Use of mindfulness, meditation and relaxation to treat vasomotor symptoms

Abstract

Postmenopausal women with bothersome vasomotor symptoms (VMS) often seek alternatives to hormone-based treatment due to medication risks or personal preference. We sought to identify the effects of meditation, mindfulness, hypnosis and relaxation on VMS and health-related quality of life in perimenopausal and postmenopausal women. To do this, we conducted an umbrella review supplemented by new randomized, controlled trials (RCTs) published since the most recent good-quality systematic review for eligible interventions. We searched MEDLINE and the Cochrane Database of Systematic Reviews, PubMed, EMBASE, CINAHL and the Allied and Complementary Medicine Databases. We identified five systematic reviews and six new RCTs that met eligibility criteria. In a new meta-analysis examining four RCTs comparing paced respiration with a control group, we found that paced respiration is not associated with a statistically significant decrease in VMS frequency (standardized mean difference (SMD) 0.04, 95% confidence interval (CI) -0.73 to 0.82, I²=56.6%, three trials) or severity (SMD 0.06, 95% CI -0.69 to 0.80; I²=65.1%, three trials). There was not sufficient new information to conduct meta-analyses that examined the effect of mindfulness or hypnosis on our outcomes of interest. No effect on VMS or quality of life was found between various relaxation or mindfulness interventions.

Keywords:

• Vasomotor symptoms
• relaxation
• paced respiration
• menopause

Acknowledgements

This manuscript is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Durham VA Medical Center, Durham, NC, funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative (Project #09-009.2016). We would like to thank Megan Van Noord for her assistance in the development and conducting of the literature search, Avishek Nagi for his technical support, and Liz Wing for editing and writing support.

Conflict of interest

No investigators have any affiliations or financial involvement that conflict with material presented in this manuscript.

Source of funding

Dr Goldstein’s effort is supported by VA HSR&D CDA #13-263. Megan Shepherd-Banigan is supported by a VA OAA HSR&D PhD Fellowship TPH 21-027. The findings and conclusions in this document do not necessarily represent the views of the Department of Veterans Affairs or the United States Government. This work was supported by the Center of Innovation for Health Services Research in Primary Care (CIN 13-410) at the Durham VA Medical Center.