Cognitive Behavioral Therapy : an Effective Treatment for Hot Flashes

Cognitive behavioral therapy : an Effective Treatment for Hot FlashesHot flashes (also known as hot flushes, or night sweats) are a symptom of the changing hormone levels that are considered to be characteristic of menopause. The sensation of heat usually begins in the face or chest, although it may appear elsewhere such as the back of the neck, and it can spread throughout the whole body. Some women pass out if the effects are strong enough. In addition to being an internal sensation, the surface of the skin, especially on the face, becomes hot to the touch.

The hot-flash event may be repeated a few times each week or constantly throughout the day, with the frequency reducing over time. Hot flashes may begin to appear several years before menopause starts and last for years afterwards. Some women undergoing menopause never have hot flashes. Others have mild or infrequent flashes.

In a new British  study, women who received psychotherapy, known as cognitive behavioral therapy, had reduced symptoms  of hot flashes, almost by half within six months.

According to a study "These results suggest that cognitive behavioral therapy delivered in group or self-help format is an effective treatment option for women during the menopause transition and postmenopause with problematic hot flashes/night sweats," wrote senior researcher Myra Hunter, at King's College London.

Hunter's team randomly assigned 96 women who had been treated for breast cancer and suffered from night sweats and hot flashes to either "talk therapy" or usual care.

The 47 women who received the therapy attended weekly 90-minute sessions for six weeks. For the others, usual care consisted of access to nurses and oncologists, telephone support and cancer support services, the researchers noted.


The therapy sessions included psycho-education, paced breathing, and behavioral strategies to manage hot flashes and night sweats, as well as interactive PowerPoint presentations, group discussion, handouts and weekly homework, Hunter said.


In addition, participants learned how to handle the stress associated with hot flashes and night sweats, and found new ways to decrease anxiety, she explained.


The women were also taught to manage hot flashes in social situations and to understand night sweats and improve sleep habits using mental and behavioral strategies.

The investigators found that the women who had received the cognitive behavioral therapy significantly reduced the number of hot flashes and night sweats they experienced in the nine weeks after the start of the study.


This reduction in symptoms lasted for 26 weeks. At nine weeks there was a 46 percent reduction in symptoms and a 52 percent reduction at 26 weeks, Hunter's team found.


Cognitive behavioral therapy : an Effective Treatment for Hot FlashesPsycho-education: an education with a goal  for the patient to understand and be better able to deal with the presented illness.


Through an improved view of the causes and the effects of the illness, psycho-education helps in  broadening the patient's view of  illness and this increased understanding can positively affect the patient. Important elements in psychoeducation are:

  • Information transfer (symptomatology of the disturbance, causes, treatment concepts, etc.)

  • Emotional discharge (understanding to promote, exchange of experiences with others concerning, contacts, etc.)

  • Support of a medication or psychotherapeutic treatment, as cooperation is promoted between the mental health professional and patient (compliance, adherence).

  • Assistance to self-help (e.g. training, as crisis situations are promptly recognized and what steps should be taken to be able to help the patient).


Paced Breathing: Rhythmic, paced breathing balances the autonomic nervous system, and is an effective therapeutic treatment for hot flashes. Apart from the prolonged training, practicing, skill, and motivation needed, effortlessly performed paced breathing involves individualized breathing patterns that typically require personal coaching. The physiological origin of the hypotensive effects of paced breathing has traditionally been attributed to the �relaxation response.�  Relaxation is a widely accepted, beneficial outcome of slow breathing. Rhythm formulas that involve breathing at six breaths per minute induce favourable psychological and possibly physiological effects.

Principles of device-guided paced breathing: (1) monitoring breathing movements, (2) composing breathing-guiding tones, and (3) synchronizing breathing movements with the guiding tones. 

Behavioral Strategies:  Behavior is defined any action that can be seen or heard. An effective method of examining behavior is to use the ABC model:  


A=Antecedent: The event occurring before a behavior. This event prompts that behavior.
B=Behavior: Response to the events that can be seen or heard.
C=Consequence: The event(s) that follow(s) the behavior. This effects whether the behavior will occur again.

By making an effective use of this strategy symptoms of hot flashes  can be considerably controlled.

By making use of these therapeutic strategies women are bound to  feel more confident about coping with menopausal symptoms, like hot flashes.


Dated 31 March 2012


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