What approaches can help you manage hot flashes?

Conventional and complementary treatments can reduce the number or severity of hot flashes.

Top practices and complementary therapies for managing hot flashes

These practices and therapies have at least modest evidence for the medical benefits listed. We add to this list as we complete new reviews of practices and therapies.

Practices and therapies we have reviewed

Further therapies

These therapies are recommended in at least one clinical practice guideline.

Breathing techniques

Hypnosis

Psychosocial counseling (cognitive behavioral therapy)

Conventional care

Estrogen replacement effectively controls hot flashes associated with biological or treatment-associated postmenopausal states in women.1Freedman RR, Blacker CM. Estrogen raises the sweating threshold in postmenopausal women with hot flashes. Fertility and Sterility. 2002 Mar;77(3):487-90. However, estrogen therapy may be unacceptable (contraindicated) for women who have or have had breast cancer, high-risk endometrial cancer, or some types of ovarian cancers in which estrogen’s growth-promoting effects on cancer cells would be harmful.

The effect of hormone replacement therapy on risk of breast cancer recurrence and mortality depends on which hormones are used.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of substantially lower risk of recurrence or mortality after a diagnosis of breast cancer among people treated with hormone therapy (mostly standard dose conjugated estrogen or its equivalent plus progestins)

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of breast cancer recurrence after diagnosis of early-stage breast cancer among people treated with menopausal hormone therapy minimizing the use of progestogen combined with estrogen

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of substantially higher risk of breast cancer events including recurrence, metastasis, or death among women with previous breast cancer treated with various hormone replacement therapies, with a default of a sequential estrogen–progestagen combination

Medroxyprogesterone acetate (Provera), 5 mg twice daily, appeared to be an effective agent for controlling hot flushes among men after orchiectomysurgical removal of one or both testicles.5Charig CR, Rundle JS. Flushing. Long-term side effect of orchiectomy in treatment of prostatic carcinoma. Urology. 1989 Mar;33(3):175-8. Hot flashes in men with prostate cancer may be treated with estrogens, progestin, antidepressants, and anticonvulsants. 

However, some hormones, such as estrogen, can make some cancers grow or increase your risk of other cancers.6Martin KA, Barbieri RL. Treatment of menopausal symptoms with hormone therapy. UpToDate. March 27, 2018. Viewed July 31, 2018; National Cancer Institute. Hot Flashes and Night Sweats (PDQ®)–Health Professional Version. September 27, 2017. Viewed March 9, 2018; Baber RJ, Panay N, Fenton A; IMS Writing Group. 2016 IMS recommendations on women’s midlife health and menopause hormone therapy. Climacteric. 2016 Apr;19(2):109-50.

Helpful links on conventional treatments for hot flashes

Complementary or self-care

Good or modest evidence of benefit

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) indicates that the practice or therapy is linked to the outcomes described with reasonable certainty. Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, but with a lower degree of certainty.

Manage your body weight: modest evidence

Moderately higher risk of hot flashes among women with breast cancer gaining weight in the 2 years after diagnosis compared to stable weight, and a weak trend toward lower risk of hot flashes among women losing weight (modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently))

Not specific to cancer:

  • Fewer hot flashes among overweight or obese women reducing body weight (modest evidence)

Recommended in at least one clinical practice guideline; see guidelines ›

Acupuncture: mixed evidence

Fewer hot flashes during cancer treatment, including hormone therapy, among people with breast cancer treated with acupuncture (good evidence)

Fewer hot flashes without regard to treatment phase among people with cancer, mostly with breast cancer, treated with acupuncture
(preliminary (conflicting) evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently))

Fewer hot flashes after cancer treatment among people with breast cancer treated with acupuncture (weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently))

Not specific to cancer:

  • Comparable effects on hot flashes among people treated with acupuncture compared to non-hormonal drugs (good evidence)
  • Higher frequency of hot flashes among people treated with acupuncture compared to hormonal therapy (modest evidence)
  • Fewer adverse effects among people treated with acupuncture compared to non-hormonal medication for hot flashes (modest evidence)

Recommended in at least one clinical practice guideline; see guidelines ›

Electroacupuncture: modest and weak evidence

Lower scores or fewer hot flashes among women with breast cancer treated with electroacupuncture, including when compared to gabapentin (modest evidence)

A decrease in hot flash scores during androgen deprivation therapy for prostate cancer among men treated with electroacupuncture (weak evidence)

Recommended in at least one clinical practice guideline; see guidelines ›

Relaxation techniques: modest evidence

Fewer and less severe hot flashes among people with primary breast cancer treated with relaxation techniques (modest evidence)

Not specific to cancer:

  • Fewer and/or less severe hot flashes among perimenopausal or postmenopausal women treated with relaxation techniques (modest evidence)
Yoga: modest evidence

Not specific to cancer:

  • Modest evidence of substantially fewer or less severe hot flashes among perimenopausal or postmenopausal women practicing yoga

Recommended in at least one clinical practice guideline; see guidelines ›

Preliminary evidence of benefit

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, although substantial uncertainty remains. Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) may mean that the effects are small or that a high degree of uncertainty remains about the links between the practice or therapy and the outcomes described.

Eating Well Learn moreSee Less
Relaxation combined with psychotherapy Learn moreSee Less

Practices and therapies with no evidence of benefit

Moving More ›

Not specific to cancer:

  • No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. of exercise on frequency or intensity of hot flashes among perimenopausal or postmenopausal women participating in exercise in a combined analysis of studies
  • Preliminary evidence of less reduction in the number of hot flashes among sedentary women with vasomotor symptoms participating in exercise compared to estrogen therapy

Flaxseed ›

Not specific to cancer:

  • No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on hot flashes or other menopausal symptoms among people eating flaxseed in a combined analysis of studies

Melatonin ›

Specific to breast cancer:

  • No evidence of an effect on hot flashes among among postmenopausal women with breast cancer treated with 3 mg of melatonin in a preliminary study

Further therapies

These therapies are reported for use in managing hot flashes. Those in bold are recommended for managing hot flashes in at least one clinical practice guideline; see guidelines ›

Angelica sinensis (dong quai)

Breathing techniques

Dl-phenylalanine

Escitalopram (off label use)

Evening primrose oil

Hesperidin

Hypnosis 

Panax ginseng (American) 

Psychosocial counseling, including cognitive-behavioral therapy

Vitamin E

Gabapentin (off label) also shows benefits in reducing hot flashes among postmenopausal women who are not recommended for hormonal therapy for medical reasons or who prefer alternatives, although use of gabapentin has its own risk of side effects, especially dizziness and unsteadiness.7Yoon SH, Lee JY, Lee C, Lee H, Kim SN. Gabapentin for the treatment of hot flushes in menopause: a meta-analysis. Menopause. 2020 Apr;27(4):485-493.

Therapies not recommended or recommendation against use for managing hot flashes in at least one clinical practice guideline:

Black cohosh

Homeopathy

Magnetic therapy

Helpful links

Tran S, Hickey M, Saunders C, Ramage L, Cohen PA. Nonpharmacological therapies for the management of menopausal vasomotor symptoms in breast cancer survivors. Support Care Cancer. 2021 Mar;29(3):1183-1193.

Authors

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Reviewer

Susan Yaguda, MSN, RN

Manager at Atrium Health’s Levine Cancer Institute and CancerChoices Clinical Consultant
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Susan Yaguda, MSN, RN, has been a nurse for nearly 40 years, working in a variety of healthcare settings. She currently works in Charlotte, North Carolina, at Atrium Health’s Levine Cancer Institute as the manager for Integrative Oncology and Cancer Survivorship. She works with a multidisciplinary team to deliver holistic, evidence-based support and education for patients and care partners at any point along the trajectory of cancer care. She completed the Integrative Oncology Scholars Program through the University of Michigan in 2020, is certified as an Integrative Health Coach through Duke Integrative Medicine and has a post-graduate certificate in Nursing Education from the University of North Carolina, Charlotte. Susan also was awarded the Planetree International Scholar’s Award in 2018 and was recognized by the Daisy Foundation for Nurse Leadership in 2021. Susan has a particular interest in empowering patients and care partners with knowledge to help drive informed decision making and educating nurses on the benefits of integrative care for patients and self-care. She has presented nationally and internationally on integrative oncology and nursing education.

She and her husband, Mark, have two adult children and a very spoiled foxhound. She enjoys hiking, knitting, cooking, and pickleball.

“As a frequent consumer of Beyond Conventional Cancer Therapies, and now CancerChoices, for both professional education and patient support, it is an honor to have the opportunity to engage with the dedicated team at CancerChoices to serve those impacted by this disease.”  

 

Susan Yaguda, MSN, RN Manager at Atrium Health’s Levine Cancer Institute and CancerChoices Clinical Consultant

Last update: May 21, 2024

Last full literature review: April 2023

CancerChoices provides information about integrativein cancer care, a patient-centered approach combining the best of conventional care, self care, and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocialtherapy, and acupuncture therapies and self carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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