Therapy could be effective treatment for non-physical symptoms of menopause

Newswise — Interventions such as mindfulness and cognitive behavioural therapy (CBT), could be an effective treatment option for menopause-related mood symptoms, memory and concentration problems, finds a new study by UCL researchers.

The research, published in the Journal of Affective Disorders, is the most up-to-date study of its kind, providing a meta-analysis of 30 studies involving 3,501 women who were going through the menopause in 14 countries, including the UK, USA, Iran, Australia, and China.

Lead author, Professor Aimee Spector (UCL Psychology & Language Sciences), said: “Women can 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.

“Menopause management is now a prioritised topic in public health. However, most studies of menopause symptom management focus on hormonal replacement therapy 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 studies that were analysed examined the effects of several different kinds of therapies on mood, cognition and quality of life.

Ten studies explored the impact of CBT-based interventions on menopausal symptoms, while nine provided Mindfulness-Based Interventions (MBI) and the remaining eleven studies encompassed Acceptance and Commitment Therapy (ACT), group counselling, marital support, health promotion coaching, and emotional freedom techniques.

The CBT-based interventions included educating women about the psychological symptoms of the menopause, alongside cognitive and behavioural strategies, relaxation techniques, and symptom monitoring.

Meanwhile, MBI-based therapies promoted a focus on the present experiences of women and a non-judgemental understanding of symptoms.

Symptoms were measured using standardised, internationally recognised self-report instruments, including the Patient Health Questionnaire PHQ-9 (which considers factors such as a lack of interest in doing things, issues with sleep, and feelings of low mood) and the GAD7 questionnaire (which asks how often a person feels worried, on edge or unable to relax).

The researchers found that women showed statistically significant improvements in anxiety and depression following CBT and MBI when compared to no or alternative treatments. This equates to small to medium changes in everyday life.

CBT and group-based psychosocial interventions were also effective in reducing memory and concentration difficulties.

All psychosocial interventions were effective in improving quality of life, regardless of their type.

With regards to the delivery of these interventions, the study suggests that CBT is the most cost-effective option for menopause management – as compared to other forms of therapy, it requires a shorter course of treatment (around 1.5 hours per session and 11.8 hours in total).

Co-author and master’s graduate, Zishi Li (UCL Psychology & Language Sciences), said: “This study provides encouraging evidence to support the use of psychosocial interventions for managing non-physiological menopausal symptoms. This is in line with the NICE Menopause guidelines, updated in 2023 and currently in the consultation phase, which promote CBT as a treatment option.”

Senior author Dr Roopal Desai (UCL Psychology & Language Sciences), said: “GPs and healthcare providers often struggle to know what to offer beyond medical treatment. This research will help give GPs and patients more options.”

In November 2023, NICE drafted updated guideline recommendations to include more treatment choices for menopause symptoms, with evidence showing that CBT could help reduce symptoms such as hot flushes and night sweats, depressive symptoms and problems sleeping.

Consequently, the guidelines stated that CBT should be considered alongside or as an alternative to Hormone Replacement Therapy (HRT).

However, this is the first study to consider other forms and doses of therapy, alongside assessing which type is best for different symptoms. 

Experts at UCL have also teamed up with leading women’s health charities to design a new education and support programme for women across the UK experiencing menopause*.

Study limitations

Without individual patient data, the study is unable to consider the best stage of the menopause to deliver interventions.

The research also can’t account for the long-term symptom changes that occur with different types of therapy. For example, some interventions may require longer exposure to show more significant effects, whilst the benefits of others might fade with time.

Notes to Editors

https://www.ucl.ac.uk/news/2023/aug/plans-uks-first-menopause-education-programme-launched-ucl-academics

For more information, please contact Poppy Tombs, UCL Media Relations. T: +44 (0)7733307596, E: [email protected] 

Aimee Spector, Zishi Li, Lexi He, Yasmeen Badawy, Roopal Desai. “The effectiveness of psychosocial symptoms of menopause: A systematic review and meta-analysis”, will be published in Journal of Affective Disorders on 28th February at 00:01 UK time.

The DOI for this paper will be: 10.1016/j.jad.2024.02.048 

About UCL – London’s Global University

UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.

Since 1826, we have championed independent thought by attracting and nurturing the world’s best minds. Our community of more than 50,000 students from 150 countries and over 16,000 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.

The Times and Sunday Times University of the Year 2024, we are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.

We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.  

For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.

We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

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