4.3 Review

Cognitive behavioral therapy for menopausal symptoms

Journal

CLIMACTERIC
Volume 24, Issue 1, Pages 51-56

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/13697137.2020.1777965

Keywords

Cognitive behavior therapy; CBT; hot flushes; hot flashes; non-hormonal treatment

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This article discusses cognitive behavioral therapy (CBT) for women experiencing problematic menopausal symptoms, highlighting its effectiveness in reducing VMS impact, improving sleep quality, and enhancing quality of life based on clinical trials. The brief, theory- and evidence-based therapy has been found to be consistently effective in various formats like group sessions, self-help books, and online resources, with or without additional support. Recommendations for using CBT in treating VMS, anxiety, depression, and insomnia in menopausal and postmenopausal women have been made by different organizations.
This article describes cognitive behavioral therapy (CBT) for women with problematic menopausal symptoms, and provides the evidence from clinical trials of women going through the menopause, women with breast cancer treatment-induced symptoms and women with problematic symptoms in a work context. The CBT focus is primarily on vasomotor symptoms (VMS) but it also targets stress, low mood and sleep problems. CBT is a brief therapy (four to six sessions) that is theory- and evidence-based; it is acceptable to women and effectively reduces the impact of VMS, improves sleep and has benefits to quality of life. VMS frequency is also reduced significantly in some trials but not others. CBT has been found to be consistently effective when delivered in groups, self-help book and on-line formats (with or without additional support). The MENOS 1 and MENOS 2 CBT protocols are recommended for the treatment of VMS by the North American Menopause Society (2015); CBT has been recommended for the treatment of anxiety and depression for women during the menopause transition and post menopause (NICE, 2015); and telephone CBT has been shown to be an effective treatment for insomnia.

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