Cognitive Behaviour Therapy (CBT): how it can help with menopause

CBT: changing mindsets

Cognitive Behaviour Therapy is a non-medical approach that can help you develop a range of coping strategies and mechanisms for things you struggle with in everyday life. It is particularly helpful during menopause.

CBT: changing mindsets

Why? Well, you may be one of the 3 out of 4 women who suffer with menopausal symptoms. These can be physical, such as hot flushes, or psychological, such as anxiety.

Add to that, it usually occurs in mid-life. This means often coping with things such as children leaving home, or having informal caring responsibilities for elderly family. For 8 out of 10 of us, on top of working too.

How can Cognitive Behaviour Therapy help?

Cognitive Behaviour Therapy is recommended in the NICE guidelines for GPs to recommend to menopausal women who have anxiety or depressed mood. It helps you develop new techniques to tackle stress and manage anxiety. These can be big contributing factors in exacerbating menopausal symptoms.

It can also help you make changes to your life. For example, looking at ways to be more active, learning how to be more accepting of situations and breaking the cycle of negative thinking which can lead to depression and low self esteem.

Physical symptoms such as hot flushes and trouble sleeping are also helped by CBT. Recent studies have shown that group and self-help CBT can reduce the impact of hot flushes and night sweats.

Women explore the relationships between their thoughts, feelings and behavioural reactions to symptoms over a 4-6 week period; they have homework tasks and try out new strategies which can gradually  become a new way of life.

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Rebecca Berry has been trialling CBT, here are her thoughts:

“My perception of CBT is that it’s a talking therapy. It’s a four-week programme, with reading and activities to complete each week that build up to a different mindset and approach to dealing with perimenopausal symptoms.

The main thing I’ve taken from CBT is identifying stress triggers and using paced breathing to deal with them. My goals for the first week were to manage my commuting stress better, and to reduce catastrophic thinking when hot flushes happened.

Both went really well. I used the paced breathing that we learned for the hot flush management during my commute, and it was really effective. Focusing on my breathing helps me to create my own little world. I barely notice all the irritating behaviours from other commuters that I normally allow to wind me up to Hot Flush Central.

A significant milestone was that I didn’t yell at a cyclist going through a red light the other day, and I normally yell at three or four a week!

Breathing through the hot flushes made me notice the strength and duration, and put them into perspective. Although it was one or two an hour, they only lasted a couple of minutes and the breathing really helped.

Now, when a hot flush happens I just automatically go into paced breathing and I hardly notice them anymore.

A new approach to menopause

A hugely beneficial side effect of the CBT approach is that I believe it’s massively accelerated psychological acceptance of the menopause. At the beginning of the programme I felt really bad about myself – unable to lose the stone and a half that I’ve put on over the last 18 months (and unable to wear all my favourite clothes).

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I’ve lost my thigh gap – I  was very proud of that thigh gap! Having to acknowledge that I’m not young any more, feeling invisible in public, I absolutely hated it.

Recently, I realised that one of things that was stopping me accepting menopause was my clothes. Every time I opened my wardrobe, all I saw in front of me was size 8 clothes that I couldn’t wear any more. Basically, I was subconsciously torturing myself every single day with the thing that upsets me most about menopause.

So one weekend I took a deep breath and cleared out all my size 8 stuff – three quarters of my clothes! Then I hit the sales in Oxford Street.  Now when I open my wardrobe, I just see clothes that fit me and I feel OK in.  And there’s still loads and loads of space for more new clothes.

Having spent so much time thinking about menopause and what it means over the last few weeks, I now feel a huge sense of liberation. For example, in the hot weather, before now I’d have thought “ooh I can’t wear shorts, my legs aren’t tanned / they’re fat and wobbly / I haven’t shaved them / etc”.  Now I think “f*ck it, I’ll wear what I want”.

And I do, and I genuinely don’t give a toss what people think. For the first time in my life, I’m well on the way to feeling truly comfortable in my own skin, even though by social media standards I’m a fat, lardy old crone.  And it’s GREAT!”

Where to find CBT

Women’s Health Concern has some excellent fact sheets on CBT for menopause and the self-help CBT is available in: Managing Hot flushes and Night sweats: a CBT self-help guide to the menopause (Hunter & Smith, Routledge 2014)

Changing the way you approach your life can work wonders. It can boost your self esteem, lift your mood and reduce stress and anxiety.

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For women suffering with menopausal symptoms, it can be a gateway into a better life.

CBT trials on BBC The Truth About The Menopause

Watch The Truth About the Menopause on iPlayer here.

menopause the change for the better book

Available now from Bloomsbury, Waterstones, Amazon and good bookshops