Can strength training cool hot flashes?

What the 2024 follow-up found

Researchers in Linköping, Sweden, went back to the women from their earlier strength-training trial. The hot flash analysis included 46 women who hadn't started hormone therapy during the follow-up: 25 who had done the training and 21 from the comparison group¹.

• At the start: the typical woman (the median) had about 6 moderate-to-severe hot flashes a day in both groups (6.1 and 5.7)¹.
• Six months after the program ended: 2.8 a day in the training group versus 4.8 in the comparison group, a difference the researchers found statistically significant¹.
• Two years on: 1.3 a day versus 3.5. The gap still pointed the same way, but it was no longer statistically significant¹.

Hot flashes eased over time in both groups¹. Part of the reason the gap closed is that, after the first 15 weeks, the comparison group was offered a four-month gym membership and a training introduction with a physiotherapist, and they became more active too. In the authors' words, the comparison group "gradually caught up"¹.

The 2019 trial behind it

The original trial, published in 2019, enrolled 65 postmenopausal women, and 58 completed it. Their average age was 55. They had at least 4 moderate or severe hot flashes or night sweats a day (7.1 on average), didn't exercise regularly, and hadn't used any treatment for hot flashes in the two months before joining².

After 15 weeks, moderate or severe hot flashes fell by about 44% on average in the training group, compared with 2% in the group that kept their usual activity. That worked out to about 2.7 fewer a day².

What the training looked like

A whole-body strength program three times a week for 15 weeks². Most of it was done on seated gym machines, plus two body-weight exercises. A physiotherapist designed it and supervised sessions at least once a week¹, and each woman's weights were set for her and increased as she got stronger².

What the experts say

The Menopause Society's 2023 nonhormone position statement lists exercise as not recommended for hot flashes (Level II). It found the evidence for exercise as a hot flash treatment sparse, while noting that exercise has other health benefits³. The exercise studies it describes are mainly walking, aerobic exercise and yoga, and it doesn't discuss this Swedish strength-training trial³. So the fair reading is this: one small randomized trial and its follow-up point to a short-term benefit, and they haven't changed the expert advice.

The limitation

These are small studies from one Swedish clinic: 65 women at the start, and 46 in the follow-up's hot flash analysis. The women knew whether they were training and counted their own hot flashes in diaries, which the authors say could exaggerate the drop. The follow-up was observational, the comparison group started exercising too, and the volunteers were already keen to be active, so the results may not apply to every woman with hot flashes¹. Everyone was postmenopausal, so these studies don't tell us about perimenopause.

One thing to try, one thing to ask

Strength training is worth doing for its own sake. US guidelines recommend muscle-strengthening activities that work all major muscle groups on 2 or more days a week⁴. If you start, jot down your hot flashes on our printable tracker for a couple of weeks before and after, so you can see whether it changes anything for you.

Then ask: "Is a strength program safe for me to start? And if my hot flashes are still bothering me, what treatment options fit my health history?"

Go deeper: Sleep and night sweats ↗

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