Objective-To obtain preliminary data on the efficacy of yoga for reducing self-reported menopausal hot flashes in a randomized study including an attention control group.Methods-We randomized 54 women late perimenopausal (2-12 months of amenorrhea) and postmenopausal women (12 or more months of amenorrhea), aged 45-58 years, with at least 4 hot flashes per day on average, for at least 4 weeks, to one of three groups: yoga, health and wellness education (HW) classes, and a wait list (WL) control group. Yoga and HW classes consisted of weekly 90 minute classes for 10 weeks. All women completed daily hot flash diaries throughout the trial (10 weeks) to track frequency and severity of hot flashes. The mean hot flash index score is based on the number of mild, moderate, severe and very severe hot flashes.Results-Hot flash frequency declined significantly over time for all three groups with the strongest decline during the first week. There was no overall significant difference in hot flash frequency decrease over time by treatment groups, but the yoga and HW groups followed similar patterns and both showed greater decreases than the WL group. By week 10, women in the yoga group reported a decrease of approximately 66% in hot flash frequency, 63% in HW, and 36% in the WL group. The hot flash index showed a similar pattern. Conclusions-Resultssuggest that yoga can serve as a behavioral option for reducing hot flashes, but they also suggest that yoga may not offer any advantage over other types of interventions.Keywords vasomotor symptoms; yoga; hot flashes; menopause Hot flashes and/or night sweats (vasomotor symptoms) are the most common and troubling symptoms associated with menopause and are experienced by 64% to 80% of women undergoing natural menopause and almost all women who undergo surgical menopause. [1][2][3] For many women, these symptoms are frequent and severe enough to become debilitating and impact their quality of life. [4][5][6][7][8][9][10] Hot flashes are one of the chief menopausal complaints Direct Correspondence to: Nancy E. Avis, PhD, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, navis@wakehealth.edu The objective of the current study was to obtain preliminary data on the efficacy of yoga for reducing self-reported menopausal hot flashes in a randomized study that included an attention control group and measured daily hot flashes. Attention control groups are important to help understand the true impact of an active intervention. We hypothesized that women participating in a yoga intervention would achieve a greater reduction in subjective hot flash frequency and severity than women in an educational control group or a waitlist control group. As a pilot study, we also sought to examine the effect of yoga on selfreported hot flash interference, sleep, anxiety, depressive symptoms, perceived stress, and quality of life; and to track the recruitment, retention, and adherence to the protocol. METHODS Study Desig...