Established Procedure
Injection Treatment

Stellate Ganglion Block

An injection of local anesthetic into a nerve bundle in the neck that may interrupt hot flash signals for several months.

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Stellate Ganglion Block (Injection Treatment)Compare

Method at a Glance

Measured outcomeRecommended (limited evidence)Guideline status: Recommended (limited evidence)
DurationUp to 6 months per injection (based on the Walega 2014 trial endpoint)
Cost$500–$1,500
Used forHot flash & night sweat relief
How you get itIn-Person Procedure · Prescription required
The details

What the evidence says

How well it works, what to watch for, who should avoid it, and the studies behind it.

Outcome & guideline status

Recommended (limited evidence)

Guideline status: Recommended (limited evidence)

Walega 2014 RCT (n=40): event rate ratio 0.50 for moderate-to-very-severe hot flash and night sweat frequency at 6 months in the active group vs sham (p<0.001), meaning symptoms were reduced by about half. The source does not report a single percentage, so no headline `typicalUse`/`perfectUse` value is used. NAMS 2023 Levels II-III recommendation (limited evidence).

Research sourceWalega 2014 RCT of stellate ganglion block for hot flashes (PMID 24496086)
Why we rate it this wayNAMS 2023 Nonhormone Therapy Position Statement

Cost & insurance

$500–$1,500

Often not covered by insurance for hot flashes; out-of-pocket varies widely per injection

Insurance CoverageNo

Duration & reversibility

Lasts forUp to 6 months per injection (based on the Walega 2014 trial endpoint)
Reversibility
Reversible

The science

How it works in the body

A clinician injects local anesthetic into the stellate ganglion, a nerve bundle in the neck that is part of the sympathetic nervous system. This may interrupt the temperature-regulation signals that trigger hot flashes.

Regulatory status & access

StatusEstablished Procedure
Used forHot flash & night sweat relief
How you get itIn-Person Procedure · Prescription required
PrescriptionRequired

Side effects

  • Temporary hoarseness
  • Drooping eyelid (Horner's syndrome, temporary)
  • Nasal congestion
  • Arm weakness (temporary)
  • Rare serious complications (seizure, cardiac arrest if injected into blood vessel)

Who shouldn't use this

  • •Active anticoagulation therapy(Use of blood-thinning medicines that increase bleeding risk)
  • •Local infection at injection site(An active infection at the procedure site or throughout the body)
  • •Severe bleeding disorder(A condition that impairs blood clotting and increases bleeding risk)
  • •Allergy to local anesthetic(An allergy to medicines used to numb a small area for procedures)

Clinical guidelines

NAMS

2023 Position Statement - Levels II-III recommendation (limited evidence)

View Guideline
The full picture

What to know about Stellate Ganglion Block

What it is

The stellate ganglion block (SGB) is an injection of local anesthetic into a nerve bundle in the neck. The stellate ganglion is part of the sympathetic nervous system, which may play a role in the temperature regulation signals that trigger hot flashes. Blocking it may interrupt those signals.

How well it works

A randomized controlled trial by Walega et al. found that the frequency of moderate to very severe hot flashes was reduced by about half at six months in the active treatment group, with an event rate ratio of 0.50 versus sham. The Menopause Society (NAMS 2023) lists it as a Levels II-III recommendation because the evidence base is still small. The injection itself is a standard pain management procedure, but its use for menopause hot flashes is off-label.

Side effects and cautions

Relief can last several months, and the procedure can be repeated. The Walega 2014 trial measured outcomes at six months and showed significant reduction at that timepoint. Common temporary side effects include hoarseness, a drooping eyelid (Horner’s syndrome), nasal congestion, and arm weakness. Serious complications are rare but include seizure or cardiac arrest if the anesthetic enters a blood vessel.

Cost and coverage

SGB is usually not covered by insurance for vasomotor symptoms. Pain management physicians, anesthesiologists, or interventional radiologists perform it in an in-person clinic setting. Check our provider directory for clinics near you.