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ESP Report: Nonpharmacologic Treatments for Menopause-associated Vasomotor Symptoms

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Nonpharmacologic Treatments for Menopause-associated Vasomotor Symptoms

Principal Investigators: Karen M. Goldstein, MD, MSPH; Remy R. Coeytaux, MD, PhD; John W. Williams, Jr. MD, MHSc
Co-investigators: Megan Shepherd-Banigan, PhD; Adam P. Goode, DPT, PhD; Jennifer R. McDuffie, PhD; Deanna Befus, BSN; Soheir Adam, MD; Varsha Masilamani, MBBS; Megan Van Noord, MSIS
Research Associates: Avishek Nagi, MS; Liz Wing, MA

Evidence-based Synthesis Program (ESP) Center, Durham VA Healthcare System, Durham, NC

Washington (DC): Department of Veterans Affairs; July 2016

Download PDF: Complete Report, Abstract, Report, Appendices


Vasomotor symptoms (VMS), which include hot flashes and night sweats, are the most common symptoms reported during the menopausal transition and are experienced by as many as 80% of women. VMS can lead to increased healthcare encounters for symptom relief and reductions in quality of life. The degree to which VMS is bothersome is determined not only by how frequently it occurs but also by other factors such as duration of VMS, coexisting sleep problems, and the extent to which VMS interferes with daily activities or job-related activities. Hormone therapy (HT) is an effective treatment for reducing VMS, but use of this therapeutic approach must be individualized through weighing benefits with known risks, such as cardiovascular events or uterine and breast cancers. Based on age (> 45 years), currently half of the approximately 360,000 women Veterans who use Veterans Health Administration healthcare are perimenopausal or postmenopausal. Due in part to concerns about possible harms from long-term hormone therapy and in part to uncertain efficacy and safety of pharmacologic treatments, many women with VMS seek nonhormonal, nonpharmacologic treatment options.

We developed the following research question in consultation with our stakeholders and a panel of technical experts:

In women with vasomotor symptoms (VMS) that are associated with perimenopause or postmenopause, what are the effects on VMS, health-related quality of life, and adverse effects of the following nonpharmacologic, nonhormonal interventions: acupuncture; yoga, tai chi, and qigong; structured exercise; and meditation, mindfulness, hypnosis, and relaxation?

See also

Non-Pharmacologic Treatments for Vasomotor Symptoms Associated with Menopause (Management Brief)

Nonpharmacologic Treatments for Menopause-associated Vasomotor Symptoms (Cyberseminar)

Shepherd-Banigan M, Goldstein KM, Coeytaux RR, et al. Improving vasomotor symptoms; psychological symptoms; and health-related quality of life in peri- or post-menopausal women through yoga: An umbrella systematic review and meta-analysis. Complementary Therapies in Medicine. 2017;34:156-164.

Befus D, Coeytaux R, Goldstein M, et al. Management of Menopause Symptomes with Acupuncture: An Umbrella Systematic Review and Meta-Analysis. The Journal of Alternative and Complementary Medicine. 2018;24(4).

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