Stellate Ganglion Block for Menopausal Vasomotor Symptoms?

Diane E. Judge, APN/CNP

A small, sham-controlled study indicates that the procedure is effective.

Many women — including those with menopause caused by treatment for breast cancer — cannot or choose not to use estrogen (the most effective therapy for relieving vasomotor symptoms [VMS]) or less-effective medications (e.g., selective serotonin reuptake inhibitors). Uncontrolled studies of stellate ganglion block (SGB) have suggested that this procedure can alleviate VMS. Now, investigators have conducted a randomized trial to compare SGB (bupivacaine injection) versus sham (saline injection) in 40 women with moderate to severe VMS. Participants maintained symptom diaries for at least 2 weeks before the procedure and throughout the 6-month study period; hot flashes were documented objectively with sternal skin conductance monitors.

At baseline, the two groups did not differ significantly in subjective mean daily VMS frequency (9.8) or intensity (63% of VMS rated as moderate to very severe). In modified intent-to-treat analysis, subjective mean daily VMS during the first 3 posttreatment months declined similarly from baseline in both groups, although objective measurement showed a decrease in vasomotor event frequency of 21% in the SGB group versus 0% in the placebo group. At months 4 to 6, the SGB group compared with the sham group showed significantly greater reductions from baseline in moderate to very severe VMS occurrence (52% vs. 4%) and intensity (38% vs. 8%). There were no study-related adverse effects.

Citation(s):

Walega DR et al. Effects of stellate ganglion block on vasomotor symptoms: Findings from a randomized controlled clinical trial in postmenopausal women. Menopause 2014 Aug 15; 21:807.