Publisher Health

Mindfulness, group and cognitive behavioural therapy could effectively treat menopause symptoms such as low mood and anxiety, analysis suggests.

The University College London research, published in the Journal of Affective Disorders, examined 30 studies involving 3,500 women in 14 countries, including the UK, the US and Australia.

Draft NHS guidelines recommend offering CBT alongside or instead of HRT.

It could “give GPs and patients more options”, the researchers said.

HRT replaces the hormones oestrogen or progestogen or both.

It is administered using gels, creams, pessaries, tablets or sprays.

But psychosocial therapies such as group counselling, marital support and health-promotion coaching, as well as mindfulness and CBT, focus on developing behavioural patterns, coping strategies and relaxation techniques.

And the UCL researchers say “empowering women” to develop positive thinking would probably have benefits beyond those of HRT, with CBT the most cost-effective as results can be achieved in a shorter timeframe.

Some women showed “statistically significant improvements” in anxiety and depression following CBT and mindfulness therapies,compared with no or alternative treatments.

CBT and group therapies improved sleep, memory, concentration.

And the talking therapies could also improve quality of life and help women whose symptoms had made them less confident cope with other common challenges.

UCL clinical-psychology-of-ageing professor Aimee Spector said: “There’s a clear link between these physical and psychological symptoms.

“So a clear example is the link between hot flushes and anxiety.

“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.

“Poor sleep can lead to depression because it reduces mood.

“But then, when people have depression, one of the symptoms is poor sleep – so again, another cycle that we see.

“What we then sometimes see is people leave, avoid situations, leave work, feel they are unable to cope, because they get into this vicious cycle.

“So what CBT aims to do is to counter these negative cycles, by getting people to use strategies to think about different ways of looking at things.

“They might do experiments that involve reducing avoidance, testing things out.”