User Outcomes for an App-Delivered Hypnosis Intervention for Menopausal Hot Flashes: Retrospective Analysis

Abstract

Background: Hypnotherapy has been shown to be a safe, nonhormonal intervention effective for treating menopausal hot flashes. However, women experiencing hot flashes may face accessibility barriers to in-person hypnotherapy. To solve this issue, a smartphone app has been created to deliver hypnotherapy. The Evia app delivers audio-recorded hypnotherapy and has the potential to help individuals experiencing hot flashes.

Objective: This study aims to determine user outcomes in hot flash frequency and severity for users of the Evia app.

Methods: This study is a retrospective analysis of a dataset of Evia app users. Participants were divided into 2 groups for analysis. The first group reported daytime hot flashes and night sweats, while the second group was asked to report only daytime hot flashes. The participants in the first group (daytime hot flashes and night sweats) were 139 women with ≥3 daily hot flashes who downloaded the Evia app between November 6, 2021, and June 9, 2022, with a baseline mean of 8.330 (SD 3.977) daily hot flashes. The participants in the second group (daytime hot flashes) were 271 women with ≥3 daily hot flashes who downloaded the Evia app between June 10, 2022, and February 5, 2024, with a baseline mean of 6.040 (SD 3.282) daily hot flashes. The Evia program included a 5-week program for all participants with daily tasks such as educational readings, hypnotic inductions, and daily hot-flash tracking. The app uses audio-recorded hypnosis and mental imagery for coolness, such as imagery for a cool breeze, snow, or calmness.

Results: A clinically significant reduction, defined as a 50% reduction, in daily hot flashes was experienced by 76.3% (106/139) of the women with hot flashes and night sweats and 56.8% (154/271) of the women with daily hot flashes from baseline to their last logged Evia app survey. On average, the women with hot flashes and night sweats experienced a reduction of 61.4% (SD 33.185%) in their hot flashes experienced at day and night while using the Evia app, and the women with daily hot flashes experienced a reduction of 45.2% (SD 42.567%) in their daytime hot flashes. In both groups, there was a large, statistically significant difference in the average number of daily hot flashes from baseline to end point (women with hot flashes and night sweats: Cohen d=1.28; t₁₃₈=15.055; P<.001; women with daily hot flashes: Cohen d=0.82; t₂₇₀=13.555; P<.001).

Conclusions: Hypnotherapy is an efficacious intervention for hot flashes, with the potential to improve women's lives by reducing hot flashes without hormonal or pharmacological intervention. This study takes the first step in evaluating the efficacy of an app-delivered hypnosis intervention for menopausal hot flashes, demonstrating the Evia app provides a promising app delivery of hypnotherapy with potential to increase accessibility to hypnotherapy.

Keywords: alternative; applications; complementary; gynecology; hot flash; hypnosis; hypnotherapy; intervention; mHealth; menopause; mind-body; mobile health; mobile phone; outcome; smartphone app; user; women’s health.

Figure 1

Simple box plot of hot flash frequency change outliers. After excluding app users based on the eligibility criteria, a box plot was created to view the distribution of the changes in hot flash frequency from baseline to end point. This method revealed 6 participants who were statistical outliers. To best represent the relevant data to answer our study aims, these 6 outliers were removed from the final analysis in a retrospective data analysis on app use and outcomes in women experiencing menopausal hot flashes who downloaded the Evia app between November 6, 2021, and February 5, 2024.