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Grand Rounds

Can Mindfulness Alleviate Menopausal Hot Flashes?

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BACKGROUND AND PURPOSE:

  • Van Driel et al. (BJOG, 2018) assessed the effectiveness of psychological interventions, including mindfulness, in reducing menopausal symptoms, both natural or treatment-induced

METHODS:

  • Systematic review and meta-analysis
    • RCTs
    • Participants were women with natural or treatment-induced menopause
    • Studies investigated the impact of
      • Cognitive behavioral therapy | Behavioral therapy | Mindfulness-based therapies
    • Menopausal symptoms
      • Combined level of burden including psychosocial symptoms (e.g. irritability, forgetfulness), physical symptoms (e.g. headaches), genital symptoms, sexual dysfunction and vasomotor symptoms (hot flushes and night sweats)
    • Follow up
      • Short-term: <20 weeks
      • Medium-term: ≥20 weeks
    • Primary outcomes
      • Frequency of hot flushes
      • Hot flush ‘bother’
      • Other menopausal symptoms
      • Sexual functioning
    • Subgroup analysis
      • Treatment-induced menopause: Exclusively breast cancer populations
      • Natural menopause

RESULTS:

  • 12 RCTs
  • Short-term benefit of psychological interventions in comparison to no treatment or control
    • Hot flush bother: Standardized mean difference (SMD) −0.54 (95% CI, −0.74 to −0.35; P < 0.001)
    • Menopausal symptoms: SMD −0.34 (95% CI, −0.52 to −0.15; P < 0.001)
  • Medium-term benefit of psychological interventions in comparison to no treatment or control
    • Hot flush bother: SMD −0.38 (95% CI, −0.58 to −0.18; P < 0.001)
  • Subgroup analysis of both treatment-induced menopause and natural menopause demonstrated positive short-term and medium-term benefit of psychological interventions
    • Short-term induced: SMD −0.47 (95% CI, −0.69 to −0.25; P < 0.001)
    • Short-term natural: SMD −0.85 (95% CI, −1.11 to −0.59; P < 0.001)
  • Too few studies to report accurately regarding sexual functioning

CONCLUSION:

  • Psychological treatments such as mindfulness successfully reduced bother of hot flushes in short- and medium-term follow- up, as well as menopausal symptoms overall in the short-term
  • Because hot flush frequency was not impacted, authors suggest the mechanism of these interventions is to enhance coping skills and thus reduce impact of symptoms

Learn More – Primary Sources:

Mindfulness, cognitive behavioural and behaviour‐based therapy for natural and treatment‐induced menopausal symptoms: a systematic review and meta‐analysis

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Related ObG Topics:

North American Menopause Society: Hormone Therapy Statement
Insomnia in Menopause: How do Treatments Compare?
Managing Sexual Concerns in Patients with Ovarian Cancer
What Hormone Profile is Associated with Hot Flashes?

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