GradedHealth

Does sage help menopause hot flashes? What the small trials show

Small trials suggest sage may ease hot flashes and sleep problems in menopause. The studies are few and small, and no long-term safety data were found.

Published October 2026

Short answer

Small trials suggest sage may ease hot flashes and sleep problems in menopause, but the evidence is limited and early. Evidence grade C (Limited). Meta-analysis of four small trials plus two placebo-controlled trials; downgraded for small size and inconsistent results, and held at C because human data do not fall below C.

Key takeaways

  • Four small trials (310 women in total) suggest sage may reduce how often hot flashes happen, but the pooled result was not clearly different from no effect [1].
  • One placebo-controlled trial of 66 women found sage tablets reduced flushing and night sweats more than placebo over three months, and sleep scores improved [2].
  • In an 80-woman trial funded by the maker of the tablet, the hot flash severity score fell by 55% on sage over four weeks [3].
  • Most trials were small, and some had no placebo group, so the results are early and need confirming in larger trials [4][5].

The short version

Sage (Salvia officinalis) is a common herb that has been traditionally used for hot flashes [4]. Small trials suggest sage may reduce how often and how strongly hot flashes happen, and may help sleep [1][2][3]. The evidence is early, because the trials are few and small [1]. See our sage topic page for the full picture.

What the studies show about sage and hot flashes

A 2023 meta-analysis pooled four trials with 310 postmenopausal women [1]. Hot flash frequency was lower with sage than with placebo, but the reported range (-2.37 to 0.14) includes no effect [1]. The pooled result for hot flash severity was not significant [1].

In a double-blind, placebo-controlled trial of 66 women, sage tablets taken three times a day for three months reduced flushing and night-sweat scores more than placebo [2]. In the same trial, the sleep score fell by 3.8 units in the sage group, from 9.4 to 5.6 [2].

In a placebo-controlled trial of 80 women, the hot flash severity score fell by 55% on sage over four weeks, and the Menopause Rating Scale fell by 39% [3]. The trial was funded by the maker of the tablet, Menosan, and one author worked for that company [3].

Two trials without a placebo group showed larger drops. An open trial of 71 women found total hot flash scores fell by 64% over eight weeks on one fresh sage tablet a day [4]. A study of 30 women taking a 100 mg sage capsule daily for four weeks found hot flash severity was lower after the four weeks than before [5]. Without a placebo group, these drops cannot be separated from natural changes in symptoms.

The nuances

The forms differ. The trials used fresh-leaf tablets, a branded ethanolic extract, and capsules, not tea, so results may not carry over to other sage products [4][3][5]. Doses in the meta-analysis ranged from 100 to 280 mg a day [1].

The trials were short. The longest ran three months [2], so there is no evidence on use beyond that.

Side effects were few in the trials that reported them. The open trial called the tablets very well tolerated [4], and the Menosan trial recorded three adverse events in total, none linked to treatment [3].

We found no study that tested sage against prescription medicines, measured liver or kidney effects, or looked at pregnancy or breastfeeding. Lab tests suggest sage contains estrogen-like flavonoids [6], so people with hormone-sensitive conditions should not assume it is safe for them. The trials did not study such people [1].

What this means for you

Sage may be worth discussing with a doctor if hot flashes are troubling you, particularly if you take other medicines, have a hormone-sensitive condition, or have a liver or kidney problem. The studies describe what happened to women in small trials. They are not a recommendation to take sage.

Go deeper

  • Sage — Small trials suggest sage (Salvia officinalis) may reduce how often and how strongly hot flashes happen in menopause, and may improve sleep and other menopause…

References

  1. The Effect of Salvia Officinalis on Hot Flashes in Postmenopausal Women: A Systematic Review and Meta-Analysis.. Int J Community Based Nurs Midwifery, 2023.
  2. The effect of Salvia officinalis extract on symptoms of flushing, night sweat, sleep disorders, and score of forgetfulness in postmenopausal women.. J Family Med Prim Care, 2020.
  3. Effectiveness of Menosan® Salvia officinalis in the treatment of a wide spectrum of menopausal complaints. A double-blind, randomized, placebo-controlled, clinical trial.. Heliyon, 2021.
  4. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes.. Adv Ther, 2011.
  5. The effect of Saliva officinalis extract on the menopausal symptoms in postmenopausal women: An RCT.. Int J Reprod Biomed, 2019.
  6. Salvia officinalis for hot flushes: towards determination of mechanism of activity and active principles.. Planta Med, 2013.