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Therapy and meditation ‘helps combat menopause symptoms’

Doctors and patients should consider CBT as an additional extra to medicines such as hormone replacement therapy
Doctors and patients should consider CBT as an additional extra to medicines such as hormone replacement therapy - ISTOCKPHOTO

Therapy and meditation help to combat menopause symptoms, a study has found.

Anxiety, depression and memory issues are common signs of menopause, but University College London (UCL) scientists have found that both mindfulness and cognitive behavioural therapy are effective at alleviating suffering.

It comes after some critics hit out at government plans to provide talking therapy as a treatment for the menopause on the NHS.

Authors of the study say doctors and patients should consider such treatments as an additional extra to medicines such as hormone replacement therapy (HRT).

A meta-analysis of 30 studies included more than 3,500 women around the world and found small to moderate benefits among menopausal women who underwent either therapy or mindfulness.

Therapy was found to be quicker, easier and more practical than mindfulness, and the scientists suggest this could be something worth considering for many women.

“The message we want to be really clear about is that we are not in any sense suggesting this as an alternative to HRT, or recommending this instead of HRT,” said study author Professor Aimee Spector, from UCL.

“We know that HRT doesn’t get to everyone and not everyone wants it, and not everyone’s eligible for it. So we do need to consider other things.”

Ongoing symptoms

Menopause usually happens between the ages of 45 and 55, with symptoms that can last for months or years.

HRT replaces the hormones the body produces less of – oestrogen, progestogen or both – and can be administered using gels, creams, pessaries, tablets or sprays.

Some women are ineligible to have HRT, such as breast cancer survivors, and people with other conditions including diabetes, epilepsy or asthma.

For those women, the findings offered hope of being able to manage some debilitating symptoms, the scientists said. The study focused on medical interventions with professional clinicians but they say practising mindfulness or meditation at home could also help women get through menopause flare-ups.

The National Institute for Health and Care Excellence (Nice) recently recommended the use of cognitive behavioural therapy (CBT) for menopause symptoms, including hot flushes, and the official guidelines are currently being written.

Draft guidance stated that “more treatment options” were being sought for menopausal women, but critics accused the health body of being patronising and too negative about HRT.

Menopause experts warned that therapy would only be able to treat some symptoms of menopause because it would be unable to address the underlying problem which is caused by a hormonal imbalance.

The scientists behind the latest study agree, but believe therapy could offer benefits as an addition to HRT.

Holistic approach

The scientists were keen to emphasise the study was not furthering the myth that menopause is “all in the head”, and they advocated for a holistic approach that combines medicines with other approaches to give as many women as possible the best outcome during menopause.

“Historically, there’s a lot of controversy about women being told their symptoms are not real or being told that symptoms are all in their head and being dismissed,” said study senior author Dr Roopal Desai.

“On the surface, this [study] may appear to be a study that says, actually, talking therapy may help with some physiological symptoms.

“I would like to see a more balanced approach between HRT and the psychosocial model where both of these things are taken into consideration and we look at the underlying hormonal imbalance, and we look at how that’s impacting somebody’s mood and cognition and anxiety symptoms, and work together in a holistic way.”

Dr Louise Newson, a GP and menopause specialist, said it was not surprising the new study had found some improvements after mindfulness and CBT “but it is important to remember that menopause is due to a hormone deficiency affecting the entire body”.

“First-line treatment of perimenopause and menopause for most women is replacing the missing hormones by prescribing the right dose and type of HRT,” she said.

“The most cost-effective and easily accessible treatment should be HRT, yet globally only the minority of menopausal women, around 5 per cent, are prescribed it.”

The study is published in the Journal of Affective Disorders.

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