Hypnosis for hot flashes: what the trials and guidelines say

What do menopause experts recommend?

In 2023, an expert panel for The North American Menopause Society reviewed the research on nonhormone treatments for hot flashes and night sweats. It graded each option as Level I (good and consistent evidence), Level II (limited or inconsistent) or Level III (consensus and expert opinion). Clinical hypnosis was recommended at Level I, alongside cognitive-behavioral therapy, SSRI/SNRI antidepressants, gabapentin and fezolinetant.^[4]

The same panel did not recommend paced breathing (Level I), or relaxation, mindfulness-based interventions, yoga, exercise, cooling techniques or avoiding triggers (Level II), as treatments for hot flashes.^[4] So the recommendation covers clinical hypnosis as it was tested, not any calming recording.

The panel also stated that hormone therapy remains the most effective treatment and should be considered for women within 10 years of their final period. Nonhormone options matter most for women who cannot or prefer not to use hormones, for example after an estrogen-dependent cancer or with cardiovascular disease.^[4]

What happened in the main trial?

The largest therapist-led trial enrolled 187 postmenopausal women who had at least seven hot flashes a day, or 50 a week. They received five weekly sessions of either clinical hypnosis or a structured-attention control: five sessions of discussion, listening and encouragement with a trained clinician, without hypnotic inductions or cooling suggestions.^[1] In the full paper, each 45-minute session used imagery of coolness, a safe place and relaxation, adjusted to each woman's preferences. Participants also got an audio recording of a hypnotic induction and were asked to practice self-hypnosis at home every day.^[1]

Hot flashes were counted in daily diaries and, separately, with a skin conductance monitor. From the start to week 12, the hypnosis group reported 74% fewer hot flashes on average, compared with 17% fewer in the control group. The monitor showed a smaller drop, 57% versus 10%, but the difference between groups held. Hot flash interference with daily life, sleep quality and treatment satisfaction also improved more with hypnosis.^[1]

What about breast cancer survivors?

An earlier trial randomized 60 breast cancer survivors with at least 14 hot flashes a week to five weekly hypnosis sessions or no treatment. Of these, 51 completed the study. By the end of treatment, hot flash scores (frequency multiplied by average severity) had fallen 68% in the hypnosis group. Compared with no treatment, the hypnosis group also reported less anxiety, less depression, less interference with daily activities and better sleep.^[2]

Two cautions. The control group got nothing, so attention and expectation were not controlled for. And the trial was small. Still, this group matters because hormone therapy is often not an option after an estrogen-dependent cancer.^[4]

Does audio alone work?

A 2025 trial of 250 postmenopausal women compared six weeks of self-administered hypnosis audio with a sham audio of white noise presented as hypnosis. Hot flash scores fell 53.4% with hypnosis and 40.9% with the sham, a statistically significant difference.^[3] The sham group improved a lot, so time, routine and expectation explain much of the change, and the extra benefit from hypnosis was much smaller than in the therapist-led trial. We cover this trial in detail in what the 250-woman audio trial found.

All three trials were led by the same researcher, Gary Elkins. In the 2025 paper he disclosed personal fees from Mindset Health outside the submitted work.^[3] Independent replication would make the case stronger.

How to use this if you are considering hypnosis

• Talk to your clinician first about whether hormone therapy suits you. It is the most effective treatment for hot flashes, and whether it fits depends on your medical and family history.^[4][6]
• If you prefer a nonhormone route, ask for a clinician trained in clinical hypnosis, or for a structured program built on the studied approach.
• Plan for weeks, not one session. The trials used five weekly sessions or six weeks of audio, with daily home practice. Our guide on how often to practice hypnosis covers building that routine.
• Keep a simple hot flash diary for a week before you start and again a few weeks in. Diaries were how the trials measured change.

Night sweats often break up sleep. If that is your main problem, our review of hypnosis for insomnia covers the sleep evidence separately. Hypnova is a wellness app for relaxation. It was not tested in any of these trials and does not treat hot flashes. Its sessions are not the protocols studied here.