Women should be offered talking therapy on the NHS to help manage menopause symptoms, according to new guidance.

The National Institute for Health and Care Excellence (NICE) recommended the use of cognitive behavioural therapy (CBT), and suggested it should be offered alongside or instead of hormonal replacement therapy (HRT).

One of the aims is to give women a wider choice of treatment options, while enabling them to make more informed decisions about their menopause care. So, what is cognitive behavioural therapy, and how could it help people going through menopause?

What is cognitive behavioural therapy?

“Cognitive behaviour therapy (CBT) is a talking therapy which can be helpful for some of the symptoms of the menopause, including low mood and anxiety, hot flushes and night sweats and insomnia,” said Dr Rebecca Smithson, a GP and founder of The Borders Menopause Clinic.

“CBT involves looking at how our thoughts, feelings and behaviours affect how we cope with day-to day-life. Sometimes we can have patterns of thoughts and behaviours which are not helpful, and which can contribute to exacerbating issues,” Smithson added.

“By changing these patterns of thinking and behaving, and by developing new strategies to manage symptoms, CBT can be an effective way to improve mental health and reduce the impact of some physical symptoms.”

Who might benefit from it?

Dr Babak Ashrafi, a women’s health specialist at Superdrug Online Doctor, explained: “Behavioural therapy for menopause is valuable for women navigating emotional and physical challenges during this life stage.

“It is particularly beneficial for those experiencing symptoms like mood swings, anxiety, depression, and hot flashes – this approach is well-suited for individuals seeking holistic, non-pharmacological methods to manage symptoms.

“Women with specific triggers or stressors exacerbating menopausal symptoms can find tailored solutions through collaborative therapy,” Ashrafi added.

“Additionally, individuals open to sustainable, long-term strategies and lifestyle modifications may benefit from the practical tools offered by behavioural therapy – it’s crucial to consult with healthcare professionals to determine the most suitable and comprehensive approach to managing menopausal symptoms, combining both medical and behavioural interventions.”

Where can you find this sort of therapy now?

While talking therapies may not yet be routinely offered for menopause care, people can still talk to their GP about CBT referrals.

Smithson said: “CBT is available from the NHS, though in some places there can be a waiting list. See the NHS website for details on how to access CBT in your area. There are many private providers, with varying costs per session.”

Ashrafi added: “Start by consulting your primary care physician or gynaecologist, as they can provide referrals to mental health professionals specialising in menopausal issues.

“Mental health clinics, psychologists, and counsellors may offer specific programmes or services tailored to menopausal symptoms. Support groups focused on women’s health and menopause, both in-person and online, can provide valuable information and resources.

“Employee Assistance Programs (EAPs) through workplaces and health insurance providers may also offer support.”

What helpful insights can people take on board now?

Smithson said: “How we think and behave really impacts how we feel, and the first step in CBT is to become aware of negative patterns of thinking and behaving. Trying to come up with practical coping strategies is helpful. Breathing exercises can really help when we are feeling overwhelmed and are an excellent starting point.”

Ashrafi added: “Utilising mobile apps focused on mental wellbeing, engaging in online communities, and incorporating mindfulness and relaxation techniques into daily life are all great places to start.

“Establishing a routine of regular exercise, making healthy lifestyle choices, and journaling to track symptoms are accessible strategies.

“While professional guidance is ideal, these self-help approaches offer practical alternatives for those facing financial constraints in accessing behavioural therapy. Consulting with healthcare professionals and exploring local resources can further enhance support.”

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