Can Hypnotherapy Help Hot Flushes and Hot Flashes? What the Research Really Shows

Hot flushes are physical, hormonal and can be maddeningly unpredictable. Clinical hypnosis is also one of the more surprising non-hormonal approaches with clear evidence behind it. So how could something happening in the mind influence something happening so obviously in the body?

You can be halfway through a sentence when it starts... A gathering warmth across the chest. Heat climbing towards the neck and face. Perhaps your heart becomes suddenly more noticeable. Your skin prickles. Within seconds, you are acutely aware of your body in a way you were not moments earlier.

For another woman, it may feel completely different. The heat arrives all at once. Sweat gathers at the hairline. Her heart races. She feels briefly light-headed or clammy, sometimes both. Someone else feels intensely hot for several minutes and then unexpectedly cold afterwards. At night, a flush can mean throwing back the duvet, waiting for your skin to cool, turning the pillow over and trying to find that comfortable place from which sleep might return.

There is no single version.

Hot flushes, commonly called hot flashes in the United States, are among the best-known symptoms of perimenopause and menopause. Along with night sweats, they are known medically as vasomotor symptoms. They can be mild and occasional. They can also arrive many times across a day and night, affecting sleep, concentration, confidence and the ordinary logistics of living, and sometimes the unpredictability becomes almost as intrusive as the heat itself.

You start thinking about the temperature of rooms you have not entered yet. You know where the window is. You have a fan in your bag. You reconsider the jumper. You wonder whether the restaurant will be warm. You look at tomorrow's meeting and hope your body behaves itself.

So when somebody suggests that hypnotherapy might help, a perfectly reasonable question is:

How?

The heat is real. The sweating is real. The hormonal changes are real. What could hypnosis possibly have to do with any of that? The answer starts with what a hot flush actually is.

What actually happens during a hot flush?

Your brain is regulating your temperature all day, every day. Most of the time, you never notice.

When your body needs to lose heat, however, it has several ways of doing it. Blood vessels close to the skin can widen so that more heat can escape, sweating can increase and changes occur in circulation.

During the menopause transition, falling and fluctuating oestrogen levels affect the neural systems involved in this temperature regulation.

One influential explanation is that the body's comfortable temperature range becomes narrower. A relatively small internal temperature change can therefore be enough to trigger a much bigger heat-loss response than is necessary.

Researchers have also learnt much more in recent years about a group of neurons in the hypothalamus known as KNDy neurons. They are involved in the communication between reproductive hormones and the brain's temperature-regulating systems, with neurokinin B signalling playing an important role. This is an area of active research, and the complete biology is still being refined, but one point is increasingly clear: A hot flush involves the brain. The hypothalamus receives and processes information about temperature and helps coordinate the physical response that follows. Blood vessels change. Sweating begins. Heat moves towards the skin.

That does not make a hot flush imaginary or somehow all in your head. Your brain is part of your body. Understanding that makes the idea of influencing this response through hypnosis considerably less strange.

Hot flushes begin with changes in the body’s temperature-regulation system. The hypothalamus plays a central role in detecting temperature changes and coordinating responses such as sweating and increased blood flow to the skin.

Is this normal, or should I be worried?

For a woman going through perimenopause or menopause, hot flushes and night sweats are extremely familiar symptoms. They can include sudden sensations of heat, particularly across the face, neck and chest, sweating, palpitations, dizziness or feeling cold afterwards. At night, the same vasomotor response can wake you from sleep.

The fact that they can feel dramatic does not usually mean that something dangerous is happening, but there is no need to assume that every unexplained episode of flushing must be menopause either.

If flushing is new or unusual for you, particularly severe, difficult to explain, happening outside the context in which you would expect menopausal symptoms, or accompanied by other symptoms that concern you, it is sensible to speak to your GP. It is also worth asking for help simply because your symptoms are interfering with your life. You don't have to wait until they become unbearable before discussing treatment. And there are treatments. More than one.

Your mind changes your body all the time

You probably already know what embarrassment can do to your face, or what fear can do to your heartbeat. You can feel sick before an important conversation. Your palms can sweat while waiting outside an interview. A nightmare can leave you with your heart pounding even though you have been lying safely in bed.

These responses are physical, yet they begin with information being processed by the brain.

See and feel it for yourself. There is a simple experiment you can do while reading this.

Imagine a fresh, zesty lemon.

See the bright yellow skin, slightly dimpled and glossy.

Imagine holding it firmly on a chopping board and drawing a sharp knife through the middle. As the blade breaks the skin, a fine mist of citrus oil escapes into the air and that clean, sharp lemon scent rises towards you.

The two halves fall apart, revealing the glistening flesh inside, bursting with tangy juice.

Now imagine cutting away a small wedge. Pick it up between your fingers. Perhaps a little juice is already running onto your fingertips. Bring it towards your mouth.

You can smell the fresh, zesty lemon before it reaches your lips.

Now imagine opening your mouth and biting firmly into the flesh. Feel the juice burst across your tongue; intensely sharp, bright and sour, catching at the sides of your mouth and underneath your tongue.

Imagine sucking the wedge once more, drawing out another mouthful of that concentrated lemon juice.

Did your mouth react? Simply imagining biting into a sharp, juicy lemon can be enough to produce a physical response. It is a small, familiar example of how vividly processed information can influence the body.

What is happening in your mouth right now?

Perhaps you noticed saliva gathering beneath your tongue. Perhaps your jaw tightened slightly, or you felt that unmistakable reaction at the sides of your mouth, and yet there is no lemon. Nothing has touched your tongue. Your body has responded to information being generated and processed by your brain.

These responses are physical, yet they begin with information being processed by the brain.

Hypnosis deliberately works with this capacity.

Rather than attention moving constantly between your surroundings, thoughts, worries and sensations, hypnosis focuses it much more narrowly. Suggestions, imagined sensations and expectations can then become unusually absorbing.

For someone using hypnotherapy to reduce the frequency and intensity of their hot flushes, that experience might involve sensations of coolness, comfort and settling.

That might mean cool air moving across the skin.

Standing beside the sea.

The sensation of water around your feet.

Opening a window on a cold morning.

Smooth, cool fabric.

Turning an imagined temperature dial slowly towards comfortable.

The exact imagery is less important than whether it evokes a convincing response for that particular person.

Is hypnosis simply relaxation?

This is where the research becomes particularly interesting.

Hypnosis can be deeply relaxing, and feeling calmer during a hot flush is hardly going to make the experience worse, but relaxation alone does not adequately explain the research.

In its evidence review of non-hormonal treatments for menopausal vasomotor symptoms, The Menopause Society included clinical hypnosis among its recommended approaches. General relaxation and paced breathing were not given the same recommendation as treatments for reducing vasomotor symptoms and that distinction is worth noticing.

Clinical hypnosis combines focused attention with suggestion, imagery and repeated rehearsal of particular experiences and responses. And when researchers began measuring what happened to women using it, they found something more interesting than simple relaxation.

The study that changed the conversation

One of the most important trials involved 187 postmenopausal women experiencing frequent hot flushes.

Clinical hypnosis produced substantial reductions in hot flushes, including those detected through physiological monitoring, not simply those reported by participants.

Women were randomly assigned either to five weekly clinical hypnosis sessions or to a structured-attention control condition.

By the 12-week follow-up, women receiving hypnosis reported a reduction of around 74 per cent in hot-flush frequency, compared with approximately 17 per cent in the control group. Their overall hot-flush score, which combined frequency and severity, fell by around 80 per cent.

Those numbers are striking.

But another part of the study may matter even more if you are wondering whether hypnosis simply makes people feel that their symptoms have improved.

Researchers also used physiological monitoring to detect hot-flush activity and they found that objectively monitored hot flushes fell by around 57 per cent in the hypnosis group, compared with around 10 per cent in the control group. The monitoring equipment was registering fewer hot flushes too.

That is one of the findings that makes this research particularly interesting. The women were not simply reporting that they felt less bothered by the same number of flushes, a measurable physiological change was detected as well.

The evidence began with women affected by breast cancer

An earlier strand of the research involved a group for whom non-hormonal approaches can be especially important.

A randomised trial studied breast cancer survivors experiencing hot flushes. Cancer treatment can trigger or intensify menopausal symptoms, while hormone therapy may be unsuitable for some women depending on their cancer and treatment history.

After five weekly hypnosis sessions, hot-flush scores in the hypnosis group fell by 68 per cent compared with the control condition.

There was another important part of the intervention. The women practised. They were taught self-hypnosis and given recordings to use between sessions. Hypnosis was not treated as something that happened once in a consulting room and then somehow continued working by itself. Repetition was built into the process.

More recent research has taken that idea considerably further.

What happens when women practise hypnosis at home?

A large randomised clinical trial published in JAMA Network Open in 2025 involved 250 postmenopausal women experiencing hot flashes. Instead of relying on weekly face-to-face hypnosis, women used self-administered hypnosis recordings over six weeks.

The comparison group listened to white-noise recordings designed to create a credible control for factors such as attention and expectation.

After six weeks, hot-flash scores had fallen by 53.4 per cent in the hypnosis group, compared with 40.9 per cent in the control group. The extent to which hot flashes interfered with everyday life also fell more in the hypnosis group.

There is an important detail in those figures. The control group improved too. It would be easy to leave that out and present the hypnosis figure on its own. It would also give a less accurate picture of the study. Expectation matters. Taking part in research can matter. Repeatedly listening to something intended to help can matter. This is precisely why researchers use comparison groups.

The useful finding is that the women practising hypnosis showed greater improvement despite those effects being present in both groups. That gives us encouraging evidence.

So what is hypnosis actually changing?

We currently know more about whether hypnosis can help than precisely how it produces those changes.

However, what we do know is that hypnosis changes the way attention, expectation, perception and suggestion are processed. In the context of hot flushes, repeated experiences of cooling and comfort may influence how the brain responds to temperature-related signals and how readily particular physiological responses are activated. Exactly where those effects enter the thermoregulatory system remains an area for further research.

Then there is everything that happens around the flush

Whilst a hot flush may last only a few minutes, it can occupy considerably more of your life than that.

You choose the seat near the window. You layer your clothes because you know that at some point you may need to remove something quickly. You are halfway through getting ready and wonder whether putting on make-up is worth it. You finally get comfortable in bed beside somebody who appears to be sleeping at an entirely reasonable temperature. Then the heat arrives again. Or you walk into a meeting and immediately register how warm the room feels.

Please, not now.

This part matters because the experience of a hot flush can gradually become larger than the physiological event itself. The anticipation comes first. Then the first hint of warmth. Then perhaps a rapid internal check.

Is this one?

How strong is it going to be?

Can anybody see?

None of those thoughts caused your menopause. They don't mean you are creating the symptom but they can become part of what your brain has learnt to associate with the beginning of a flush and that gives us another possible place to intervene.

The importance of what happens next

Imagine noticing the first warmth beginning. For months, perhaps years, that sensation may have set off a familiar sequence almost automatically: recognition, frustration, a quick scan of the body.

How bad is this one going to be? Can anybody see? How long will it last?

Now imagine that the first hint of warmth begins to cue something different. Perhaps it is a slower breath. Perhaps your mind goes almost immediately to the cooling sensation you have rehearsed, or you notice your body beginning to settle rather than bracing for what comes next.

The flush has not been wished away. You are simply no longer meeting its arrival in quite the same way and this is where hypnosis becomes particularly interesting. The aim is not only to make a hot flush easier to tolerate. Clinical trials suggest that repeated hypnosis practice may reduce the hot flushes themselves, as well as the extent to which they interfere with everyday life.

Which raises another question: Why practise cooling when you aren't hot?

Why practise when you're not having a hot flush?

Because a difficult moment is rarely the ideal time to learn a new response.

Repeated self and guided-hypnosis gives the brain an opportunity to become familiar with cooling and settling when there is no immediate pressure to make anything happen.

Think about the difference between these two situations. In the first, a flush is already intense and you are desperately trying to think of something cold because you want it to stop. In the second, you have experienced the same cooling sequence dozens of times. You recognise the first warmth and begin moving into something familiar.

One is improvisation under pressure. The other is practice.

This helps explain why recordings feature in the research. They allow the experience to be repeated between sessions until the response becomes easier to access. You're not trying to win an argument with your body every time a hot flush arrives. You're giving it a route you have travelled before.

And what about night sweats?

Night sweats bring another difficulty into the picture: sleep. A flush wakes you. Then the mind wakes up too. You notice the bedding. You notice how warm you feel. You look at the clock. Now you are thinking about the meeting tomorrow, the school run, the alarm or how many hours remain before morning. Perhaps you cool down quickly but you are still awake.

Clinical hypnosis research has reported improvements in sleep as well as in hot-flush symptoms and the extent to which those symptoms interfere with everyday life.

For someone dealing with night sweats, the useful response may therefore include two parts: settling the physical experience and becoming better able to return to sleep once the flush has passed. Sometimes the difference that matters the following morning is not only whether you woke at 2.17am. It is whether you were still awake at 3.17am.

A hot flush can carry meaning as well as heat

There can be another layer to all of this that is harder to capture in a symptom score but is, nonetheless, something that comes up in client sessions.

For some women, a hot flush feels like a very public announcement of something deeply personal. The body reveals the transition before they have decided whether they want anybody else to know about it. Perhaps they are still getting used to the idea themselves.

Menopause can intersect with feelings about ageing, fertility, sexuality, attractiveness, work, identity and the strange experience of inhabiting a body that has begun behaving differently from the one you knew. That is not every woman's experience. For some, menopause feels liberating. For others, emotionally neutral. For many, the feelings change depending on the day. But if a hot flush makes you feel suddenly conspicuous, embarrassed or unlike yourself, that deserves to be recognised as part of the experience rather than dismissed as vanity. What the symptom means to you can matter alongside what the symptom physically does.

So what can you actually do about hot flushes?

You have options.

For women who can and want to use it, HRT is an established and highly effective treatment for menopausal vasomotor symptoms. The choice of HRT depends on individual circumstances and medical history and should be discussed with an appropriate healthcare professional.

Menopause-specific cognitive behavioural therapy can also help with vasomotor symptoms and with some of the sleep difficulties associated with menopause.

There are non-hormonal prescription treatments that may be appropriate for some women, particularly when HRT is unsuitable or unwanted.

And clinical hypnosis is recognised by The Menopause Society as one of the evidence-based non-hormonal approaches for hot flushes.

Practical measures have a different role. Lightweight clothing, a cooler bedroom, fans, cold drinks and learning which personal triggers matter to you may make hot flushes easier to navigate. It is useful to distinguish those comfort measures from treatments studied specifically for reducing vasomotor symptoms.

You don't have to choose one camp and defend it. For some women, the answer will be HRT. For others, a non-hormonal approach. For some, several things used together. The aim is to find an approach that is appropriate for your health and improves your life.

Where does that leave hypnosis?

As an evidence-led option that sits at the point where physiology, perception, attention and learning meet.

It doesn't require you to believe that menopause is psychological. It doesn't require you to reject HRT. And it doesn't ask you to pretend that the heat isn't happening.

Clinical hypnosis gives you a structured way of practising a different response, while the research suggests that its effects may extend beyond coping with the symptom to reductions in the symptom itself.

For a woman who feels she has been waiting for her body to decide what happens next, that possibility can be significant.

What does hypnosis for hot flushes actually feel like?

Probably much less dramatic than you might imagine. There is no requirement to lose consciousness, surrender control or see elaborate pictures in your mind. You remain able to hear, think and respond throughout the session.

What changes is the quality of attention. You may first become more physically comfortable and settled. Then your attention might be guided towards an experience you associate with cooling.

For one woman, that could be standing barefoot where the North Sea reaches the sand. For another, opening a bedroom window on a crisp morning. Someone else may see almost nothing mentally but respond strongly to the remembered feeling of cool air across her arms. Another may prefer something abstract, such as turning a temperature dial down until the body reaches exactly the right level of comfort.

There is no prize for having the best imagination. The useful experience is the one your brain responds to. Then you practise it.

Perhaps the most important thing is having a response

There is an unhelpful division that still appears in conversations about symptoms like these. Something is either physical, in which case the mind is treated as irrelevant, or it is psychological, which can leave people feeling that the symptom is somehow being questioned.

Hot flushes show us how inadequate that distinction can be. Hormonal changes matter, the hypothalamus matters, blood vessels and sweat glands matter, and the brain remains part of the body.

Clinical hypnosis gives researchers an intriguing way of working with that fact because the studies are not asking women to think positively until menopause disappears. Instead, they are showing that a physiological response involving the brain appears to be responsive, to some degree, to a deliberate process involving attention, suggestion and repeated experience. That's interesting whether you ever choose hypnosis or not.

Perhaps the most useful conclusion from all of this is not that every woman experiencing hot flushes should have hypnotherapy. It is that having hot flushes doesn't mean your only option is to put up with them and wait. There are treatments. There are practical ways of making the difficult moments easier. There is increasingly sophisticated science explaining why these symptoms happen and there is evidence that at least some of the processes involved may be more responsive to our own experience than we once realised.

For some women, hypnosis may mean fewer hot flushes. For others, the difference may be that they become less disruptive. There can also be value in something smaller and harder to measure: moving from 'I hope this doesn't happen,' to 'If it does, I know what I can do. Your body is changing. That doesn't mean you're powerless within that change.

A note on medical support

Hot flushes and night sweats can have causes other than menopause. If flushing is new, unusual, severe, unexplained or accompanied by other worrying symptoms, speak to your GP.

If menopause symptoms are affecting your sleep, work, relationships or quality of life, you can also speak to your GP about the treatment options available to you. You don't need to wait until symptoms become severe before asking for support.

If you are curious about the kind of cooling response described in this guide, my free Hot Flush Cool-Down offers a short introduction to the approach. You can also find more information about hypnotherapy for menopausal hot flushes through Jonathan James Pathways.

Research and further reading

• Elkins GR, Marcus J, Stearns V, et al. Randomised trial of a hypnosis intervention for treatment of hot flashes among breast cancer survivors. Journal of Clinical Oncology. 2008.

• Elkins GR, Fisher WI, Johnson AK, Carpenter JS, Keith TZ. Clinical hypnosis in the treatment of postmenopausal hot flashes: a randomised controlled trial. Menopause. 2013.

• The North American Menopause Society Advisory Panel. The 2023 Non-hormone Therapy Position Statement of The North American Menopause Society. Menopause. 2023.

• Elkins G, et al.Self-Administered Hypnosis vs Sham Hypnosis for Hot Flashes: A Randomized Clinical Trial. JAMA Network Open. 2025.

• National Institute for Health and Care Excellence (NICE). Menopause: identification and management (NG23). Current clinical guidance on assessment and treatment of menopausal symptoms.

• NHS. Menopause and perimenopause: symptoms, treatment and things you can do.