Mindfulness and cognitive behaviour therapy (CBT) could be effective treatment options for some symptoms related the menopause, say UK researchers.
A meta-analysis of 30 studies from around the world involving 3,500 women going through the menopause found talking therapies were associated with significant improvements in anxiety and depression and there were also benefits in difficulties with memory and concentration.
All the psychosocial interventions looked at led to medium to large improvements in quality of life, the University College London researchers reported in the Journal of Affective Disorders.
CBT-based interventions included educating women about the psychological symptoms of the menopause, alongside strategies to manage and monitor their symptoms and relaxation techniques.
Therapies based on mindfulness instead promoted a focus on the present experiences of women and a non-judgemental understanding of symptoms.
The analysis also found cognitive behaviour therapy was the most cost-effective intervention because it required a shorter course of treatment.
More work is needed to understand how long-lasting any benefits are and when during the menopause such therapies might be most helpful as well as who would most benefit.
In January NICE updated its guidance on menopause to include new information on individualised risks of HRT that GPs should discuss with patients and recommended that CBT should be offered as a treatment option for menopause symptoms.
The update – the first since 2015 and expected to be finalised later this year – did prompt some concerns from menopause campaigners who wanted more balanced wording around the benefits of hormone replacement therapy (HRT).
Study lead Professor Aimee Spector, professor of clinical psychology of ageing at UCL said women could spend a notable number of years in their lives dealing with a range of menopausal symptoms, such as hot flushes, mood changes and brain fog. ‘These symptoms can have a great impact on women’s wellbeing and quality of life.’
She added that most studies of menopause symptom management focus on HRT and physiological symptoms.
‘This restricts treatment options for women who are concerned about the risks of hormone replacement therapy and overlooks the wellbeing of women with non-physiological symptoms, such as brain fog and mood problems, which are highly prevalent.’
The researchers stressed that the findings do not undermine the benefits of HRT, just that other approaches could also help.
Senior author Dr Roopal Desai, a clinical fellow in psychology, added: ‘GPs and healthcare providers often struggle to know what to offer beyond medical treatment. This research will help give GPs and patients more options.’
Professor Kamila Hawthorne, chair of the RCGP, 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.
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.
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Surprised Paul McKenna (pseudo psychologist) has not stepped in here