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Hypnosis for Menopause Symptoms: Hot Flashes, Sleep, and Mood

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For hot flashes, yes: the North American Menopause Society’s 2023 position statement on nonhormone therapies recommends clinical hypnosis, based on what it rates as good and consistent evidence. The evidence for sleep and mood is thinner, coming mainly from one trial in breast cancer survivors. Hormone therapy remains the most effective treatment for hot flashes, so hypnosis matters most for women who cannot or prefer not to use it.

What do the guidelines say?

The 2023 nonhormone therapy position statement from the North American Menopause Society reviewed treatments for hot flashes and night sweats, which it describes as the most common symptoms of menopause. It recommends cognitive behavioral therapy and clinical hypnosis at its highest evidence level, Level I, alongside several prescription medicines.

It does not recommend everything that sounds similar. Relaxation, yoga, mindfulness-based interventions and paced breathing are on its list of approaches not recommended for hot flashes, either because the evidence is limited or because larger trials found no benefit. Clinical hypnosis, in the statement’s description, involves a deeply relaxed state together with individualized mental imagery and suggestion.

An earlier, 2015 version of the statement was more cautious, recommending hypnosis while acknowledging that favorable evidence was limited, as the NCCIH page on hypnosis notes. The 2023 update rates the evidence more strongly.

What did the trials find?

The statement describes two trials, both using five weekly in-person sessions plus self-hypnosis practice at home:

  • Breast cancer survivors: in 60 women, clinical hypnosis reduced hot flashes and improved mood and sleep more than no treatment.
  • Postmenopausal women: in a 2013 single-blind trial of 187 women with at least 50 hot flashes a week, hypnosis was compared over 12 weeks with an attention-control program with the same number of sessions, discussion and encouragement. Women in the hypnosis group reported significantly fewer hot flashes and lower hot flash scores, which combine frequency and severity, and physiologically monitored hot flashes also fell significantly more. A follow-up analysis found the effects were not related to whether women expected hypnosis to work.

The statement adds that the program can be delivered by a trained provider or through a smartphone app.

What about sleep and mood?

The evidence here is narrower. The improvements in mood and sleep come from the trial in breast cancer survivors, compared with no treatment. If night sweats are what disturb your sleep, reducing hot flashes may help indirectly, but sleep or mood problems that persist deserve their own assessment.

What are the other options?

The statement concludes that hormone therapy remains the most effective treatment for hot flashes and should be considered by women within 10 years of their final menstrual period. For women who cannot use it, for example because of estrogen-dependent cancers or cardiovascular disease, or who prefer not to, it lists cognitive behavioral therapy, clinical hypnosis and several prescription medicines among the recommended nonhormone options.

Keep a hot flash record

For two weeks, note how many hot flashes you have each day and rate how much each one bothers you, along with your sleep and mood. Take the record to your doctor to discuss the options above, including whether hormone therapy is suitable for you. If you choose hypnosis, ask for a structured program of several sessions with self-hypnosis practice, like the ones in the trials, and keep recording so you can see whether it is working.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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