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What works, and what does not

Sage

Four small trials, all pointing the same way, and none of them big enough to settle it.

For hot flashes: might helpFor night sweats and sleep: not proven

The short answer

For hot flashes: might help
All four trials in a 2023 review reported fewer and less severe hot flashes, but together they included only 310 women.
For night sweats and sleep: not proven
Only one of the four trials looked at how long flashes lasted, and sleep was not the thing being measured.

What it is

The kitchen herb, Salvia officinalis, sold as a tablet or extract for hot flashes. It contains plant compounds with some estrogen like activity.

What the studies say

  • A 2023 systematic review searched six databases and found 4 trials with 310 people in total.
  • Three of the four looked at how often hot flashes happened, three at how severe they were, and one at how long they lasted.
  • All four reported that sage reduced the frequency and severity of hot flashes in postmenopausal women.
  • The reviewers still said wider use should wait until the finding is confirmed in further research. Four small trials is not much to build on.
  • The NHS says there is very little evidence on how well herbal remedies for menopause work, or how safe they are.

What a label is allowed to say

No approved claim for hot flushes or sweating. Claims for plant extracts like this one are on hold in the UK.

In the US the rules are looser. A label may say how a nutrient supports the body if the company holds evidence for it. The FDA does not check the claim first, which is why US labels carry the line saying the FDA has not evaluated it.

Safety

  • Herbal products are not regulated like medicines, so strength and purity vary between brands.
  • Sage in large amounts or as a concentrated oil contains thujone, which is why culinary amounts and supplement amounts are not the same thing.
  • Herbal remedies can cause serious side effects when taken with other medicines, so a pharmacist should see your list.
  • Nobody has tested taking it for years.

Ask your doctor first if

  • You have epilepsy or a seizure disorder.
  • You take any prescription medicine, particularly for diabetes, seizures or sedation.
  • You have had a hormone sensitive cancer.

This is general information, not medical advice. Check with your doctor or pharmacist, especially if you take medication.

Sources

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