Yoga for Hot Flashes

Yoga is a mind-body practice that combines physical postures (asana), breath regulation (pranayama), and meditation techniques. By promoting relaxation and stress reduction, yoga may help alleviate menopausal vasomotor symptoms such as hot flashes, while also improving sleep quality, mood, and overall well-being. Recent research has investigated different yoga styles—from integral to restorative—to determine their feasibility, acceptability, and effectiveness in mitigating menopause-related challenges.

Protocols Studied in Research

Integral Yoga for Menopausal Hot Flashes [1]

• Protocol: In this pilot randomized controlled trial, 54 late perimenopausal and postmenopausal women (ages 45–58, experiencing ≥4 hot flashes per day for at least 4 weeks) were randomized into three groups: yoga, health and wellness education (HW), and a wait list (WL). Both the yoga and HW groups attended weekly 90‑minute classes for 10 weeks while all participants maintained daily hot flash diaries to track frequency and severity (calculated as a hot flash index).
• Outcome: Although hot flash frequency declined significantly across all groups—with the strongest decline in the first week—the yoga and HW groups showed a markedly greater reduction by week 10 (66% and 63% decrease, respectively) compared to a 36% decrease in the WL group. The findings suggest that while yoga can effectively reduce hot flashes, its benefit may be comparable to other behavioral interventions.

Yoga for Menopausal Women with Hot Flashes [2]

• Protocol: This secondary analysis from the MsFLASH network involved 186 late transition and postmenopausal women (ages 40–62) with hot flashes. Participants were randomized to 12 weeks of yoga, supervised aerobic exercise, or usual activity. Actigraphy was used to objectively measure sleep parameters—total sleep time, wake after sleep onset, and variability—both at baseline and at weeks 11–12.
• Outcome: Overall changes in actigraphic sleep measures were small and did not differ significantly between the groups. However, an exploratory analysis revealed that among women with poor baseline sleep quality (Pittsburgh Sleep Quality Index >8), yoga was associated with a significant reduction in sleep variability compared to usual activity, suggesting a potential benefit for sleep stability in this subgroup.

Restorative Yoga for Hot Flushes [3]

• Protocol: In this pilot trial, 14 postmenopausal women experiencing ≥4 moderate to severe hot flushes per day (or ≥30 per week) participated in a restorative yoga intervention. The program included a 3‑hour introductory session followed by eight weekly 90‑minute restorative yoga sessions. Feasibility was assessed via recruitment, retention, and adherence rates, while acceptability was measured using participant interviews and questionnaires. Hot flush frequency and severity were recorded using 7‑day diaries.
• Outcome: The trial demonstrated high feasibility (93% completion, 92% attended at least 7 sessions) and acceptability (75% continued yoga practice after 3 months). There was a significant reduction in mean weekly hot flush frequency by 30.8% and a 34.2% reduction in the hot flush score by week 8, with no adverse events observed.

Yoga for Vasomotor Symptoms [4]

• Protocol: In a three-by-two factorial RCT, 249 healthy menopausal women were randomized to one of three activity groups: yoga (n=107), aerobic exercise (n=106), or usual activity (n=142), and simultaneously to receive either ω‑3 fatty acid capsules or placebo. The yoga intervention consisted of 12 weekly 90‑minute classes with daily home practice. Primary outcomes were vasomotor symptom (VMS) frequency and bother, recorded via daily diaries at baseline, 6, and 12 weeks; secondary outcomes included insomnia symptoms measured by the Insomnia Severity Index.
• Outcome: There was no statistically significant difference in the change in VMS frequency or bother between the yoga and usual activity groups over 12 weeks. However, at week 12, yoga was associated with a significant improvement in insomnia symptoms compared with usual activity. The study concludes that while yoga may not significantly reduce vasomotor symptoms, it can improve sleep in menopausal women.

Yoga & Exercise for Vasomotor Symptoms [5]

• Protocol: This secondary analysis of a randomized controlled trial involved 335 peri- and postmenopausal women (ages 40–62) with vasomotor symptoms. Participants were randomized to a 12‑week intervention of either a yoga program tailored for midlife women, a supervised aerobic exercise program with specific intensity goals, or usual activity. Heart rate variability (HRV) was measured using 15‑minute Holter monitor recordings at baseline and 12 weeks to assess time and frequency domain parameters as indicators of parasympathetic activity.
• Outcome: Neither the yoga nor the exercise intervention produced significant changes in HRV measures compared with the usual activity group. Additionally, subgroup analyses limited to postmenopausal women yielded similar results. The findings suggest that improvements in health from these interventions may occur via mechanisms other than changes in HRV.

Research Interpretation: Summary and Conclusion

Overall, these studies demonstrate that yoga can be a feasible, acceptable, and often beneficial intervention for managing certain menopausal symptoms—particularly hot flashes, sleep difficulties, and stress. While yoga may not outperform every comparator in reducing vasomotor symptoms, it consistently shows promise in improving sleep quality and overall well-being in midlife women.

In simple terms, as a low-risk, holistic practice, yoga can serve as a valuable complementary approach to conventional therapies for menopause-related challenges.

Publications

[1] Avis NE, Legault C, Russell G, Weaver K, Danhauer SC. Pilot study of integral yoga for menopausal hot flashes. Menopause. 2014 Aug;21(8):846-54. doi: 10.1097/GME.0000000000000191. PMID: 24473534; PMCID: PMC4110168.

[2] Buchanan DT, Landis CA, Hohensee C, Guthrie KA, Otte JL, Paudel M, Anderson GL, Caan B, Freeman EW, Joffe H, LaCroix AZ, Newton KM, Reed SD, Ensrud KE. Effects of Yoga and Aerobic Exercise on Actigraphic Sleep Parameters in Menopausal Women with Hot Flashes. J Clin Sleep Med. 2017 Jan 15;13(1):11-18. doi: 10.5664/jcsm.6376. PMID: 27707450; PMCID: PMC5181601.

[3] Cohen BE, Kanaya AM, Macer JL, Shen H, Chang AA, Grady D. Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial. Maturitas. 2007 Feb 20;56(2):198-204. doi: 10.1016/j.maturitas.2006.08.003. Epub 2006 Sep 18. PMID: 16979311.

[4] Newton KM, Reed SD, Guthrie KA, Sherman KJ, Booth-LaForce C, Caan B, Sternfeld B, Carpenter JS, Learman LA, Freeman EW, Cohen LS, Joffe H, Anderson GL, Larson JC, Hunt JR, Ensrud KE, LaCroix AZ. Efficacy of yoga for vasomotor symptoms: a randomized controlled trial. Menopause. 2014 Apr;21(4):339-46. doi: 10.1097/GME.0b013e31829e4baa. PMID: 24045673; PMCID: PMC3871975.

[5] Jones SM, Guthrie KA, Reed SD, Landis CA, Sternfeld B, LaCroix AZ, Dunn A, Burr RL, Newton KM. A yoga & exercise randomized controlled trial for vasomotor symptoms: Effects on heart rate variability. Complement Ther Med. 2016 Jun;26:66-71. doi: 10.1016/j.ctim.2016.03.001. Epub 2016 Mar 4. PMID: 27261984; PMCID: PMC4893767.