Menopausal women need more support
The menopause effects all women, but it doesn't have to be a nightmare. Researchers found that women given CBT reported that their problems had significantly diminished at nine weeks after starting therapy, and at six months they still found the hot flushes and night sweats less of a problem. Their mood, their sleeping patterns and their quality of life had all improved. CBT shows that by changing negative thought patterns and replacing balanced alternatives there is an elevation of mood, increased motivation, and the ability to manage change more effectively.
The menopause can cause hot flushes, mood swings and even depression, and for some women it can last for more than a decade. The menopause is an important occupational health issue for the 3.5 million women currently in work. Employers need to recognise that women of menopausal age may need extra consideration, as changes during the menopause can affect how a woman does her work, and her relationship with her boss and colleagues. The government's Business Champion for Older Workers, Ros Altmann, says it can also have an economic impact, as a lack of support is forcing some women out of their jobs. She is due to publish a report calling for more help for women coping with the menopause.
CBT wins NICE backing for menopause anxiety
CBT should be more widely available to women who experience low mood and anxiety related to the menopause, a new draft guideline from NICE says.
Around 80 per cent of women experience some symptoms during menopause and these commonly continue for around four years, although for one in 10 they can last for up to 12 years.
The guideline says that low mood related to the menopause can be helped by hormone replacement therapy and psychological therapies such as CBT, but that there is no evidence that other non-pharmacological treatments, such as herbal treatments, are effective. CBT is also effective for anxiety, and there is evidence for the effectiveness of genistein and red clover, but there are concerns about the safety of these two treatments.
The guideline committee says that, while psychological symptoms are common in women in menopause and can affect their personal, social and professional lives, it could find only limited evidence of effective psychological treatments. But the one randomised controlled trial that has been published – comparing usual care with usual care and group CBT – does, it says, provide enough evidence of effectiveness to recommend its wider availability.
SSRIs/SNRIs should not be prescribed as a first-line treatment for menopause-related low mood, unless the woman has clinical depression. This is because of their adverse side effects and because the low mood may be the result of hormonal changes.
If you would like to discuss how CBT can help you manage symptoms, please call me.