Mind–body interventions for vasomotor symptoms in healthy menopausal women and breast cancer survivors. A systematic review

Abstract

Mind–body therapies are commonly recommended to treat vasomotor symptoms, such as hot flushes and night sweats (HFNS). The purpose of this systematic review was to evaluate the available evidence to date for the efficacy of different mind–body therapies to alleviate HFNS in healthy menopausal women and breast cancer survivors. Randomized controlled trials (RCTs) were identified using seven electronic search engines, direct searches of specific journals and backwards searches through reference lists of related publications. Outcome measures included HFNS frequency and/or severity or self-reported problem rating at post-treatment. The methodological quality of all studies was systematically assessed using predefined criteria. Twenty-six RCTs met the inclusion criteria. Interventions included yoga (n = 5), hypnosis (n = 3), mindfulness (n = 2), relaxation (n = 7), paced breathing (n = 4), reflexology (n = 1) and cognitive behavioural therapy (CBT) (n = 4). Findings were consistent for the effectiveness of CBT and relaxation therapies for alleviating troublesome vasomotor symptoms. For the remaining interventions, although some trials indicated beneficial effects (within groups) at post-treatment and/or follow up, between group findings were mixed and overall, methodological differences across studies failed to provide convincing supporting evidence. Collectively, findings suggest that interventions that include breathing and relaxation techniques, as well as CBT, can be beneficial for alleviating vasomotor symptoms. Additional large, methodologically rigorous trials are needed to establish the efficacy of interventions on vasomotor symptoms, examine long-term outcomes and understand how they work.

Keywords:

• Hot flashes
• mind–body interventions
• night sweats
• vasomotor symptoms

Disclosure statement

The authors report that they have no conflicts of interest.

Current knowledge on the subject

• Mind–body interventions have shown promise for the management of menopausal complaints including enhanced mood, wellbeing and improved sleep.

• Recent position statements regarding the management of menopausal symptoms make different recommendations regarding the role of mind–body interventions.

What this study adds

• We critically evaluate evidence from available randomised controlled trials regarding the efficacy of mind–body therapies to alleviate vasomotor symptoms in healthy, menopausal women and in breast cancer survivors.

• We found little to moderate evidence for long-term effectiveness of clinical hypnosis, yoga, mindfulness and reflexology interventions for vasomotor symptom relief in healthy menopausal women and breast cancer patients.

• In line with the recommendations of the North American Menopause Society, this review supports the use of CBT as a relatively risk free non-pharmaceutical therapy for the management of vasomotor symptoms.