Breathing exercises for hot flashes: what the trials really found

Name: Breathing exercises for hot flashes: what the trials really found
Creator: MenoWoman

Early small studies suggested slow, paced breathing could cut hot flashes, but larger, better trials found it worked no better than normal breathing. Slow breathing may still help you feel calmer and less stressed.

Researched by the MenoWoman team. Edited by Marcela Sat. Updated 7 November 2026. We may earn from links.

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See a doctor if hot flashes disrupt your sleep, work or daily life, as proven treatments are available. Also see one if breathing exercises leave you dizzy or short of breath.

What paced breathing is

Paced breathing, or paced respiration, means slow, deep breathing from the belly. It usually aims for about six to eight breaths a minute, instead of the usual 12 to 16.⁴

It is often suggested for hot flashes because it is free, easy and has few side effects. The idea is that it may calm the body's stress response.

You will still see it recommended on many websites and apps. This page explains why the advice has changed, and what slow breathing can still offer.

Why it seemed promising

In a small 1992 trial, women who learned paced breathing had fewer hot flashes. Women taught muscle relaxation or a dummy treatment did not.¹ Several other small lab-based studies also reported benefits.⁴

A 2019 review of four studies with 398 women, cited by the NIH, concluded paced breathing could improve hot flashes.⁵ But that summary pooled the early small studies with later, larger ones.

What the larger trials found

The biggest trial included 218 women, 96 of them breast cancer survivors.² They were randomly assigned to paced breathing, fast shallow breathing, or usual care for 16 weeks.² Hot flashes were no less frequent, severe or bothersome with paced breathing than in the other groups.² Small differences in other symptoms were as likely to favor the shallow breathing group.² Most women practiced correctly every day, yet still did not get a 50% reduction.²

A Mayo Clinic trial of 92 women compared slow breathing at six breaths a minute with ordinary breathing. Hot flashes fell by 42 to 52% in every group, including the ordinary breathing group.³ Because the comparison group improved almost as much, the trial did not show that slow breathing itself made the difference.³ The authors called for a larger trial.³

A third trial gave 123 women a breathing-guide device or a look-alike device that played music.⁸ Hot flashes fell by about 21% with paced breathing and 35% with music, so the breathing device did worse.^8,4

Based on these studies, The Menopause Society says paced breathing is unlikely to help hot flashes and does not recommend it.^4,7 It rated this as Level I evidence, meaning the evidence that it does not work is good and consistent.⁴

Can breathing still help?

Yes, but for different reasons. A 2023 review of trials in adults found breathwork lowered stress, anxiety and low mood by a small-to-medium amount.⁶ The authors warned that studies were small and the hype runs ahead of the evidence.⁶

Some women find slow breathing helps them stay calm and feel more in control when a hot flash starts. That is a reasonable reason to try it. Just know that it will probably not change how many you have.

Slow breathing is also a common part of relaxation training and CBT, which can make it a useful skill to learn.⁵

Sit or lie comfortably with one hand on your belly.
Breathe in gently through your nose so your belly rises, then breathe out slowly, a little longer than the in-breath.
Keep it gentle and slow. Do not breathe fast or forcefully, and do not hold your breath. Breathing too fast or too deeply can cause dizziness, tingling around the mouth or in the hands, or a pounding heartbeat.⁹
If you feel lightheaded or tingly, stop and breathe normally. Do not practice while driving, in water, or standing somewhere you could fall.
If you have a lung or heart condition, or are pregnant, ask your doctor before trying breathing techniques.

For hot flashes, options with good evidence include hormone therapy, some non-hormonal medicines, CBT and clinical hypnosis.⁷ See hormone therapy, non-hormonal prescription treatments and CBT for menopause.

What it is used for: evidence rated

Option	Evidence	What the research shows
Stress and anxiety	Some evidence	A review of trials in adults found small-to-medium reductions in stress and anxiety; menopause-specific data are lacking.⁶
Low mood	Some evidence	The same review found small-to-medium improvements in low mood, with moderate risk of bias in most studies.⁶
Hot flashes	Weak evidence	Early small studies were positive, but larger trials found no benefit over normal breathing; The Menopause Society says it is unlikely to help.^2,3,4
Sleep	Weak evidence	Relaxation methods on their own have not been shown to treat insomnia, though they can be part of CBT for insomnia.⁵

Ratings explained: how we rate. Always talk to a doctor or pharmacist before starting a medicine or supplement.