Clinical hypnosis found more effective against hot flashes vs CBT

Clinical hypnosis found more effective against hot flashes vs CBT | Image Credit: © Zadvornov - © Zadvornov - stock.adobe.com.

Clinical hypnosis is more effective than cognitive behavioral therapy (CBT) for managing hot flashes, according to a recent review presented at the 2024 Annual Meeting of The Menopause Society.¹

The prevalence of nonhormone treatment methods for menopause symptoms such as hot flashes has increased over time, especially among women with health conditions that leave them unable to take hormone therapies. These conditions include being a breast cancer survivor or having concerns about the potential risks of hormone therapy.

In 2023, The Menopause Society addressed the significant percentage of women who cannot take hormone therapy in their Nonhormone Therapy Position Statement. This statement discussed the possibility of clinical hypnosis and CBT as alternative treatment methods for hot flashes.

The statement was developed following evaluation of literature published after a 2015 statement from The Menopause Society by an advisory panel of clinicians and research experts.² Lifestyle, mind-body-techniques, prescription therapies, dietary supplements, and acupuncture, other treatments, and technologies were discussed.

Lifestyle techniques to control core body temperature include clothing adjustments and environmental controls. A small trial has indicated reductions in sleep problems and hot flashes from the use of a forehead cooling device and sleep hygiene instructions, but more data is needed to establish the efficacy of these methods.

In comparison, data from 2 double-blind randomized controlled trials has indicated a clinically significant improvement in hot flashes among women receiving CBT, with further trials supporting this evidence. Two trials also evaluated the efficacy of clinical hypnosis against hot flashes over a 5-week period, finding significantly reduced hot flash frequency after intervention vs no treatment.

Since publication of the Nonhormone Therapy Position Statement, a new review has compared the efficacy of clinical hypnosis vs CBT for treating hot flashes.¹ The review included 23 studies conducted between 1996 and 2022, 8 of which administered clinical hypnosis and 15 administered CBT.

Results indicated significantly increased efficacy from clinical hypnosis interventions in reducing hot flash frequency and severity when compared to CBT. Other symptoms significantly improved by clinical hypnosis vs CBT included quality of life, sleep quality, and mood.

A significant reduction of over 60% for hot flash frequency was reported following clinical hypnosis, while mixed results were reported following CBT. However, CBT was linked to reduced daily interference and stress caused by hot flashes.

According to Vanessa Muniz, lead author from Baylor University, these results highlight the potential impact of hypnosis to act through mechanisms beyond response expectancy and placebo effect. This indicates potential alteration of activity in the medical preoptic area of the hypothalamus.

Investigators recommended additional research to determine the neurophysiological mechanisms of hypnosis. This may allow delivery of the intervention to be improved through methods such as smartphone apps, as well as ensuring the intervention is tailored for individual characteristics, optimizing hot flash management.

"Since hot flashes are one of the most common bothersome symptoms of menopause, evaluating the available treatment options, including the nonhormone options, are important so we can provide our patients with the option that will work best for them, said Stephanie Faubion, MD, MBA, medical director for The Menopause Society.

Additional study results will be discussed at the abstract presentation, “Clinical hypnosis and cognitive behavioral therapy for hot flashes: a scoping review,” presented at the 2024 Annual Meeting of The Menopause Society.

Reference

1. Clinical hypnosis vs. cognitive behavioral therapy: What's better for managing hot flashes? The Menopause Society. September 10, 2024. Accessed September 9, 2024.
2. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause: The Journal of The North American Menopause Society. 2023;30(6):573-590. doi:10.1097/GME.0000000000002200