Behavioral Therapy May Help Ease Hot Flashes
Essentially, that means the symptoms were noticeably less problematic" and interfering less in the women's daily lives, explained senior researcher Myra S. Hunter, of King's College London in the UK. Right now, hormone replacement therapy is considered the most effective treatment for bothersome hot flashes. But since hormones have been linked to increased risks of heart disease, blood clots and breast cancer, many women want alternative remedies. Some antidepressants have been found to cool hot flashes. Natural" products -- such as black cohosh, soy and flaxseed -- have been studied but generally failed to stand up to the test of clinical trials.
Past research has shown that certain thoughts and reactions to hot flashes can make women feel worse, while other responses can help them feel better, Hunter told Reuters Health in an email. We think that cognitive behavioral therapy works mostly by changing women's perception and interpretation of the (hot flashes) -- as well as countering overly negative beliefs about menopause," Hunter explained. Cognitive behavioral therapy is a treatment option for a host of health problems, from depression to sleep problems to digestive disorders. In general, it aims to change the unhealthy thinking patterns and behaviors that can feed a person's physical or mental symptoms.
When it comes to menopause symptoms, Hunter said, the therapy involves developing helpful, accepting approaches to hot flashes and also using breathing exercises to focus attention away from the flashes and negative thoughts." But in the real world, behavioral therapy specifically aimed at menopause symptoms is not widely available. MOSTLY SELF-TAUGHT For now, it's under study. For their trial, Hunter and her colleagues recruited 140 women who'd been having bothersome hot flashes and night sweats at least 10 times a week for a month or more. They randomly assigned the women to either have group-based therapy, a self-help version or no treatment. Women who had group therapy went to four sessions over a month. The self-help therapy was not completely independent; women had one meeting and a phone call with a psychologist who guided the therapy. But otherwise, they used a book and CD to teach themselves tactics for dealing with hot flashes.
After six weeks, Hunter's team found, 65 percent of women who'd had group therapy reported a meaningful drop in how problematic their hot-flash symptoms were. The same was true of 73 percent of women in the self-help group. That compared with 21 percent of women who'd had no treatment. And the benefit, the study found, was still apparent after six months -- though by then one-third of the untreated group had improved. When it came actual numbers, women in the therapy groups said they were having fewer hot flashes. But women who'd gotten no treatment reported a similar drop. Instead, the benefit seemed to come from changes in how women perceived their symptoms.
Women say that they might still have hot flashes but not notice them, and that they feel more confident about coping with them," Hunter said. She said she and her colleagues are publishing their self-help book and plan to train health professionals in different countries so that behavioral therapy for menopausal symptoms can become more widely available. In the U.S., the cost of cognitive behavioral therapy varies based on the specific program, but a typical figure would be between $100 and $200 an hour.