Relief from one of menopause’s most frustrating symptoms could be a self-guided session away, say experts. A gentle breeze; water trickling over a fountain; crisp mountain air. Such scenes sound cool – and simply imagining them could help people feel cooler, too, the scientists have suggested.
For women experiencing hot flushes, self-guided hypnosis using cooling mental imagery may provide some relief, they wrote in JAMA Network Open.
Science News reports that in a clinical trial of 250 postmenopausal women, hypnosis delivered via self-administered audio recordings offered greater improvements in hot flush symptoms than listening to white noise.
Previous studies have built a case for hypnosis as an effective therapy for hot flushes, but they typically involved in-person sessions, said Gary Elkins, a clinical health psychologist at Baylor University in Waco, Texas. In his team’s trial, women learned how to hypnotise themselves – no professional hypnotists required.
Skipping the in-person component could make it easier for women to get help, said JoAnn Manson, an endocrinologist at Harvard Medical School. Scientists are “moving in the direction of making hypnosis more accessible,” she added.
Hot flushes are a symptom of peri-menopause and menopause, when women’s bodies dial down the production of key hormones and menstrual periods eventually end. Some 85% of women experience hot flushes during menopause, and symptoms can flare up even years later.
Though severity varies, some women find these “very bothersome and distressing”, Manson said. For instance, they can disrupt sleep and drench women with sweat in the middle of the night.
Effective hot flush treatments exist, but they’re largely pharmaceutical. People can take hormone replacement therapy, recently backed by the US Food and Drug Administration.
Doctors may also recommend non-hormonal options, like the drug Lynkuet, approved in October. But some women prefer to avoid taking meds, Manson said, so doctors need more behaviour-based treatment options, like hypnosis.
Elkins’s therapy guides people into a state of deep relaxation and offers therapeutic suggestions and mental imagery specific for hot flushes. Forget hypnosis tropes from movies. There’s no swinging pocket watch here. Instead, a short recording directs people to relax and notice a feeling of calm in their bodies. Sprinkled in is imagery evoking coolness and comfort.
For six weeks, women listened daily to either the hypnosis recordings or recordings of white noise. All kept track of their flushes in a diary. At the end of the six weeks, those in the hypnosis group saw a 53% reduction in hot flush scores, which factor in frequency and severity. That’s compared with a 41% reduction in the white noise group.
It’s typical to see placebo effects like these in hot flush trials, Manson said. Sometimes people in randomised trials make other changes in their lives that can improve symptoms. But the benefit observed in the hypnosis group is substantial, she pointed out, even compared with the control group.
What’s more, the effect seemed to grow after the study ended. At the three-month follow-up, women in the hypnosis group had a 61% reduction in hot flush scores, compared with 44% in the white noise group.
“That really makes the point that once you learn [self-hypnosis], you keep doing it, and the benefits continue over time,” Elkins said.
For people interested in hypnosis for hot flushes, Elkins recommends Evia, a paid hypnotherapy app he helped develop. It requires about 15 to 20 minutes per day and a quiet place where users won’t be disturbed.
That sounds simple, but he recognises that carving out even a little alone time can be difficult. The average age of menopause is 51, a time when women may be managing busy careers and households and taking care of teenagers, elderly parents and grandchildren.
Beyond hot flush relief, self-hypnosis may also ease stress and improve sleep, as some study participants found. In the trial, Elkins says, women’s “overall quality of life improved”.
Study details
Self-administered hypnosis vs. sham hypnosis for hot flushes: a randomised clinical trial
Gary Elkins, Noel Arring, Grant Morgan, et al.
Published in JAMA Network Open on 11 November 2025.
Importance
Many women experience significant adverse effects from menopausal hot flushes. Clinical hypnosis has been shown to be an effective and safe non-hormonal treatment for hot flushes, but there is a need to increase the accessibility of this intervention.
Objectives
To evaluate the efficacy of a self-administered hypnosis intervention for hot flushes compared with a self-administered sham white noise hypnosis control, evaluate the efficacy of the intervention compared with sham hypnosis for hot flush activity interference and perception of benefit, and examine the interaction between practice adherence and treatment effect.
Design, Setting, and Participants
This multicentre, 2-arm, single-blind, randomised clinical trial was conducted from March 4, 2019, to February 16, 2024. Participants were 250 postmenopausal women self-reporting a minimum of 4 daily or 28 weekly hot flushes at baseline who were recruited at Baylor University in Waco, Texas, and the University of Michigan in Ann Arbor.
Intervention
Participants were randomised into either a six-week self-administered hypnosis condition or a self-administered sham white noise condition. The hypnotic inductions consisted of cooling imagery and suggestions for relaxation, while the white noise condition was designed to be an active control accounting for all components present in the intervention arm, including placebo and cognitive expectancy effects, without the therapeutic components present in the active arm.
Main Outcomes and Measures
The primary outcome was the change in hot flush score from baseline to 6 weeks, with a 12-week follow-up. The hot flush score (lower scores indicate less frequent and less severe hot flushes) was calculated as a product of the frequency and severity of hot flushes as reported in their daily hot flush diary. Secondary outcomes included hot flush activity interference, measured using the Hot Flush Related Daily Interference Scale (HFRDIS; score range, 0-100; lower scores indicate less interference from hot flushes on participants’ daily activities, enjoyment, or quality of life), and perception of benefit, measured using the Subject Global Impression of Change. Analysis was conducted on an intent-to-treat basis.
Results
Participants were 250 women (mean [SD] age, 55.9 [6.9] years) experiencing hot flushes, 62 (24.8%) of whom had a history of breast cancer. Overall improvement in mean (SD) hot flush scores at 6 weeks was greater for participants in the hypnosis group (baseline score, 88.7 [61.3] vs 6-week score, 41.3 [50.8]; 53.4% decrease) than those in the white noise group (baseline score, 94.6 [81.6] vs 6-week score, 55.9 [50.9]; 40.9% decrease; P = .04). The intervention group reported a significantly greater reduction in daily interference from baseline to week 6 (baseline mean [SD] HFRDIS score, 49.3 [22.6] vs 6-week score, 25.0 [22.4]; 49.3% decrease) compared with the control group (baseline mean [SD] HFRDIS score, 47.3 [22.4] vs 6-week score, 29.6 [22.0]; 37.4% decrease) as well as greater perceived benefits (90.3% [93 of 103] vs 64.3% [63 of 98]).
Conclusions and Relevance
In this randomised clinical trial, the clinical hypnosis group experienced significantly greater reductions of hot flush scores and daily interference from hot flushes compared with the active control condition at week 6. This study suggests that hypnosis delivered through self-administered audio files is a clinically significant and effective method to reduce hot flushes in postmenopausal women.
See more from MedicalBrief archives:
UK first to approve new non-hormonal drug for hot flushes
Bayer seeks approval for ‘hot flushes’ drug
Hormone therapies best for menopause symptoms, new review finds