The benefits of Cognitive Behavioural Therapy in managing menopause symptoms

What is CBT?

Cognitive Behavioural Therapy, or CBT, is a type of psychotherapeutic treatment (talking therapy) that can help people to manage their difficulties by identifying and changing any maladaptive thought patterns and behaviours that are having a sustained and adverse impact on their mental health and wellbeing. CBT is recommended by the National Institute for Health and Care Excellence (NICE) as safe, effective, and a first-choice psychological treatment for common mental health difficulties, including anxiety, and depression as well as physical symptoms such as hot flushes. The Menopause Guideline (NICE guideline, 2015; NG23: 1.3.3) also recommends that GPs and health professionals give information and advice to women experiencing troublesome menopausal symptoms about CBT – as it can equip them with self-management skills aimed at reducing psychological distress commonly associated with such symptoms and improving their quality of life.

CBT is among the most widely utilised therapeutic approaches; it is also easily adaptable as it can be delivered in a variety of ways. Specifically, CBT can be offered via face-to-face, over the phone or online (i-CBT) sessions, depending on symptom severity and personal preference.

How does it work?

CBT is based on the concept that our thoughts, feelings, and behaviours are all interconnected – and the idea that how we think about situations can affect the way we feel and behave. According to the CBT model, it is not events that can really bother us. Instead, it is the way that we interpret these events or the meaning that we make of those experiences that can give rise to our feelings. This can, therefore, explain why two people experiencing the same event can also respond in different ways.

Why could it be helpful?

Women experience menopause in widely varying ways. For some women, menopause can be a welcome stage in their lives. They may experience less problematic menopausal symptoms, or their symptoms can even go unnoticed. For others, menopausal symptoms, such as loss of libido, tiredness and low energy, memory and concentration difficulties, hot flushes and night sweats, palpitations and sometimes shivering, can sometimes lead to anxiety, low mood, mood swings, discomfort, and sleep difficulties. For these women, symptoms can be quite severe and have a significant impact on their quality of life and everyday activities.

Midlife can also bring extra challenges, including work demands, caring roles (e.g., caring for elderly parents and/or children), and accumulated stress. Having persistent and/or troublesome menopausal symptoms can leave women feeling more stressed and irritable, which in turn, can exacerbate these symptoms. The stigma around aging and the taboo about discussing menopausal symptoms (e.g., in the workplace) may also compound any negative feelings, leaving women feeling too isolated, anxious, or embarrassed to tell others how they feel: they may not want to be thought of as getting older, they may fear that this will somehow put them in a bad light, or that others will think that they are no longer able to cope. They may also believe that nothing can help, that others will laugh at them and/or dismiss their symptoms.

CBT can encourage women to consider a range of psychological and social factors, such as social meanings of menopause (e.g., social media influences, overly negative and stigmatizing images of menopausal and older women on TV), attribution of symptoms to menopause, appraisal of bodily changes, coping strategies, past experiences, lifestyle habits, and triggers that may be impacting their menopause experience. At the same time, they are provided with a range of effective practical strategies for managing their troublesome symptoms more effectively.

Final thoughts…

It may help to remember that women experience menopause in widely varying ways. It is not unusual for some women to feel that their body is changing dramatically, or equally for others, to feel that nothing has hardly changed at all. There is also no single ‘best therapy’ that can work for everyone – as a ‘one size fits all’ approach cannot be applicable considering the complexity of the human experience. CBT is most useful when used by appropriately trained professionals, for specific problems, and in conjunction with other techniques and approaches – all taking a different approach in addressing unhelpful underlying patterns that may be contributing to psychological distress.

Want to learn more about CBT? Why not check out this free webinar with our co-founder Dr Clare Spencer and CBT expert Darren Woodward, from therapy specialists livelife.

If you want to learn how CBT with a livelife practitioner could help you, click here.

If you experience troublesome menopausal symptoms, please speak to your GP or a health care professional, or one of the menopause doctors and nurses in our clinic. They can discuss things with you in more detail and suggest available treatment or other support options, if appropriate.