Synopsis: Hot flashes and night sweats can be frustrating, especially if hormone therapy or medications aren’t the right fit for you. This blog explores stellate ganglion blocks (SGBs) as a promising non-hormonal alternative for managing vasomotor symptoms, explaining how they work, what to expect, and who might benefit from this treatment.
Exploring Relief for Menopausal Symptoms
Hot flashes, hot flushes, and night sweats are some of the most frustrating symptoms that plague many women in menopause. If you're reading this blog, chances are we’re preaching to the choir on this and you are looking for real relief.
Perhaps you've tried traditional treatments like hormone replacement therapy (HRT), or maybe you've been told medication is your best option. But today you find yourself on this page because you don’t like these options and you simply don’t want them.
That's where stellate ganglion blocks (SGBs) come in. While it’s a lesser-known treatment, it is gaining attention as a potential alternative for managing vasomotor symptoms (VMS). So let’s dive into what SGBs are, how they work, and whether they might be the right choice for you.
What Are Hot Flashes, and Why Do They Happen?
If you’ve ever had a hot flash, you know the drill - a sudden wave of heat, sweating, and flushing that can seem to come out of nowhere. Over 75% of menopausal women experience these symptoms, but it is still not fully understood how or why they occur.
The current thought is these symptoms are a result of the drop in estrogen that accompanies menopause - although not necessarily low levels of estrogen but rather the fluctuations. The redness (aka vasodilation) and sweating is a result of the dysregulation or throwing off your internal thermostat - the thermoregulatory center in your hypothalamus. Changes in norepinephrine and serotonin levels and number of receptors shift your set point of your body’s heat tolerance, making you more likely to suddenly sweating and flushing.
Why Does This Matter?
By understanding, to the best of our ability, how and why host flashes occur, it is from there that you can understand why many doctors recommend hormonal and non-hormonal options, as well as treatments like stellate ganglion blocks.
Exploring treatment options for hot flashes? From HRT to non-hormonal medications, find out what works and what alternatives exist.
Common Treatments for Vasomotor Symptoms
Now that you have an understanding why we think these vasomotor symptoms occur, you can better see how these common treatments work.
Hormone Replacement Therapy (HRT)
For many women, HRT is the go-to solution for hot flashes by replacing declining estrogen levels. While HRT can reduce hot flash frequency by up to 75%, It’s not for everyone.
If you’ve had breast cancer, blood clots, or other medical conditions, you may have been advised to avoid estrogen therapy. And even if you are prescribed this treatment, many doctors recommend keeping the dose as low as possible for the shortest time necessary.
Non-Hormonal Medications
If HRT isn’t an option, there are non-hormonal treatments that can help, including:
Clonidine: This medication raises your sweating threshold by reducing norepinephrine release. However, some women find the side effects—like dizziness or dry mouth—too uncomfortable.
Selective Serotonin Reuptake Inhibitors (SSRIs) & Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): These antidepressants help regulate serotonin and norepinephrine, which play a role in temperature control. Paroxetine is currently the only FDA-approved SSRI for VMS relief.
Seeking a Different Option?
If you haven’t found relief or prefer a non-medication approach, you may be wondering: What else is out there?That’s where stellate ganglion blocks come in.
What Are Stellate Ganglion Blocks, and How Do They Help with Hot Flashes?
A stellate ganglion block (SGB) is an outpatient procedure involving an injection of a local anesthetic near the stellate ganglion, a cluster of nerves in your neck. This is a 30-45 minute treatment which aims to ease symptoms traditionally associated with post-traumatic stress disorder (PTSD) and trauma-related mental health issues by offering a reset to your body's stress response system.
How Does It Work?
Originally used for pain management and PTSD treatment, there is a growing body of research supporting its use to relieve vasomotor symptoms. Researchers have found that SGBs may also help regulate temperature dysregulation, which is exactly what triggers hot flashes.
Although not fully understood, the idea is the SGB will interrupt the sympathetic nervous system (which the stellate ganglion is part of ) and thus may affect blood flow and modulation of norepinerphines levels involved in the thermoregulation center of the hypothalamus.
Simply put the stellate ganglion is part of your body’s stress and temperature regulation system. If you’ve ever started sweating in a stressful situation, that’s your sympathetic nervous system kicking in.
SGBs temporarily block this response, helping to restore balance to your body’s temperature control. This may reduce the frequency and intensity of hot flashes.
What’s the Process of Getting a Stellate Ganglion Block?
In this section, you’ll explore what to expect when receiving an SGB
The Procedure
You'll sit comfortably while a provider injects a local anesthetic into your neck.
At our clinic we use ultrasound guidance to ensure precise placement for safety and effectiveness.
The entire procedure takes 30-45 minutes.
What to Expect After the Procedure
Most patients feel fine after an SGB, but temporary and expected side effects may include:
Horner’s Syndrome – A droopy eyelid, red eye, and mild hoarseness, which typically resolve within a few hours.
Mild nasal congestion, headache, or soreness at the injection site—easily manageable and short-lived.
Wondering if a stellate ganglion block is right for you? Learn who may benefit from SGB for hot flashes—and who should avoid it.
Should You Consider a Stellate Ganglion Block for Hot Flashes?
Should you get a stellate ganglion block? Let’s talk about some reasons to try an SGB or to completely avoid it as you look to alleviate your vasomotor symptoms.
You Might Be a Good Candidate If:
You’ve tried HRT without success.
You can’t take HRT due to medical reasons.
You’ve had side effects from traditional treatments.
You want a non-pharmaceutical option.
You also have PTSD, as SGBs are widely used in PTSD treatment.
You Should Avoid SGB If:
❌ You’ve had a recent heart attack (the risks due to sympathetic nervous system manipulation might outweigh the benefits.)
❌ You’re on blood thinners or have a bleeding disorder (this procedure carries a small risk of bleeding).
❌ You have glaucoma, pre-existing nerve damage, or certain heart conditions that could be affected by the treatment.
Want to learn a framework to help you decide if a medical procedure like a stellate ganglion block is for you? If so, check out our BRAIN: A 5-Step Guide to Navigating Medical Choices with Confidence blog post.
Closing Thoughts on Stellate Ganglion Blocks for Hot Flashes
Stellate ganglion blocks are growing in popularity to treat PTSD, and now there is a growing body of research showing that it can be a safe alternative therapy for hot flashes.
If hot flashes and night sweats are affecting your daily life, you deserve options. Stellate ganglion blocks are an emerging alternative that may offer relief, especially if HRT and medications aren’t working for you.
While this treatment is promising, it’s not a one-size-fits-all solution. Your medical history and personal needs should always come first. If you’re curious about whether an SGB could work for you, the best next step is to talk with a trained provider to explore your options.
Ready to take the next step? If you’re interested in learning more about stellate ganglion blocks for menopausal symptoms, reach out today to see if this treatment is right for you.
References:
Lee YS, Wie C, Pew S, Kling JM. Stellate ganglion block as a treatment for vasomotor symptoms: Clinical application. Cleve Clin J Med. 2022 Mar 1;89(3):147-153. doi: 10.3949/ccjm.89a.21032. PMID: 35232827.
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Explore Stellate Ganglion Blocks (SGBs) as a non-hormonal option for hot flashes. Learn how they work, who they help, and what to expect
