Hot Flashes After Breast Cancer: An Option That Isn't a Pill | Heal and Be Radiant

Yesterday was World Menopause Day, so this week I want to talk about hot flashes -- and in particular about the women for whom they arrive as part of cancer treatment.

How Treatment Changes the Menopause

For many women with breast cancer, menopause does not come gradually. It arrives because chemotherapy has brought it on early, or because of surgery, or because the medicines that protect against the cancer coming back -- tamoxifen and its relatives -- work by lowering or blocking oestrogen. The hot flashes that follow can be more frequent and more severe than in an ordinary menopause.

And the usual remedy, hormone therapy, is generally off the table for exactly the reason they are having hot flashes in the first place.

That leaves a lot of women waking at three in the morning soaked through, with fewer options than their friends, and often with a feeling that they ought to be grateful and stop complaining. You are allowed to want better nights.

What the Research Shows

This is one of the places where the evidence for hypnosis is at its strongest, so let me give it to you plainly.

In 2008, a trial of sixty breast cancer survivors gave half of them five weekly hypnosis sessions. By the end, their hot flash scores -- a measure that combines how often and how severe -- had fallen by about two-thirds. Their sleep, mood, and day-to-day life improved as well. The honest weakness of that trial is that the comparison group received nothing at all, so some of the benefit could have come simply from being attended to.

The same research group went back and tested exactly that. In 2013 they ran a larger trial of 187 women past menopause, this time comparing hypnosis with the same number of sessions spent with an attentive clinician. Twelve weeks later, the hypnosis group reported about three-quarters fewer hot flashes. The comparison group reported about a sixth fewer.

And for those of us who like objective proof: the women also wore skin monitors that recorded hot flashes directly. Those showed a clear reduction too. It was not just a change in how people described their nights.

Those women did not have cancer, and I want to be careful about that. But the treatment was the same one used with the breast cancer survivors, and the results point in the same direction.

How It Is Rated by the Professionals

In 2023, the Menopause Society reviewed every non-hormonal approach to hot flashes. Clinical hypnosis was recommended at their highest level of evidence, alongside several prescription medicines.

Relaxation, mindfulness, paced breathing, and yoga were not recommended for hot flashes. I find that telling, because it shows that hypnosis is not simply relaxation under another name. It is doing something different.

What It Looks Like in Practice

In the trials, women chose an image of coolness that suited them personally -- a mountain stream, a snowfall, a shaded path. Over five sessions they learned to call it up on their own, and they practised daily with a recording. That is very close to how I work.

It does not help everyone equally. Some people respond more strongly than others, and I cannot tell you in advance which you will be. But it has no side effects to speak of, it sits alongside any medicine your doctor has prescribed, and for women who have been told hormones are not an option, it is an option.

And If You Are Reading This in an Ordinary Menopause

If there is no cancer anywhere in your story, all of the above still applies. The evidence does not restrict itself to breast cancer survivors. Hot flashes are hot flashes, and the research shows that hypnosis addresses them effectively regardless of the route they took to arrive.

One Important Note

As always, tell your oncology team or your own doctor what you are doing, so everyone involved in your care has the whole picture. That has been the thread through everything I have written this month. Alongside, never instead.

If you would like to talk through any of this, the call is complimentary and there is no obligation.

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