Most patients with advanced metastatic prostate cancer are commonly treated with endocrine drugs. Compared with surgical treatment and chemotherapy, endocrine therapy has obvious advantages in terms of safety and adverse effects. However, in clinical work, it is true that some patients receiving endocrine therapy have recurrent symptoms of significant hot flashes and sweating. Although these symptoms do not lead to serious adverse consequences, recurrent episodes can significantly affect the quality of life of patients. Moreover, there is no uniform and effective clinical management for hot flashes and sweating symptoms, which causes problems for many patients who must apply endocrine drugs regularly. What exactly causes these symptoms and how to deal with them? Hot flashes that occur after receiving endocrine therapy are generally characterized by the following: the patient first feels a rise in temperature on the face and trunk, accompanied by a flushing of dilated skin vessels on the face, neck and extremities, which is usually followed by a significant display of sweating. It occurs because after the use of anti-androgen producing drugs, the patient’s body levels of luteinizing hormone and follicle stimulating hormone are significantly reduced, reflexively leading to the release of catecholamine hormones in the hypothalamus, especially norepinephrine. These increased hormones act like a tidal wave on the thermoregulatory center in the anterior hypothalamus, leading to abnormal and poorly regulated peripheral vasodilatation in the body, which in turn leads to recurrent hot flashes and sweating. In most patients, the symptoms of hot flashes and sweating will gradually decrease or disappear after regular endocrine medication is started. For patients with persistent symptoms that do not resolve or significantly affect quality of life, targeted medication is recommended. Currently reported effective drugs include estrogen, progesterone, colistin, gabapentin, and selective 5-hydroxytryptamine reuptake inhibitors. Because the clinical application of these drugs also involves effects or reactions on other systems, it is recommended that patients should be selected for application under the guidance of a physician during an outpatient follow-up visit.