Hot Flushes, Anxiety and a Non-Hormonal Option Worth Knowing About

By Kylie Gallaher & Romi Cristaudo, Clinical Hypnotherapists | Newcastle Clinical Hypnotherapy

If you are moving through perimenopause and/or menopause, you already know that a hot flush is rarely just a flush.  There is the sudden heat, yes, but there is also everything that gathers around it: the broken sleep, the damp sheets at 3am, and the quiet dread of it happening at the wrong moment, in a meeting, on a stage, across a dinner table.  Many of the women we see describe that second layer as the hardest part.  Not the flush itself so much as the anticipatory anxiety of waiting for the next one, or sweating through one and trying to pretend it isn’t happening.

This is one of the areas where we most wish more women knew what the research now says about treatment options beyond menopausal hormone therapy (MHT, still widely known as HRT).  Because when it comes to peri and menopausal hot flushes, clinical hypnosis is not a fringe idea or a hopeful nice to have.  It is one of the strongest bodies of evidence in the whole field, a genuine non-hormonal option, and a great adjunct alongside hormone treatment as well.

The flush, and the worry that rides with it

Hot flushes and anxiety can feed each other.  A flush disrupts sleep, and poor sleep frays the nervous system, which can make the next day’s flushes feel more intense and harder to ride out.  Anxiety can act as a trigger in its own right, so the very worry about flushing can help bring one on.  Over time, many women start to brace: scanning the room for exits, dressing in careful layers, thinking twice about the meeting or the dinner.  That bracing is anticipatory anxiety, and it is tiring all by itself.

We name this because it points to exactly what makes our work such a good fit here.  It does not only work on the flush.  It works on the nervous system, and the thinking, that the flush winds up.

What the evidence shows

Randomised controlled trials have shown that clinical hypnosis substantially reduces both the frequency and the severity of hot flushes (Elkins et al., 2008, 2013; MacLaughlan et al., 2013).  The numbers from one of these trials are striking: women practising clinical hypnosis saw their daily hot flushes fall by around 74%, compared with roughly 17% in the control group (Elkins et al., 2013).   That’s 74%, ladies!

This is not a one-off result.   In the United States, The Menopause Society, formerly the North American Menopause Society, reviewed the whole body of evidence and found that just two non-drug therapies have enough support to be formally recommended for hot flushes: cognitive behavioural therapy and clinical hypnosis (North American Menopause Society, 2023).  Each brings something distinct.  Cognitive behavioural therapy is well evidenced for the distress, and the thinking and behaviour patterns, that surround hot flushes, while clinical hypnosis has been shown to reduce the flushes themselves, lowering how often they come and how severe they feel, “even when physiological measures are used” (North American Menopause Society, 2023).  Held together, they address both the flushes and the experience of living with them.  Keep that word together in mind, because it is central to how we work.

Closer to home, the Australasian Menopause Society lists hypnosis among its non-hormonal options for menopausal symptoms too, noting that it can ease the frequency and severity of hot flushes and help with anxiety and sleep (Australasian Menopause Society).

Why this matters if you cannot take hormone therapy

For many women, menopausal hormone therapy is a sensible and effective choice, and that is a conversation for you and your doctor.  But not everyone can take it, and not everyone wants to, which is where a well-evidenced non-hormonal option really earns its place.

It matters most, perhaps, for women who have come through breast cancer.  Two of the trials above were run specifically with breast cancer survivors (Elkins et al., 2008; MacLaughlan et al., 2013), a group for whom hormone therapy is usually not an option, and for whom treatments such as aromatase inhibitors can make hot flushes more frequent and more intense.  If that is you, it is worth knowing that clinical hypnosis has been studied in exactly your situation, and found to help.

Why it helps with the anxiety too

Here is what ties it together.  Because this work settles the nervous system and gently reshapes the anxious thinking that rides with a flush, it eases the flushes and the worry at the same time.  You are not tackling two separate problems.  You are calming one overwound system, and both tend to improve together.  Women often tell us the anticipatory worry loosens first: the dread of flushing in a meeting eases before the flushes themselves have fully settled.

CBT and hypnosis, together by design

Here is something worth understanding about those two recommended approaches.  At Newcastle Clinical Hypnotherapy they are not options you have to choose between.  Our work is built on strategic psychotherapy, which carries a cognitive and behavioural scaffolding and is goal-oriented and collaborative by nature.  Clinical hypnosis sits inside that frame as one of the tools we use.  In truth, clinical hypnosis is only ever the therapeutic use of hypnosis: it does not exist apart from the cognitive and behavioural work that gives it direction.  You can read more about our approach on our about page.

What this means in practice is that a woman working with us on hot flushes is not receiving CBT or hypnosis.  She is receiving both, woven together, which is exactly the combination the research points to.  Adding hypnosis to cognitive and behavioural work tends to improve outcomes (Kirsch et al., 1995; Ramondo et al., 2021), and for hot flushes it is these two approaches that share the strongest evidence base.

It is also worth knowing how hypnosis is tested.  In a trial it has to be delivered in a standardised, scripted way so that it can be measured cleanly.  That is good science, but it is a narrower version of the work than you would actually experience.  Working collaboratively, toward goals that matter to you, we shape the language, the pace and the focus around you and adjust as we go, rather than following a fixed protocol.  The research tells us the approach works.  The way we deliver it is built around the person in front of us.

What the work involves

Two simple things drive the results.  The first is a little daily self-hypnosis, a few quiet minutes at home on most days: it is that steady practice, rather than anything done to you in the room, that retrains the response.  The second is that the work is shaped around you.  Many women notice welcome flow-on effects along the way, better sleep and a calmer, steadier baseline of stress.

You may have come across the word hypnotisability in the research.  The studies rely on measurable scales, so they sort people into higher and lower responders, and in one hot flush study the higher responders improved by around week three while others reached the same point by about week twelve (Alldredge, Sliwinski et al., 2024).  Everyone in that study improved.  In our clinical experience, that is the real story: every person can experience hypnosis in some form, and within a collaborative, goal-oriented approach a skilled clinician reads how you respond and adjusts to meet you, where you are at in each moment.  A generic recording cannot do that.

A warm invitation

If the hot flushes, the broken sleep or the low hum of anticipatory anxiety are wearing you down, we would be glad to talk it through.  You can book a discovery call with Newcastle Clinical Hypnotherapy, an easy and unhurried chat about what you are experiencing and whether this could help.  There is nothing to lose in asking.  And please keep your GP or treating specialist in the loop; our work sits alongside good medical care, not in place of it.

Related reading

More from us: The science is in: what clinical hypnosis really is; Menopause and your mind: confidence, mood and the mind-body shift; how we work at Newcastle Clinical Hypnotherapy.  Browse the full NCH blog.

Selected sources

Hypnotherapy is a complementary approach and is not a substitute for medical or psychological care.  If you have a health concern, please also speak with your GP or treating practitioner.