Psychoeducational interventions to alleviate hot flashes: a systematic review.

OBJECTIVE: Hot flashes are frequent and bothersome in menopausal women and breast cancer survivors. Most pharmacological interventions or herbal therapies for hot flashes have limitations because of contraindications in breast cancer survivors, side effects, or lack of proven efficacy. The aim of this study was to assess the effects of psychoeducational interventions, including relaxation, on hot flashes in menopausal women and women previously diagnosed with breast cancer. DESIGN: MEDLINE, CINAHL, PsycInfo, the Cochrane Library, and reference lists of articles were searched for relevant articles published between January 1980 and December 2006. Data extraction and quality assessment were carried out by two of the authors. RESULTS: Fourteen studies involving 475 patients were included. Five studies evaluated psychoeducational interventions, including education, counseling, cognitive-behavioral strategies, and mindfulness-based stress reduction. All showed an improvement in vasomotor symptoms, although the experimental group in the two studies containing the largest numbers of participants also received pharmacological therapies. Nine trials evaluated the efficacy of relaxation techniques to improve hot flashes. Five of these studies showed a significant improvement in hot flashes. Only three of the 14 studies evaluated a psychoeducational intervention in breast cancer survivors. Two of these showed a significant improvement in hot flashes. CONCLUSIONS: Psychoeducational interventions, including relaxation, seem to alleviate hot flashes in menopausal women and breast cancer survivors; however, the methodological quality of published research is either fair or poor. More studies are required, especially in the breast cancer population where only a few studies are available, before psychoeducational interventions are offered as a treatment option.