World Menopause Month: CBT for Coping with Symptoms
Did you know? NICE recommends considering CBT for alleviating low mood or anxiety that arise as a result of the menopause
CBT and Menopause – NICE Recommendation
CBT (Cognitive Behavioural Therapy) is an evidence-based, short course of psychotherapy, that uses a behavioural approach used to helps people understand relationship between their beliefs, thoughts, and feelings and behaviours. In the case of menopausal symptoms, negative thoughts and beliefs, stigmas and issues with self-esteem and embarrassment can impact day-to-day life, and CBT approaches can help address these and improve outcomes.
In addition to helping address emotional and physical symptoms of the menopause (e.g. stress, low mood), it has also been shown to help with, sleep problems, hot flushes, and night sweats in other studies (see below).
NICE (which recommends the treatments the NHS should use for particular conditions*), recommends considering CBT (Cognitive Behavioural Therapy) for the psychological symptoms of menopause:
“1.4.6 Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.”
NICE: Menopause: diagnosis and management (NG23): p7
* “NICE helps practitioners and commissioners get the best care to patients, fast, while ensuring value for the taxpayer” (Source: NICE, 2023)
The Research:
Research studies that have supported its use in this field include:
Studies:
• A recent (2022) systematic review and meta-analysis by Ye et al, of the efficacy of cognitive therapy and behaviour therapy for menopausal symptoms; looked at 14 randomised controlled studies (n=1618 patients). The researchers were able to support treatment guidelines recommendation of CBT as a treatment option for menopausal symptoms.
• van Driel et al’s (2018) systematic review and meta-analysis found that CBT could reduce bother by hot flushes in the short- and medium-term; as did Samani et al’s (2019) systematic review
• a systematic review and meta-analysis by Lem et al (2022), found CBT could help improve menopausal sleep symptoms
The Reasoning:
As per Samani et al’s explanation, the CBT approach can provide understanding about menopause and hot flushes, as well as providing tools and techniques for the patient for stress management, problem-solving, cognitive and behavioural strategies to help manage hot flushes. Alongside relaxation and breathing techniques, CBT can help with identifying and controlling worries and beliefs to help patients to feel empowered to deal with the symptoms and not be overwhelmed by them.
Mindfulness and Hypnotherapy Approaches:
Studies have also outlined potential benefits of mindfulness (e.g. Carmody et al, 2006; 2011) and hypnotherapy (e.g. Kendrick et al, 2015) for dealing with hot flushes, quality of life, and menopausal symptoms.
Find a Practitioner
Start with our Cognitive Behavioural Therapy Page to find out more, and see the practitioners who offer this service here at Bedford Consulting Rooms.
For other talking therapy approaches as mentioned above, the Hypnotherapy and Mindfulness pages may be of assistance, as may counselling, psychotherapies or psychology.
REFERENCES:
Carmody JF, Crawford S, Salmoirago-Blotcher E, Leung K, Churchill L, Olendzki N. Mindfulness training for coping with hot flashes: Results of a randomized trial. Menopause. 2011;18:611–620.
Carmody J, Crawford S, Churchill L. A pilot study of mindfulness-based stress reduction for hot flashes. Menopause. 2006;13:760–769.
Kendrick C, Johnson AK, Sliwinski J, Patterson V, Fisher WI, Elkins GR, et al. Hypnotic relaxation therapy for reduction of hot flashes in postmenopausal women: Examination of cortisol as a potential mediator. Int J Clin Exp Hypn. 2015;63:76–91.
Lam, C.M., Hernandez-Galan, L., Mbuagbaw, L., Ewusie, J.E., Thabane, L. and Shea, A.K., 2022. Behavioral interventions for improving sleep outcomes in menopausal women: a systematic review and meta-analysis. Menopause, 29(10), pp.1210-1221.
NICE (2015) Guideline – Menopause: diagnosis and management. Last updated 2019. https://www.nice.org.uk/guidance/ng23
Samami, E., Shahhosseini, Z. and Elyasi, F., 2022. The effects of psychological interventions on menopausal hot flashes: A systematic review. International journal of reproductive biomedicine, 20(4), p.255.
Van Driel, C.M., Stuursma, A., Schroevers, M.J., Mourits, M.J. and de Bock, G.H., 2019. Mindfulness, cognitive behavioural and behaviour‐based therapy for natural and treatment‐induced menopausal symptoms: a systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 126(3), pp.330-339.
Ye, M., Shou, M., Zhang, J., Hu, B., Liu, C., Bi, C., Lv, T., Luo, F., Zhang, Z., Liang, S. and Feng, H., 2022. Efficacy of cognitive therapy and behavior therapy for menopausal symptoms: a systematic review and meta-analysis. Psychological Medicine, 52(3), pp.433-445.
