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Mind and body go together, and psychosomatic interactions are very common, although not fully understood. Traditional medicine is perhaps a very good example for the healing potential of alternative therapies. Hot flushes, although believed to be derived from menopause-associated hormonal changes, may be influenced by a variety of emotional and psychological factors. Two recent studies have highlighted the role of cognitive behavior interventions on hot flushes [1, 2]. In the first study [1], a secondary analysis was performed of 140 women with problematic hot flushes/night sweats (HF/NS) who were recruited to the MENOS2 trial. Women suffered at least ten episodes per week for at least a month. Forty-eight women were randomly assigned to group cognitive behavior therapy (CBT), 47 were randomly assigned to self-help CBT, and 45 were randomly assigned to usual care. Self-report questionnaires were completed at baseline, 6 weeks post-randomization, and 26 weeks post-randomization. CBT was effective at reducing HF/NS problem-rating regardless of age, body mass index, menopause status, or psychological factors at baseline. Fully reading the manual in the self-help CBT arm and completing most homework assignments in the group CBT arm were related to greater improvement in problem-rating at 6 weeks. The effect of CBT on HF/NS problem-rating was mediated by changes in cognitions (beliefs about coping/control of hot flushes, beliefs about night sweats and sleep) but not by changes in mood. The findings suggested that CBT works mainly by changing the cognitive appraisal of HF/NS. In the second study [2], CBT was provided through self-help CBT intervention (booklet and relaxation/paced breathing CD) during a 4-week period. Women ([i]n[/i] = 47) also received one ‘guiding’ telephone call from a clinical psychologist 2 weeks into treatment to provide support and discuss individual treatment goals. Questionnaires were collected at baseline, 6 weeks (post-treatment) and 3 months (follow-up) after the end of the intervention. There was a significant reduction in HF/NS problem-rating following the intervention which was maintained at follow-up. Moreover, women reported less frequent HF/NS along with further improvements in sleep quality, mood and HF/NS beliefs and behaviors. Thus, self-help CBT for HF/NS proved effective in women unable to attend face-to-face sessions, or living at a distance, while using an additional, minimal telephone guidance.

Author(s)

  • Amos Pines
    Department of Medicine T, Ichilov Hospital, Tel-Aviv, Israel

Citations

  1. Norton S, Chilcot J, Hunter MS. Cognitive-behavior therapy for menopausal symptoms (hot flushes and night sweats): moderators and mediators of treatment effects. Menopause 2013 Oct 21. Epub ahead of print
    http://www.ncbi.nlm.nih.gov/pubmed/24149919
  2. Stefanopoulou E, Hunter MS. Telephone-guided self-help cognitive behavioural therapy for menopausal symptoms. Maturitas 2013 Oct 1. Epub ahead of print
    http://www.ncbi.nlm.nih.gov/pubmed/24144959
  3. Pachman DR, Jones JM, Loprinzi CL. Management of menopause-associated vasomotor symptoms: Current treatment options, challenges and future directions. Int J Womens Health 2010;2:123-35.
    http://www.ncbi.nlm.nih.gov/pubmed/21072305
  4. Mann E, Smith MJ, Hellier J, et al. Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial. Lancet Oncol 2012;13:309-18.
    http://www.ncbi.nlm.nih.gov/pubmed/22340966
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