Clinical self-hypnosis improves hot flash symptoms, study shows

Self-administered clinical hypnosis reduced hot flash frequency and severity by more than 50%, according to the results of a recent study published in Obstetrics and Gynecology.

A team of researchers, including corresponding author Gary Elkins, Ph.D., Department of Psychology and Neuroscience, Baylor University in Texas, recruited 250 postmenopausal women who reported at least 28 hot flashes a week, 62 of whom had a history of breast cancer. The average age of participants was 56 years old. The trial was conducted from Mar. 4, 2019, to Feb. 16, 2024.

Participants were either assigned self-guided audio recordings of hypnosis sessions, consisting of cooling imagery and relaxation suggestions, for 20 minutes a day for 6 weeks or assigned white noise recordings labeled as hypnosis.

More than half (53%) of women in the hypnosis group had hot flash symptom relief compared with 41% in the control group. The primary outcome was measured by the change in hot flash score from baseline to 6 weeks, with a 12-week follow-up.

The average hot flash scores for the hypnosis group were 89 at baseline, 41 at week 6 and 35 at follow-up. For the sham hypnosis group, baseline hot flash scores were 95, 56 at week 6 and 53 at follow-up.

“As reported in prior literature, interventions must achieve a 50% or more reduction in hot flash frequency and daily interference to be considered clinically significant,” Elkins and his team wrote in the study. “This study’s findings for self-administered clinical hypnosis are consistent with prior randomized clinical trials comparing a therapist-delivered clinical hypnosis intervention with a waiting list and structured-attention control groups.”

Participants maintained a Hot Flash Daily Diary to record hot flash frequency and severity. Perception of benefit was measured using the Subject Global Impression of Change, a 7-point scale, with lower scores indicating a greater benefit. Secondary outcomes were measured using the Hot Flash Related Daily Interference Scale.

Up to 80% of women report hot flashes for an average of 4 to 7 years after menopause. In addition to the sweating and discomfort felt during a hot flash, additional symptoms can include fatigue and sleep interference, which can lead to a decreased quality of life.

Hormone therapies can address menopause symptoms; however, an FDA black box label warning was placed on most products in the early 2000s because the results of the Women’s Health Initiative Study showed the therapy led to an increased risk of cardiovascular disease, breast cancer and dementia. In November, the FDA revisited the recommendation and is now in the process of removing all the warnings except for the boxed warning for endometrial cancer for systemic estrogen-alone products. The FDA currently recommends that women can start hormone replacement therapy within 10 years of menopause onset or before 60 years of age.

The Menopause Society currently recommends clinical hypnosis for the treatment of vasomotor symptoms, according to level 1 evidence, the study says.

“Randomized clinical trials of therapist-delivered hypnosis have shown clinically significant efficacy for reductions in the frequency and severity of hot flashes,” Elkins and his team write in the study. “In prior studies assessing the effectiveness of clinical hypnosis across different delivery modes, self-administered hypnosis interventions for irritable bowel syndrome and chronic pain have shown promising results with effectiveness comparable to in-person delivery, while also improving accessibility.”