Podcast Summary: Dr. Chapa’s OBGYN Clinical Pearls

Episode: Self-Hypnosis For Hot Flash Relief
Date: November 12, 2025
Host: Dr. Chapa
Theme: Evidence-based, practical discussion on self-hypnosis as a tool for hot flash relief in postmenopausal women, focusing on a new landmark clinical trial.

Overview

This episode dives deep into a brand-new randomized clinical trial published in JAMA Network Open (Nov 11, 2025), evaluating whether self-hypnosis, delivered via audio recordings, can provide measurable relief from bothersome hot flashes in postmenopausal women. Dr. Chapa reviews the scientific background of hypnosis, outlines the study’s design and results, addresses safety considerations, and offers practical insights for integrating this non-pharmacologic option into patient care.

Key Discussion Points & Insights

1. The Science and Perception of Hypnosis

• Dr. Chapa kicks off with a playful, slightly creepy mock-hypnotic script, quickly clarifying the legitimate, evidence-based uses of hypnosis.
• Recounts the historical roots of hypnosis in medical practice:
  • "It was first done, I mean, 1843, that was the time that hypnosis was first described as potentially a medical tool... Scottish surgeon James Braid." (07:20)
  • Explains origins: ‘hypnosis’ from Greek word for sleep—hypnos.
• Addresses skepticism around hypnosis:
  • “Historically, I’ve had my concerns. I thought it was kind of hokey. It’s not. Hypnosis is real.” (08:30)
  • Recognizes the confusion between entertainment hypnosis and genuine therapeutic hypnosis.

2. Hot Flash Management: The Context

• Connects the episode’s topic to ongoing changes in menopausal therapy:
  • Recent FDA shift about estrogen products’ black box warning (01:58).
  • Recaps that while estrogen is considered standard (“the Cadillac”), there’s a need for accessible, non-hormonal alternatives.
• Touches briefly on other methods (central agents, “candy receptor modulators”):
  • “It's not always about estrogen for hot flash relief...there's non estrogen alternatives that work on the candy receptors.” (02:23)
  • Notes self-hypnosis as a cost-free option with new evidence.

3. The Groundbreaking Clinical Trial

• Study Reference: Self-Administered Hypnosis versus Sham Hypnosis for Hot Flashes (JAMA Network Open, Nov 11, 2025)
• Multi-center, two-armed, single-blind randomized controlled trial (RCT):
  • Conducted from March 2019–Feb 2024.
  • N=250 postmenopausal women with bothersome hot flashes.
  • Venues: Baylor University (Waco, TX) & University of Michigan (Ann Arbor, MI).
  • Dr. Chapa expresses pride in the Texas connection: “This is from Waco, Texas. That’s right. That is Baylor Bears. Sic 'em Bears.” (03:24)
• Interventions:
  • Active Group: Daily self-guided hypnosis via audio tape (after initial coaching).
  • Control: Sham hypnosis—white noise recordings.
• Key Results:
  • “After six weeks...they had a 53% drop in both frequency and, and the intensity of hot flash.” (15:18)
  • By three months, “the reduction reached 60%, actually 60.9% compared to the baseline. And the control was a drop of 40.9%.” (16:00)
  • For women with contraindications to estrogen (e.g., breast cancer): “they saw even better results...a 64% reduction as early as six weeks.” (16:34)
• Strong safety profile; no adverse events reported.

4. Methodological Significance

• Highlights this as the first study to compare self-guided hypnosis to an active sham control:
  • Quote from study author Elkin:

    “This was a major breakthrough and innovation. And almost all prior studies of mind body interventions have only used wait list psychoeducation or simple relaxation to compare the active hypnotherapy intervention.” (17:48)

• Stresses practical value:
  • Entirely self-administered—“No risk. Nobody wigged out with this.” (18:44)
  • Dr. Chapa’s commentary: “Super affordable, no risk...all sessions were self-administered, which showed that women can do this themselves.” (18:38)

5. Cautions & Pop Culture References

• Briefly references problematic portrayals of hypnosis in media, including a “tragic” documentary (Prime Video’s Look Into My Eyes) concerning school-based misuse.
  • Emphasizes that such events are not representative of licensed therapeutic hypnosis (19:14).
  • “These are the things that are out there that give hypnosis a bad name. But this Baylor study, I love it. Very good. Good for Baylor.” (20:36)
• Safety Reminders:
  • “Probably don’t do hypnosis if you’re driving or operating heavy machinery.” (04:24, 23:14)
• Reinforces the importance of offering all reasonable, evidence-based options for menopausal symptom relief.

Notable Quotes & Memorable Moments

• On public perceptions:

  “All that matters is the sound of my voice…Oh, I don't know about you, but that's pretty darn creepy...But the truth is, hypnosis, whether guided by a professional or self hypnosis, that that truly works. It is a thing.”
  —Dr. Chapa (00:14–01:19)

• Historical tidbit:

  “Hypnosis, 1843, that was Scottish surgeon James Braid.”
  —Dr. Chapa (07:20)

• Skepticism becomes respect:

  “I’ve had my concerns. I thought it was kind of hokey. It’s not. Hypnosis is real.”
  —Dr. Chapa (08:30)

• Key result:

  “After six weeks...they had a 53% drop in both frequency and the intensity of hot flash.”
  —Dr. Chapa (15:18)

• Efficacy for high-risk groups:

  “Even in those patients who unfortunately can't use a traditional estrogen…they saw even better results. They had a 64% reduction as early as six weeks.”
  —Dr. Chapa (16:38)

• Major breakthrough:

  “A major breakthrough and innovation.”
  —Elkin cited by Dr. Chapa (17:48)

• Patient-centered care:

  “Talk to your patients. Hey, would you like to try an estrogen? ... Or would you like to try some hypnosis? Everything, everything for patient benefit? I’m all for.”
  —Dr. Chapa (20:45)

Recommended Listening Segments

• What is (and isn’t) hypnosis? (00:14–04:20)
• Trial background, design & stats (05:50–08:00, 13:55–17:30)
• Key results and clinical implications (15:18–17:25)
• Safety and future directions (18:32–20:45)
• Cultural context, quirks & wrap-up (19:14–end)

Conclusion & Takeaways

• Self-hypnosis, delivered via daily audio recordings, is a powerful, evidence-backed, non-hormonal option for managing hot flashes in postmenopausal women, including those unable to take estrogen.
• Well-designed RCT finds significant reduction in hot flash frequency and severity—especially in high-risk, non-estrogen users.
• Safe, affordable, and fully self-administered; Dr. Chapa encourages clinicians to consider this option as part of a holistic approach.
• Final safety tip: Don’t hypnotize yourself while driving or operating heavy machinery!

For the full study reference and practice tips, check the episode show notes.