Talking therapies could help women going through the menopause, improving their quality of life and reducing symptoms such as depression and anxiety, research has suggested.
The menopause marks the end of menstruation for women and it involves a transition that can last for several years.
This is often accompanied by a host of symptoms due to hormonal changes, including hot flushes, night sweats, memory problems and psychological difficulties including depression and anxiety.
Now researchers say talking therapies such as Cognitive Behavioural Therapy (CBT) and Mindfulness-Based Interventions (MBI) could help.
Prof Aimee Spector, an author of the study from University College London (UCL), said there is a clear link between the physical and psychological symptoms of the menopause, giving hot flushes as one example.
“When people have hot flushes they tend to get very anxious about having them, and that anxiety can often cause people to have more hot flushes,” she said.
Spector said therapies such as CBT could help women counter the negative thoughts they may have over such symptoms, such as fears over what others may think.
Writing in the Journal of Affective Disorders, Spector and colleagues described how they pooled data from 22 robust studies that looked at the impact of CBT, MBI and other interventions such as marital support on the psychological symptoms of the menopause.
Considered together, they found such therapies had a medium to large effect on quality of life, and a small but positive impact on anxiety and depression.
They were also associated with a small improvement in memory and concentration – however, as those results came from only three studies, it is unclear whether the finding is robust.
More specifically, CBT had small effects on depression and anxiety, whereas MBI had small effects for the former but medium to large effects for the latter – a finding the team caution may be related to the duration of MBI interventions being longer than for CBT.
A further eight studies, which did not have enough data to be included in the analysis and included a range of therapies, offered some additional support for the findings.
However it is not clear how long-lasting any benefits are, when during the menopause such therapies might be most helpful, or whether they might benefit some women more than others.
In addition the research was unable to shed light on just how meaningful an improvement in mood women might gain from such therapies.
Spector said more research was needed, including around how best to implement these therapies and whether CBT could help women live with or manage cognitive problems associated with the menopause, such as brain fog.
The possibility of using talking therapies such as CBT to help tackle symptoms associated with the menopause has caused considerable controversy in recent months after draft guidelines from the National Institute for Health and Care Excellence (Nice) to GPs suggested CBT could be offered “alongside or as an alternative to” hormone replacement therapy (HRT) for treating symptoms including night-time sweats.
However, the team behind the new study stressed their research does not undermine the importance of HRT, but offers another approach that could also bring benefits.
“I don’t think we at any point want to say that addressing the hormone imbalance isn’t probably the most important thing that can be done for many people,” said Spector.
Dr Paula Briggs, chair of the British Menopause Society, said HRT does not always completely resolve symptoms associated with the menopause, while women can also face other difficulties during the menopause, including those relating to lifestyle.
“Anything that helps women in this period of their lives is useful,” she said.
Prof Kamila Hawthorne, chair of the Royal College of GPs, said while HRT has been shown to be safe and effective, it is not suitable for everyone.
“So research that explores alternative treatments that will potentially improve the experience of women going through menopause is encouraging and welcome,” she said. “As such, it’s important that the findings of this research are taken on board as clinical guidelines are updated.”
