4 (25.0) 12 (12.6)   2.45±0.74  
    Coffee intake (1 day) ≤1 cup 4 (25.0) 56 (59.0) 8.09 2.12±0.66 1.12
    2 cups 5 (31.2) 24 (25.2) (.013) 2.09±0.71 (.329)
    ≥3 cups 7 (43.8) 15 (15.8)   2.35±0.61  
    Regular exercise (1 week) ＜3 times 5 (31.2) 25 (26.3) 0.16 2.05±0.58 -1.01
    ≥3 times 11 (68.8) 70 (73.7) (.762) 2.20±0.69 (.314)
    Duration of treatment since diagnosis (year) ＜1 9 (56.3) 37 (38.9) 1.52 2.01±0.63 3.50
    1~5 5 (31.2) 41 (43.2) (.457) 2.18±0.64 (.033)
    ＞5 2 (12.5) 17 (17.9)   2.48±0.70 a＜c
    Duration of hormone therapy (year) ＜1 10 (62.5) 47 (49.5) 0.93 2.05±0.64 -1.84
    ≥1 6 (37.5) 48 (50.5) (.422) 2.28±0.68 (.068)
    Kinds of hormones LHRH agonist 14 (87.5) 50 (52.6) 0.68 2.22±0.65 1.10
    Antiandrogen 2 (12.5) 45 (47.4) (.012) 2.08±0.69 (.272)
    Additional treatment No 10 (62.5) 56 (59.0) 1.69 2.21±0.69 0.50
    Yes 4 (25.0) 16 (16.8) (.417) 2.04±0.65 (.606)
    Operation radiotherapy y 2 (12.5) 23 (24.2)   2.13±0.61  

    DTS=decreased testosterone symptoms; LHRH=luteinizing hormone releasing hormone.

    †Obtained by Fisher's exact test.

    Influencing Factors of Hot Flashes in Prostate Cancer Patients Receiving Hormone Therapy by Binary Logistic Regression Analysis (N=111)

    Characteristics Categories B Wald OR (95% CI) p
    BMI Obesity -0.36 0.21 1.44 (0.30~6.80) .643
    Overweight -0.30 0.00 0.96 (0.20~4.52) .964
    Normal weight     1  
    Smoking status Smoker -0.40 0.26 0.66 (0.14~3.11) .606
    Nonsmoker     1  
    Eating habits Irregular 2.48 3.93 11.95 (1.02~138.90) .047
    Average -0.31 0.12 0.73 (0.13~4.02) .719
    Regular     1  
    Coffee intake (1 day) ≥3 cups 2.18 7.12 8.89 (1.78~44.24) .008
    2 cups 0.95 1.44 2.58 (0.54~12.18) .230
    ≤1 cup     1  
    Regular exercise (1 week) ≥3 times 0.20 0.08 1.22 (0.30~4.92) .771
    ＜3 times     1  
    Kinds of hormones LHRH agonist 2.03 5.70 7.61 (1.44~40.25) .017
    Antiandrogen     1  

    OR=odds ratio; CI=confidence interval; BMI=body mass index; LHRH=luteinizing hormone releasing hormone.
    Table 1. Characteristics of Prostate Cancer Patients Receiving Hormone Therapy with Hot Flashes (N=16)

    Table 2. Characteristics of Prostate Cancer Patients Receiving Hormone Therapy with Hypogonadism Symptoms (N=111)

    Table 3. Hot Flashes and Hypogonadism Symptoms according to General Characteristics in Prostate Cancer Patients Receivin Hormone Therapy (N=111

    DTS=decreased testosterone symptoms; LHRH=luteinizing hormone releasing hormone.

    Obtained by Fisher's exact test.

    Table 4. Influencing Factors of Hot Flashes in Prostate Cancer Patients Receiving Hormone Therapy by Binary Logistic Regression Analysis (N=111)

    OR=odds ratio; CI=confidence interval; BMI=body mass index; LHRH=luteinizing hormone releasing hormone.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

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