Cognitive Behavioral Therapy for Menopause Symptoms

Myra S. Hunter, PhD, CPsychol, FBpS


The North American Menopause Society (NAMS) 

In This Article

Commentary by Myra S. Hunter, PhD, CPsychol, FBpS

CBT is a well-researched treatment for anxiety, depression, and sleep problems with strong evidence for its efficacy. Recently, three randomized controlled trials including over 600 women have also demonstrated that CBT is effective in reducing the impact of hot flashes and night sweats, ie, menopausal symptoms.[1,2,3]

In these trials, CBT was found to be effective for peri- and postmenopausal well women, as well as women with menopausal symptoms induced or exacerbated by breast cancer treatments. Moreover, a self-help form of the CBT (a booklet and CD) was as effective as 8 hours of group CBT.[1,4] While both forms of the intervention also improved mood, sleep, and aspects of quality of life, group CBT was more effective in these respects.

Green et al present a pilot study that draws on the above approaches and offers group CBT, combining sessions on hot flashes, mood, sexual problems, and sleep. The setting is a women’s health clinic serving women with mental health difficulties such as anxiety and depression in perinatal and menopausal contexts. Although only eight women were included, six of whom had a psychiatric diagnosis, there were significant benefits in terms of hot flashes, mood, and quality of life. Given that emotional problems are common during this life stage and that women are more likely to seek help when they experience both menopause symptoms and low mood, this represents an innovative type of service. However, one cannot conclude that the psychiatric problems are due to menopause; there are likely to be complex interactions.

Given its effectiveness, CBT should arguably be offered within the context of multidisciplinary menopause clinics and within breast cancer services.