‘The mind is medicine’: How virtual reality can cool bothersome hot flashes
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Key takeaways:
- Tailored virtual reality experiences may help relieve menopausal hot flashes.
- More research is needed on the potential role of VR for menopause symptoms.
CHICAGO — For menopausal women experiencing disruptive, bothersome hot flashes, some relief may come from visiting a snowy landscape by slipping on a virtual reality headset, according to a speaker.
The idea, while sounding a bit like science fiction, is already being tested by researchers at the Mayo Clinic and Cedars-Sinai Los Angeles, who are working to design a VR experience that provides cognitive behavioral therapy (CBT) along with an immersive experience that can help rewire how the brain experiences a hot flash. The findings were reported at the Annual Meeting of The Menopause Society.
“Menopause symptoms can be treated medically, but there is also evidence that cognitive behavioral therapy can help manage the symptoms, particularly vasomotor symptoms,”
Brennan Spiegel, MD, MSHS, the George and Dorothy Gourrich Chair in Digital Health Ethics and professor of medicine and public health at Cedars-Sinai, told Healio. “The question is: Are there ways to create a tailored, at-home CBT therapeutic to help manage menopause among the millions of women experiencing the symptoms of this life change?”
Spiegel has worked with Stephanie S. Faubion, MD, MBA, NCMP, IF, director of the Mayo Clinic Center for Women’s Health and medical director of The Menopause Society, and other menopause experts to cocreate a VR therapy that provides fully immersive experiences for women experiencing bothersome vasomotor symptoms.
“This is based upon extensive evidence that VR is very effective for managing a variety of symptoms through various forms of CBT,” Spiegel told Healio during an interview. “It can manage pain, anxiety, sleep, depression.”
There is little empirical evidence demonstrating VR therapies can manage menopause symptoms, but Spiegel said there are studies that suggest it can work. In a related poster presentation, Spiegel and colleagues conducted a literature search of studies that assessed any form of virtual or augmented reality for menopausal women between 2012 and 2024, finding only three studies specifically targeting menopause-related symptoms, with limited data. However, the researchers noted that medical VR and AI have proved to be effective in administering CBT for various health conditions, and the same technology could improve quality of life and reduce symptom burden related to menopause.
“We are working with women experiencing menopause and learning from them to codevelop a new therapy, currently underway,” Spiegel told Healio. “This would be an 8-week, at-home, self-administered treatment program to help manage the symptoms of menopause through a whole variety of different VR experiences while also using AI to help support tailored, personalized CBT.”
Immersion in a ‘beautiful, snowy environment’
Spiegel said a woman experiencing hot flashes, along with the distress that can accompany them, might be surprised how they feel after putting on a VR headset and feeling as if they have been transported to a cool, snowy landscape.
“You hear wind rustling in your ears and literally start to feel your body cooling down,” Spiegel told Healio. “It is one thing to look at a photo of the snow. It is quite different to immerse yourself in a beautiful, snowy environment. There is evidence that when the brain is immersed in VR, it thinks it is there. Even if you know it is a simulation, the brain acts as if it is real. It is an interesting philosophical thought experiment, because the world around us is constructed within our own mind, using the senses of our body. Our brain never evolved to live in two realities at once. It lives in the reality that it constructs.”
Using VR, Spiegel said, clinicians can modify, therapeutically, the environments that are therapeutically aligned with the outcomes of interest.
“We can play distracting games,” Spiegel said. “We developed a game where you can throw snowballs at penguins running around, for example. Or you can participate in a meditation, counteracting the symptoms of hot flashes.”
Spiegel said he has seen firsthand patients with severe gastrointestinal symptoms who report significantly less pain — and are sometimes emotionally moved to tears — after spending time in a VR environment.
“The mind is medicine,” Spiegel told Healio. “This is an easy thing to say — and it sounds a little woo-woo — but the brain and the body are connected. They coevolve with one another. The brain will send signals through the vagus nerve and if we modify the brain in moments of distress, we do modify the body. That will change vasomotor symptoms and other symptoms, too.”
Moving beyond VR
Spiegel said the goal of a VR intervention is for patients to realize that they can manage their pain without a special headset.
“What VR is teaching people is that you do have this ability to control your body’s physiology, through your own mind,” Spiegel told Healio. “This is something we all know to be true, but it is not part of traditional, typical medical therapy. We like to medicalize lots of things, and menopause is one of them.”
Spiegel said there remains a role for pharmacotherapy for bothersome menopause symptoms, but CBT can be “powerful.” Through VR, CBT could become more accessible for patients who cannot access traditional talk therapy due to high cost, stigma or lack of access to a local therapist.
“With this system, you have your own personal AI VR therapist, whenever you need it,” Spiegel told Healio. “Can we parlay the advantages of VR for those similar but slightly different conditions, like chronic pain, and leverage them for menopause? Through our partnership with Mayo Clinic, we hope to have answers within the next year.”
Reference:
- Suchak KK, et al. P130. Presented at: Annual Meeting of The Menopause Society; Sept. 10-14, 2024; Chicago.
For more information:
Brennan Spiegel, MD, MSHS, can be reached at brennan.spiegel@cshs.org