Yoga for Hot Flashes: Cooling Breaths, Poses and What Research Shows

Yoga does not reduce hot flashes. The largest trial on the question found no change in how often they happened or how much they bothered women, and the North American Menopause Society lists yoga among the options it does not recommend for hot flashes. That's worth knowing before you spend weeks waiting for a result. It doesn't mean yoga is useless in menopause. It means yoga has a different job.

What the research actually shows

In the MsFLASH trial, funded by the National Institutes of Health, 249 women averaging more than seven hot flashes a day were randomly assigned to 12 weekly 90-minute yoga classes with daily home practice, or to their usual activity. After 12 weeks there was no difference between the groups in hot flash frequency or bother. The one clear benefit was better sleep: women who did yoga had fewer insomnia symptoms.

In 2023, the North American Menopause Society reviewed the evidence for non-hormonal hot flash treatments. It grouped yoga with exercise, relaxation, mindfulness and cooling techniques as not recommended for hot flashes, because the evidence is negative or insufficient. Paced breathing, often sold as a hot flash fix, was not recommended either, and at the society's highest level of evidence.

What does reduce hot flashes

If hot flashes are disrupting your sleep, work or mood, that's reason enough to talk to a clinician. Ask specifically about hormone therapy and about the non-hormonal options above if hormones aren't right for you.

Three things yoga is still good for

Yoga earns its place in a hot-flash season in three ways, none of which involve stopping the flashes themselves.

1. Sleeping better despite night sweats. The same trial that found no effect on hot flashes found fewer insomnia symptoms. A short, cool-room evening practice helps many women fall back asleep after waking. Try our cooling bedtime routine for night sweats.
2. Riding out a flash more calmly. A flash still happens, but a slow exhale can make the minute feel less alarming. That's comfort, not treatment, and it's worth having.
3. Keeping strength, balance and routine. Menopause is also when bone and muscle start to decline faster. Regular movement matters for the decades ahead, as our symptom-by-symptom menopause guide explains.

A cooling breath for comfort during a flash

Sitali, the "cooling breath," won't prevent hot flashes. Many women simply find it soothing in the moment.

1. Sit or stand where you can loosen a layer or step toward cooler air.
2. Curl your tongue into a tube and let it rest just past your lips. If your tongue doesn't curl, keep your teeth lightly together and breathe in through the gaps.
3. Breathe in slowly across the tongue. You'll feel cool air.
4. Close your mouth and breathe out slowly through your nose.
5. Repeat 5 to 8 times, then return to normal breathing.

For the full technique and its cousin, sitkari, see our guide to sitali and sitkari cooling breaths.

What hot flashes are, and how long they last

A hot flash is a sudden wave of heat, usually in the face, neck and chest, often with flushing, sweating and a racing heart. It typically passes within a few minutes and may leave you chilled. At night the same thing is called a night sweat. Hot flashes are linked to changing estrogen levels and the way the brain regulates body temperature during the menopause transition.

They often last much longer than people expect. In the US Study of Women's Health Across the Nation, the median total duration of frequent hot flashes and night sweats was about seven and a half years, and many women had them for longer. That's why an effective treatment is worth pursuing rather than waiting them out.

A comfort toolkit (while you sort out treatment)

These steps won't reduce how often hot flashes happen, according to the Menopause Society's review, but many women find they make each one easier to live with:

• Dress in layers you can remove quickly, in breathable cotton or linen.
• Keep a small fan at your desk and by your bed.
• Keep your bedroom cool, with light bedding and a spare pillowcase or top nearby.
• Carry cold water and sip it at the start of a flash.
• Notice your personal triggers, such as alcohol, spicy food or hot drinks, and adjust if they seem to matter for you.

How to talk to your doctor about hot flashes

Many women put up with hot flashes for years without mentioning them. Bring these questions to your next appointment:

1. Am I a good candidate for hormone therapy, and what are the benefits and risks for me specifically?
2. If hormones aren't right for me, which non-hormonal medicines would you suggest?
3. Can you refer me for CBT or clinical hypnosis for hot flashes?
4. Could any of my current medicines be making hot flashes worse?
5. Is there anything else that could be causing my symptoms?

If your clinician isn't familiar with current menopause care, it's reasonable to ask for a referral to a menopause specialist.

Questions people ask

Does exercise help hot flashes?

The Menopause Society's 2023 review did not recommend exercise specifically for hot flashes, because the evidence doesn't show it reduces them. Exercise is still one of the best things you can do for your heart, bones, mood and sleep in midlife.

Does the cooling breath work?

It's a comfort technique, not a treatment. Paced breathing was specifically not recommended for reducing hot flashes. If sitali helps you feel calmer during a flash, use it for that.

Do supplements like black cohosh or soy help?

The Menopause Society did not recommend supplements, herbal remedies or soy products for hot flashes, because the evidence is negative or insufficient. Some supplements can also interact with medicines.

The bottom line

For the flashes themselves, look to hormone therapy, CBT, clinical hypnosis or one of the recommended medicines. For sleep, calm and long-term strength, keep your yoga. Used for the right job, it's a genuine help.

Sources

1. Newton KM et al. Efficacy of yoga for vasomotor symptoms: a randomized controlled trial (MsFLASH). Menopause, 2014 — no change in hot flash frequency or bother; insomnia improved
2. The North American Menopause Society: 2023 Nonhormone Therapy Position Statement (press release) — recommended and not-recommended options
3. The 2023 nonhormone therapy position statement of The North American Menopause Society, summary — evidence levels
4. Avis NE et al. Duration of menopausal vasomotor symptoms over the menopause transition (SWAN). JAMA Internal Medicine, 2015 — median duration about 7.4 years