Hypnosis for menopausal hot flushes

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Gary Elkins · 2008 · Baylor University

What it is

A short course of clinical hypnosis for vasomotor symptoms (hot flushes and night sweats), given by a trained clinician. Each session uses a standard hypnotic induction transcript individualised with the client's own imagery for relaxation and coolness, followed by deepening, dissociation from the…

Format

• Format (self-administered version). In the 2025 trial (250 postmenopausal women, two US universities) women listened to a daily 20-minute audio session for six weeks; the recordings contained relaxation suggestions and cooling mental imagery, and the comparison was white-noise sham audio. The Evia…
• Phases (the phase structure and transition criteria are synthesis built around the published five-session format and its measures)

Who practises it, and how they are trained or regulated

• Format (in-person version). Individual sessions, five sessions, about once a week, following a treatment manual. In the 2008 breast cancer trial each session lasted 50 minutes and was delivered by a PhD clinical psychologist with more than 40 hours of training from the principal investigator. (Elkins' lab feature gives about 45 minutes for earlier exploratory work.) In the 2013 trial a research therapist followed…
• Monitoring used in the trials. Daily hot-flush diaries of frequency and severity, giving a hot flash score (frequency × average severity, severity weighted from 1 = mild to 4 = very severe); 24-hour sternal skin conductance with an ambulatory monitor, the client pressing an event marker when she feels a flush; the Hot Flash Related Daily Interference Scale; anxiety, depression and sleep measures (CES-D, HADS-Anxiety…
• Version followed: the clinical hypnosis protocol from Gary Elkins and colleagues (Mind-Body Medicine Research Laboratory, Baylor University). The main version is five weekly individual sessions plus daily audio-guided self-hypnosis, as in Elkins et al. 2008 (J Clin Oncol, breast cancer survivors) and Elkins et al. 2013 (Menopause, postmenopausal women; methods published in the 2011 BMC study protocol). The 2025…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Grogginess, headache or emotional reactions. Allow time before she drives.
• Confidence ("I can do it myself") and the hot flash score holding steady after the recording is faded.
• A change in medical status (e.g. a change in endocrine therapy) that affects flushes. Coordinate with the prescriber.
• Insomnia that persists despite fewer flushes (consider CBT-I referral), and depressive symptoms that don't lift (assess and treat).
• Scenes that stir worry about health or recurrence (choose an everyday scene instead), and over-ambitious images that set up disappointment.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.