A Promising Treatment for Symptoms of Menopause: Stellate Ganglion Block

Understanding Menopausal Symptoms

Menopause marks a natural phase in a woman’s life, signifying the end of menstrual cycles. While it is a normal biological process, many women experience disruptive symptoms during the perimenopausal and menopausal periods. Common complaints include hot flashes, night sweats, mood swings, and insomnia. Hot flashes, in particular, affect up to 80% of women in the United States (Carpenter et al., 2015). These sudden episodes of heat, accompanied by sweating and flushed skin, can be distressing, particularly when they disrupt sleep.

While hormone replacement therapy (HRT) has traditionally been the gold standard for managing these symptoms, many women seek alternatives due to personal preferences, medical contraindications, or concerns about long-term risks associated with HRT (Carpenter et al., 2015). Nonhormonal therapies, including lifestyle modifications, herbal supplements, and pharmacologic options such as selective serotonin reuptake inhibitors (SSRIs), are available but often lack the immediate efficacy of HRT. Recently, a novel approach—stellate ganglion block (SGB)—has emerged as a promising, nonhormonal treatment for perimenopausal hot flashes and insomnia.

If you’re struggling with menopausal symptoms like hot flashes and insomnia, and you’ve been frustrated with the results of other treatments, Stellate Ganglion Block might be worth considering. The procedure is quick, minimally invasive, and generally well-tolerated. Most women are able to go back to their normal activities the same day.

What Is Stellate Ganglion Block?

The stellate ganglion is a bundle of nerves in the neck that plays a role in regulating the autonomic nervous system, including temperature regulation and sleep cycles. Stellate ganglion block involves an injection of a local anesthetic near this nerve cluster. Originally developed to treat chronic pain and post-traumatic stress disorder (PTSD), SGB is now gaining attention for its ability to alleviate menopausal symptoms such as hot flashes and insomnia.

Current Evidence Supporting SGB

Evidence from clinical trials and case studies demonstrates that stellate ganglion block provides effective and rapid relief from vasomotor symptoms, particularly hot flashes, and also improves sleep quality. One randomized controlled trial found that women who underwent SGB experienced significant reductions in the frequency and intensity of hot flashes compared to those who did not receive the treatment. Sleep disturbances, another major concern during menopause, also showed substantial improvement, with many women reporting better rest starting the night after the procedure (Li et al., 2023).

Initial case reports brought attention to the ability of SGB to address menopausal symptoms, showing that some women experienced complete or near-complete resolution of their hot flashes following the procedure. These findings led to further investigations into the neurobiological mechanisms of SGB. Research suggests that the procedure works by modulating the sympathetic nervous system, which plays a critical role in temperature regulation and sleep cycles (Lipov et al., 2005; Lipov & Kelzenberg, 2011).

A review of the procedure's clinical applications highlights its unique advantages, including the rapid onset of effects and its nonhormonal nature. Unlike other treatments, SGB offers a one-time or occasional intervention rather than requiring daily medication. These qualities make it particularly appealing to women who prefer to avoid the risks or inconvenience associated with hormone replacement therapy or other pharmacological options (Lee et al., 2022).

The broader push for effective nonhormonal treatments has been recognized in clinical guidelines, which underscore the need for innovative approaches like SGB. Current recommendations emphasize the importance of providing women with diverse options to manage their menopausal symptoms effectively (Carpenter et al., 2015).

A Real-World Perspective Dr. David George of Neuregen Integrative Psychiatry and Neurologic Health in Scottsdale, Arizona, has been an early adopter and pioneer of using Stellate Ganglion Block (SGB) in Arizona to treat PTSD, insomnia, chronic pain, and perimenopausal symptoms. According to Dr. George, “We’ve seen excellent results with SGB for women experiencing debilitating hot flashes and insomnia. One of the most remarkable aspects is that the effects are often immediate. Many patients report significantly improved sleep starting the very first night after the procedure.”

Dr. George also noted that SGB offers a unique advantage over traditional therapies: it is a one-time treatment for many women, though some opt for periodic boosters to maintain results. Unlike daily medications, SGB does not require ongoing monitoring, making it a convenient and effective option. He added, “The medical literature is increasingly supporting what we’ve observed in practice. It’s an exciting development in women’s health.”

Conclusion: A Bright Future for SGB in Menopause Care

For women seeking relief from the disruptive symptoms of menopause, stellate ganglion block offers a safe, effective, and nonhormonal alternative. With growing evidence from clinical trials and real-world success stories, SGB is poised to become an important tool in the management of hot flashes, insomnia, and other vasomotor symptoms.

References

Carpenter, J. S., Gass, M. L. S., Maki, P. M., Newton, K. M., Pinkerton, J. V., Taylor, M., Utian, W. H., Schnatz, P., Kaunitz, A. M., Shapiro, M., Shifren, J., Hodis, H. N., Kingsberg, S. A., Liu, J. H., Richard-Davis, G., Santoro, N., Sievert, L., Schiff, I., & Pike, C. J. (2015). Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause, 22, 1155–1174. https://doi.org/10.1097/GME.0000000000000546

Lee, Y., Wie, C., Pew, S., & Kling, J. (2022). Stellate ganglion block as a treatment for vasomotor symptoms: Clinical application. Cleveland Clinic Journal of Medicine, 89, 147–153. https://doi.org/10.3949/ccjm.89a.21032

Li, Y., Chang, J., Shi, G., Zhang, W., Wang, H., Wei, L., Liu, X., & Zhang, W. (2023). Effects of stellate ganglion block on perimenopausal hot flashes: A randomized controlled trial. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1293358

Lipov, E., Lipov, S., & Stark, J. (2005). Stellate ganglion blockade provides relief from menopausal hot flashes: A case report series. Journal of Women’s Health, 14(8), 737–741. https://doi.org/10.1089/JWH.2005.14.737

Lipov, E., & Kelzenberg, B. (2011). Stellate ganglion block (SGB) to treat perimenopausal hot flashes: Clinical evidence and neurobiology. Maturitas, 69(2), 95–96. https://doi.org/10.1016/j.maturitas.2011.02.008